About the Institute for Improving Medical Education

What is the AAMC's Institute for Improving Medical Education (IIME) and why is it being launched now?

The AAMC established the IIME in the fall of 2002 to identify opportunities to improve the three phases of U.S. medical education: medical school, residency and continuing medical education (CME). The institute's mission is to boost the health of Americans by fostering innovations in medical education that will better align the knowledge, skills and professionalism of medical students, residents and practicing physicians with the needs and expectations of the public.

To help the institute find these opportunities, an ad hoc committee of 10 medical school deans was convened by the AAMC in March 2003 to conduct a year-long comprehensive review of the U.S. medical education system and recommend strategies for change. AAMC's report, "Educating Doctors to Provide High Quality Medical Care, A Vision for Medical Education in the United States," is the result of that review.

What are the institute's goals?

The IIME seeks to achieve wide-ranging goals across the continuum of medical
education:

• Harmonize standards across the accrediting bodies responsible for evaluating each phase of medical education

• Inspire educational innovations

• Strengthen learning objectives for the clinical education of medical students by emphasizing basic clinical skills, as well as more general cross-cutting issues of importance to the practice of medicine such as cultural competence.

• Modernize the content and structure of clinical clerkships for medical students to create a better balance among in-patient, ambulatory and community-based experiences and to foster more educational experiences involving other health professions, such as nursing, pharmacy and dentistry

• Develop and support faculty whose primary role is the education of students and residents

• Strengthen institutional accountability for graduate medical education

• Provide young doctors with more opportunities during residency training to care for chronically ill patients-those they are more likely to encounter in their future practices

• Shift CME programs toward formats that broaden and improve the specific skills and knowledge physicians need to better serve patients in their clinical practices

• Promote public policy changes that will help remove the financial barriers to improvements in medical education

• Inform the public about initiatives to improve medical education.

Why do we need to change the way the United States educates and trains doctors?

While America has the best doctors in the world, health care has undergone rapid changes in the past few decades. Numerous national organizations, such as the Institute of Medicine and The Commonwealth Fund, have raised serious questions about the adequacy of contemporary physician education. The results of a number of well-conducted studies indicate that doctors fail on occasion to use proven diagnostic and therapeutic approaches, to communicate with patients and their families, and to recommend beneficial health promotion and disease prevention practices.

These national organizations have called upon the academic medicine community to modify the content and process of medical education to better prepare physicians for the nation's rapidly evolving health-care needs. The IIME is the AAMC's focused response to this call to action.

What changes does the report recommend for medical student education? For residency training? For CME and other aspects of the U.S. health-care system?

The IIME's ad hoc deans committee acknowledges that changes to the current medical education system cannot be made immediately. However, the panel recommends the following short-term strategies for improving medical education:

• Medical schools and teaching hospitals should-

  • Establish rigorous assessment programs to ensure students and residents acquire the knowledge and skills necessary to provide superior patient care

  • Provide students with appropriate experiences to acquaint them with the various career options available to physicians

  • Offer a variety of joint degree and research training programs that will allow students, residents and practitioners to acquire the education needed to pursue specific career goals

  • Require faculty to complete periodically a program that reconnects them to the goals and objectives of medical education curriculum as a whole and to the specific student learning experiences in which they participate

  • Ensure students are exposed to outstanding clinicians and clinician teachers

  • Share resources such as simulation laboratories, standardized patient programs, information technology applications, etc., to ensure all learners receive the highest quality educational experience

• Continuing medical education should-

  • Create and conduct CME programs that improve how physicians practice medicine

  • Develop and conduct, with medical schools and teaching hospitals, CME programs that effectively improve physicians' practice behaviors.

• Accrediting bodies and specialty boards should-

  • Regularly review existing program requirements to ensure they truly reflect the education and training experiences needed for medical practice

  • Facilitate the integration of clinical education across medical school and residency by adopting relevant accrediting policies

• Licensing authorities should-

  • Grant licensure only to physicians who have completed an accredited residency program and regularly demonstrated clinical competency in their specialty

  • Revise their CME policies to engage physicians in career-long learning experiences that improve their practice behaviors.