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Intro -- FrontMatter -- Reviewers -- Foreword -- Acknowledgments -- Contents -- Boxes, Figures, and Tables -- Summary -- 1 Introduction -- 2 Background on the Pipeline to the Physician Workforce -- 3 GME Financing -- 4 Governance -- 5 Recommendations for the Reform of GME Financing and Governance -- Appendix A: Abbreviations and Acronyms -- Appendix B: U.S. Senate Letters -- Appendix C: Public Workshop Agendas -- Appendix D: Committee Member Biographies -- Appendix E: Data and Methods to Analyze Medicare GME Payments -- Appendix F: Illustrations of the Phase-In of the Committee's Recommendations.
Graduate medical education (GME) is critical to the career development of individual physicians, to the functioning of many teaching institutions, and to the production of our physician workforce. However, recent reports have called for substantial reform of GME. The current lack of established GME outcome measures limits our ability to assess the impact of individual graduates, the performance of residency programs and teaching institutions, and the collective contribution of GME graduates to the physician workforce. To examine the opportunities and challenges in measuring and assessing GME outcomes, the National Academies of Sciences, Engineering, and Medicine held a workshop on October 10â€"11, 2017, in Washington, DC. Workshop participants discussed: meaningful and measurable outcomes of GME; possible metrics that could be used to track these GME outcomes; possible mechanisms for collecting, collating, analyzing, and reporting these data; and further work to accomplish this ambitious goal. This publication summarizes the presentations and discussions from the workshop.
In the United States, broad study in an array of different disciplines â€"arts, humanities, science, mathematics, engineeringâ€" as well as an in-depth study within a special area of interest, have been defining characteristics of a higher education. But over time, in-depth study in a major discipline has come to dominate the curricula at many institutions. This evolution of the curriculum has been driven, in part, by increasing specialization in the academic disciplines. There is little doubt that disciplinary specialization has helped produce many of the achievement of the past century. Researchers in all academic disciplines have been able to delve more deeply into their areas of expertise, grappling with ever more specialized and fundamental problems. Yet today, many leaders, scholars, parents, and students are asking whether higher education has moved too far from its integrative tradition towards an approach heavily rooted in disciplinary "silos". These "silos" represent what many see as an artificial separation of academic disciplines. This study reflects a growing concern that the approach to higher education that favors disciplinary specialization is poorly calibrated to the challenges and opportunities of our time. The Integration of the Humanities and Arts with Sciences, Engineering, and Medicine in Higher Education examines the evidence behind the assertion that educational programs that mutually integrate learning experiences in the humanities and arts with science, technology, engineering, mathematics, and medicine (STEMM) lead to improved educational and career outcomes for undergraduate and graduate students. It explores evidence regarding the value of integrating more STEMM curricula and labs into the academic programs of students majoring in the humanities and arts and evidence regarding the value of integrating curricula and experiences in the arts and humanities into college and university STEMM education programs.
Bioterrorism, drug-resistant disease, transmission of disease by global travel . . . there's no shortage of challenges facing America's public health officials. Men and women preparing to enter the field require state-of-the-art training to meet these increasing threats to the public health. But are the programs they rely on provide the high caliber professional training they require? Who Will Keep the Public Healthy? provides an overview of the past, present, and future of public health education, assessing its readiness to provide the training and education needed to prepare men and women to face 21st century challenges. Advocating an ecological approach to public health, the Institute of Medicine examines the role of public health schools and degree-granting programs, medical schools, nursing schools, and government agencies, as well as other institutions that foster public health education and leadership. Specific recommendations address the content of public health education, qualifications for faculty, availability of supervised practice, opportunities for cross-disciplinary research and education, cooperation with government agencies, and government funding for education. Eight areas of critical importance to public health education in the 21st century are examined in depth: informatics, genomics, communication, cultural competence, community-based participatory research, global health, policy and law, and public health ethics. The book also includes a discussion of the policy implications of its ecological framework.
Because of changes in the health care system, the hospital has become less suitable as the primary focus of graduate medical education for primary care physicians. However, the current system of financing health care education and services makes it difficult to accomplish the needed shift to training in primary care ambulatory settings. This book suggests ways of lowering financial barriers to primary care training in ambulatory settings.
PRAISE FOR EDUCATING PHYSICIANS "Educating Physicians provides a masterful analysis of undergraduate and graduate medical education in the United States today. It represents a major educational document, based firmly on educational psychology, learning theory, empirical studies, and careful personal observations of many individual programs. It also recognizes the importance of financing, regulation, and institutional culture on the learning environment, which suffuses its recommendations for reform with cogency and power. Most important, like Abraham Flexner's classic study a century ago, the report recognizes that medical education and practice, at their core, are profoundly moral enterprises. This is a landmark volume that merits attention from anyone even peripherally involved with medical education." —Kenneth M. Ludmerer, author, Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care "This is a very important book that comes at a critical time in our nation's history. We will not have enduring health care reform in this country unless we rethink our medical education paradigms. This book is a call to arms for doing just that." —George E. Thibault, president, Josiah Macy, Jr. Foundation "The authors provide us with the evidence-based model for physician education with associated changes in infrastructure, policy, and our roles as educators. Whether you agree or not with their conclusions, if you are a teacher this book is a must-read as it will frame both what and how we discuss medical education throughout the current century." —Deborah Simpson, associate dean for educational support and evaluation, Medical College of Wisconsin "A provocative book that provides us with a creative vision for medical education. Using in-depth case studies of innovative educational practices illustrating what is actually possible, the authors provide sage advice for transforming medical education on the basis of learning theories and educational research." —Judith L. Bowen, professor of medicine, Oregon Health & Science University
The U.S. system of graduate education in science, technology, engineering, and mathematics (STEM) has served the nation and its science and engineering enterprise extremely well. Over the course of their education, graduate students become involved in advancing the frontiers of discovery, as well as in making significant contributions to the growth of the U.S. economy, its national security, and the health and well-being of its people. However, continuous, dramatic innovations in research methods and technologies, changes in the nature and availability of work, shifts in demographics, and expansions in the scope of occupations needing STEM expertise raise questions about how well the current STEM graduate education system is meeting the full array of 21st century needs. Indeed, recent surveys of employers and graduates and studies of graduate education suggest that many graduate programs do not adequately prepare students to translate their knowledge into impact in multiple careers. Graduate STEM Education for the 21st Century examines the current state of U.S. graduate STEM education. This report explores how the system might best respond to ongoing developments in the conduct of research on evidence-based teaching practices and in the needs and interests of its students and the broader society it seeks to serve. This will be an essential resource for the primary stakeholders in the U.S. STEM enterprise, including federal and state policymakers, public and private funders, institutions of higher education, their administrators and faculty, leaders in business and industry, and the students the system is intended to educate.
Graduate medical education (GME) is critical to the career development of individual physicians, to the functioning of many teaching institutions, and to the production of our physician workforce. However, recent reports have called for substantial reform of GME. The current lack of established GME outcome measures limits our ability to assess the impact of individual graduates, the performance of residency programs and teaching institutions, and the collective contribution of GME graduates to the physician workforce. To examine the opportunities and challenges in measuring and assessing GME outcomes, the National Academies of Sciences, Engineering, and Medicine held a workshop on October 10â€"11, 2017, in Washington, DC. Workshop participants discussed: meaningful and measurable outcomes of GME; possible metrics that could be used to track these GME outcomes; possible mechanisms for collecting, collating, analyzing, and reporting these data; and further work to accomplish this ambitious goal. This publication summarizes the presentations and discussions from the workshop.
Evaluates Medicare's policy regarding graduate medical education (GME) & addresses concerns about federal budget spending. Provides an overview of the changing physician work force & the effects of Medicare's GME policy on residency training & teaching hospitals at which such training is based. Presents various options for GME policy & explores their implications. Charts & tables.