Educational Programs in US Medical Schools, 1994-1995

Abstract

This is a time of considerable uncertainty about the future of medical education. There are threats to medical school finances from state and federal levels. While medical schools derive only an average of about 11% of total revenues from state and local sources, these funds potentially give states the basis for imposing specific mandates on medical schools, in areas such as enrollment levels, curriculum content, and a desired specialty mix of graduates. Medical schools appear to be changing at varying rates in response to the health care system, including the growth of managed care. While the total number of full-time faculty members continues to increase, there are regional differences. It is unclear how the faculty size and composition ultimately will be affected or what implications this will have for educational programs. A number of medical schools are expanding into the community to ensure a patient base, and educational opportunities for medical students appear to be increasing in the community, including some limited use of managed care organizations. as educational settings. Medical school practice sites in the community have the potential to exacerbate "town-gown" tensions in the increasingly competitive health care environment. This, in turn, could jeopardize community-based medical education by the large number of practicing physicians who serve as volunteer faculty members and who are a valuable resource. Care will need to be taken to minimize these tensions as much as possible. As the health care system becomes even more competitive, concerns are being raised about whether volunteer faculty will continue to serve without compensation. The ability to begin to compensate community physicians who serve as teachers could be affected by decreasing medical school revenues from patient care, which, in the past, have been used to support activities such as community-based education. This is a time for strong and visionary academic leadership: medical schools must not only adapt to a changing health care system, but also maintain excellence in education, research, and patient care. This annual article will continue to describe the efforts of educational programs to do so.

Design, implementation, and evaluation of an innovative anatomy course

“…As the course evolved to more successfully engage students in professional behaviors, it placed more emphasis on the skills of observation, drawing inferences, constructing hypotheses and testing them (Pangaro, 2006). In the paradigm of knowledge-skills-attitudes (Barzansky and Etzel, 2003), the clinically engaged course fostered an attitude that shifted a classical emphasis on accumulation of facts towards an emphasis on knowledge in the service of skills. These attitudes and skills might affect clinical training in ways that would not be measured by the longterm effectiveness examination reported here.…”

Colour neglect in an artist

“…4 In the academic year 2001-02, 34 859 applicants submitted 403 609 applications for a total first year medical school enrolment of 16 933. 3 Thus, for this group the AAMC probably received about $468 from each of the overwhelming majority of applicants, or roughly $15 million. Previously, there was no AAMC application fee, since applicants dealt directly with each medical school.…”

“…2 AMCAS charges each of more than 30 000 medical school applicants $150 for an initial preliminary medical school application and $30 for each additional preliminary one. 2,3 Hence, someone who applies to a fairly large number of schools will have to pay the AAMC a substantial fee, in addition to the actual medical school application fee of up to $100 per institution paid directly to the medical school after the preliminary application. 4 In the academic year 2001-02, 34 859 applicants submitted 403 609 applications for a total first year medical school enrolment of 16 933.…”

“…1 Graphic neglect can become especially evident in the work of professional painters, offering the unique opportunity to examine the effect of brain damage upon artistic graphical expression. [1][2][3] Here, we describe a 71-year-old, right-handed, female professional painter, who had a haemorrhage in the right posterior parietal lobe, leading to left lower quadrantanopia without sensory or motor loss. Drawing and copying during neuropsychological assessment showed mild left-sided graphic neglect, but this disorder was more obvious in a spontaneous drawing (figure): the bouquet of roses is shifted to the right of the paper and is less elaborated on the left side.…”

Relato de experiência: o uso de simulações no processo de ensino-aprendizagem em medicina

“…Currículos que incorporam métodos de aprendizagem interativa, como as simulações, parecem ser mais bem-sucedidos do que aqueles que utilizam exclusivamente métodos tradicionais de ensino 8,9,10 . Além disso, a participação de atores interpretando pacientes é bem aceita por estudantes 11,12 , pois os atores também podem avaliar o desempenho do estudante, colaborando para enriquecer o processo de ensino-aprendizagem 13 .…”