Toward Defining and Measuring Social Accountability in Graduate Medical Education: A Stakeholder Study

Reddy, Anjani; Lazreg, Sonia A.; Phillips, Robert L.; Bazemore, Andrew; Lucan, Sean C.

doi:10.4300/jgme-d-12-00274

Cited by 9 publications

(9 citation statements)

References 6 publications

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“…The ACGME has made some progress in addressing social accountability in medical education, although it does not as fully embrace the social accountability principles that the Canadian model does. 18 The ACGME's diversity initiative includes common program requirements that have the potential to address social accountability. These requirements include that programs address recruitment and retention of a diverse and inclusive workforce, that program directors create an environment that facilitates residents' ability to raise concerns without fear, that programs address evaluation so as not to rely on first-time board pass rates as a measure of program excellence, and that programs and sponsoring institutions create a professional and respectful environment.…”

Section: Accreditation Of Gme Institutionsmentioning

confidence: 99%

Social Accountability and Graduate Medical Education

Kaufman

Scott

Andazola

et al. 2021

Fam Med

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Because graduate medical education (GME) is largely publicly funded, it should be judged on how well it addresses the public’s health needs. However, the current system distributes GME resources inequitably by specialty and geography, and neglects to focus on training physicians adequately in the care of populations while reducing health disparities. Instead, GME continues to concentrate training in hospital-based academic centers and in subspecialties, which often exacerbates disparities in health outcomes and access to care. GME can be more socially accountable by shifting incentive structures to support primary care, creating more equitable distribution of residency slots and funding, and promoting training programs that focus on social and structural determinants of health.

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Section: Accreditation Of Gme Institutionsmentioning

confidence: 99%

Social Accountability and Graduate Medical Education

Kaufman

Scott

Andazola

et al. 2021

Fam Med

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“…There is a need for increased social accountability of US medical [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] • Focused on search results that applied to the United States. Reviewed workforce data for Canada, [26][27][28][29] New Zealand, [30][31][32][33] and United Kingdom.…”

Section: Outcomes Producedmentioning

confidence: 99%

“…schools to produce the workforce to provide adequate health care for the nation. [19][20][21][22] This requires a strong foundation in primary care. 3,7,8 As family physicians provide the majority of primary care throughout the nation, especially in rural and underserved communities, medical schools must produce more family physicians.…”

Section: Identified Collaboratorsmentioning

confidence: 99%

Collaborating to Achieve the Optimal Family Medicine Workforce

Kelly

Coutinho

Goldgar

et al. 2019

Fam Med

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When the Family Medicine for America’s Health (FMAHealth) Workforce Education and Development Tactic Team (WEDTT) began its work in December 2014, one of its charges from the FMAHealth Board was to increase family physician production to achieve the diverse primary care workforce the United States needs. The WEDTT created a multilevel interfunctional team to work on this priority initiative that included a focus on student, resident, and early-career physician involvement and leadership development. One major outcome was the adoption of a shared aim, known as 25 x 2030. Through a collaboration of the WEDTT and the eight leading family medicine sponsoring organizations, the 25 x 2030 aim is to increase the percentage of US allopathic and osteopathic medical students choosing family medicine from 12% to 25% by the year 2030. The WEDTT developed a package of change ideas based on its theory of what will drive the achievement of 25 x 2030, which led to specific projects completed by the WEDTT and key collaborators. The WEDTT offered recommendations for the future based on its 3-year effort, including policy efforts to improve the social accountability of US medical schools, strategy centered around younger generations’ desires rather than past experiences, active involvement by students and residents, engagement of early-career physicians as role models, focus on simultaneously building and diversifying the family medicine workforce, and security of the scope future family physicians want to practice. The 25 x 2030 initiative, carried forward by the family medicine organizations, will use collective impact to adopt a truly collaborative approach toward achieving this much needed goal for family medicine.

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“…In this discourse, however, the perspective of teaching staff on what is morally right in the internationalisation of medical education has received little attention, despite the fact that they are key players whose decisions in their daily practice affect individuals and society. Although previous studies have confirmed that teachers recognise the importance of social accountability, they have not explored whether and how teachers in international medical education are confronted with and act upon ethical concerns and dilemmas when organising, designing and implementing education. Therefore, in order to grasp the complexity of this debate and to obtain a comprehensive picture of the issues it concerns, it is imperative that we include teachers’ perspectives.…”

Section: Introductionmentioning

confidence: 99%

‘Being international is always a good thing’: A multicentre interview study on ethics in international medical education

et al. 2020

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Context: Internationalisation in medical education raises ethical concerns over, for instance, its for-profit orientation, the potential erosion of cultural diversity and the possibility that standardised education may not meet the needs of patients everywhere. These concerns fit into a broader debate on social responsibility in higher education. This study aims to explore how academic staff in international medical education experience and act upon the ethical concerns that pertain to their programmes. By adding their perspectives to the debate, this study helps us understand how theory-based ethical concerns are reflected in practice. Methods:We conducted a multicentre instrumental case study across three international medical programmes, all of which were characterised by an international student intake, an internationalised curriculum and international partnerships, and all of which used English as the medium of instruction. We conducted 24 semi-structured interviews with purposively sampled curriculum directors and teaching staff. Participants shared their personal experiences and responded to ethical concerns expressed in the literature. Our multidisciplinary team performed a template analysis of the data based on theoretical frameworks of ethics and social responsibility.Results: Participants primarily experienced the internationalisation of their institutions and programmes as having a positive impact on students, the university and the future global society. However, they did face several ethical dilemmas. The first of these involved the possibility that marketisation through international recruitment and the application of substantial tuition fees might widen access to medical education, but might allow weaker students to enter medical schools. The second concern referred to the homogenisation of education methods and content, which offers opportunities to expose students to best practices, but may also pose a risk to education quality. The third issue referred to the experience that although student diversity helped to promote intercultural learning, it also jeopardised student well-being. Conclusions:In the eyes of teaching staff in international medical education, internationalisation can benefit education quality and society, but poses ethical dilemmas through the forces of marketisation, homogenisation and diversification. The findings reflect a tension between the views of scholars and those of practitioners. The critical perspective found in academic debates is largely missing in practice, and theoretical frameworks on ethics possibly overlook the benefits of international education. To facilitate ethical decision making, we propose that scholars and practitioners globally try to learn from each other.

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Toward Defining and Measuring Social Accountability in Graduate Medical Education: A Stakeholder Study

Cited by 9 publications

References 6 publications

Social Accountability and Graduate Medical Education

Social Accountability and Graduate Medical Education

Collaborating to Achieve the Optimal Family Medicine Workforce

‘Being international is always a good thing’: A multicentre interview study on ethics in international medical education

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