The medical education system strives to produce well-rounded, compassionate, and competent healthcare professionals who are prepared to meet the evolving needs of patients and the healthcare system. However, some argue that the medical education system in the United States falls short of that goal.
As a faculty member and assistant clinical professor at Kaiser Permanente School of Medicine, I am privileged to work with and instruct medical students weekly. They truly inspire me and remind me why I went into medicine—sometimes by how naïve they are, and sometimes by how aware they are of the broken system and desire to improve it. I am particularly impressed by the students who work to improve their own medical education.
Medical education faces challenges that affect the quality of training and the preparedness of future healthcare workforce. Each challenge could compose a novel unto itself, but the list includes:
- Length of training.
- Prohibitive cost of medical education.
- Lack of diversity among medical students and faculty.
- Overreliance on standardized testing.
- Lack of emphasis on prevention and primary care.
- Variability in clinical exposure.
- Student burnout and poor mental health.
- Shortages of qualified faculty.
- Preparing students for a rapidly evolving healthcare environment.
- Resistance to changing traditional teaching methods and curricula.
- Striking a balance between knowledge acquisition and competency development.
New practices and innovations in medical education try to address these challenges. Technology is now an integral aspect of medical education, which has enabled broader knowledge acquisition and access. The expansion of medical knowledge continues at an astonishing rate, and there is no way a student can learn it all. Medical schools now place increased focus on teaching their students the tools and processes needed to learn while staying updated on the most essential information. Virtual reality and high-fidelity models and simulation have changed the way students can learn anatomy and offer a chance to learn how students may react in various clinical environments.
Some schools have shifted towards problem-based learning, where students work on clinical cases and real-world scenarios to learn and enhance critical thinking and problem-solving skills. Other medical schools have reduced or eliminated lectures entirely to make space for more interactive learning processes. Perhaps the innovation that has the greatest potential is competency-based education. Many medical schools are moving away from traditional time-based curricula in leu of competency-based education, which offers flexibility to meet an individual student’s strengths and weakness to maximize their time and education.
Students advance or complete a level or skill when they can show proficiency in specific skills and knowledge areas. Some medical education programs take this concept a step farther and use adaptive learning technologies that tailor educational content to individual student needs and progress.
Early clinical exposure helps students gain practical experience and develop patient-centered skills at an earlier stage in their education. Medical education now emphasizes patient-centered care, communication skills, and empathy training to prepare students to provide more compassionate care. Additionally, there is a growing emphasis on interprofessional education, where students from different healthcare disciplines learn together to promote collaboration and a holistic approach to patient care. Medicine is a “team sport,” and medical education is better preparing students for team-based care models.
Medical education, and medicine in general, is grueling, and the mental and physical health of students and physicians may suffer as a result. Medical schools that focus on students’ well-being and provide them with skills that boost resilience, recognizing the challenges and stress associated with medical training, and act accordingly. These schools also must find a balance that prepares student for the demands for a career in medicine. Furthermore, programs and resources that provide mental health support and destigmatize mental health care are increasingly common.
There is good evidence that physicians who mirror the culture and language of their community see improved patient outcomes and increased quality of care. Unfortunately, Black and Latinx physicians are woefully underrepresented. Efforts are being made to promote diversity and inclusion in medical education, ensuring that students from various backgrounds are represented while feeling supported and welcomed within medicine. However, there is a need to highlight and promote mentors and the leadership of underrepresented physicians in medicine. An increased focus on global health issues and healthcare disparities offers opportunities for international experiences and learning about healthcare challenges worldwide, which could provide a broader perspective of medicine in the US. Medical education must emphasize culturally competent care. Addressing global health issues, social determinants of health, and health disparities in the curriculum could help to produce socially conscious physicians.
The regulatory policy and systems within healthcare in the United States is complex—many would argue it is dysfunctional. However, future physicians must learn to function in this environment. An emerging theme within medical education is understanding health systems. From an early stage of their careers, many students wish to help improve the health system environment. To do so, they must first understand the system.
The Next Steps to Take
Medical education has come a long way, but there is still work to do. Funding for medical schools and residency education must be re-examined and updated to meet the changing needs of our communities. Medical schools should design flexible curricula that can adapt to accommodate the individual learner while also considering changes in healthcare delivery and emerging medical specialties. This allows students to gain skills relevant to the current and future healthcare landscape. Students also need insight into healthcare policy and advocacy to empower them to influence these policies and address systemic issues that affect the physician workforce.
Medical education must encourage more students to pursue primary care specialties by offering incentives, scholarships, and loan forgiveness programs. Primary care physicians are critical for improving access to care and emphasizing preventative medicine and population health to address the growing importance of health promotion and disease prevention.
Medical schools should engage with local communities and underserved populations to provide students with real-world experiences and a better understanding of community health needs and population health. We must continue to expand the diversity of the physician work force. This effort begins before medical school; however, medical school admissions play a key role in educating the doctors that will best serve our communities.
Addressing challenges in medical education requires ongoing collaboration between medical educators, institutions, policymakers, and healthcare professionals that ensures medical education remains relevant, accessible, and effective in producing highly skilled and compassionate healthcare providers that will meet the health needs of our communities.
