For more than 100 years, exposing students to basic and clinical research has been an essential component of a medical school education in the United States. However, today, new models of medical education in which research plays a minimal role are likely to create a two-tiered system of education, decrease the physician-scientist pipeline and diminish the application of scientific advances to patient care.

Those are the concerns outlined in "American Medical Education at a Crossroads" - a position paper published April 29 by Science Translational Medicine and co-authored by Arthur Feldman, MD, PhD, Executive Dean of Temple University School of Medicine and Chief Academic Officer for the Temple University Health System, Arthur H. Rubenstein, MBBCh, Professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania, and colleagues. The abstract explores the reasons why research is being deemphasized, particularly at some of the nation's newer medical schools, and at those which are not affiliated with a major research university. The authors argue that the U.S. is headed for a two-tiered system, one that exposes students to research and physician-scientists, and another that trains students with exclusively practitioners as role models.

"Research at our nation's medical schools has led to discoveries that have changed the face of American medicine," says Dr. Feldman. "Unfortunately, many of the nation's newer medical schools do not prioritize research or are unable to compete for scarce research funding. The result is an increased proportion of U.S. medical school graduates matriculating from programs where the faculty members pursue little to no clinical or translational research."

According to the authors, many of the new U.S. medical schools share other features beyond just the absence of a research portfolio: they are not partnered with major research universities; they have a small basic science faculty; and, in many cases, their students take clerkships solely in community hospitals rather than in research-oriented quaternary care hospitals.

Proponents of this model argue that empiric instruction (i.e., exposure to clinical settings) is sufficient and students who intend to pursue a career in primary care do not require hands-on exposure to laboratory-based translational research, to clinical research that is focused on the complex array of disease found in research-oriented hospitals, or to outcomes research, comparative effectiveness research and investigations centered on health care delivery systems.

The authors find this argument problematic. Just as it is axiomatic that clinical medicine is best taught at the bedside, the authors believe that the most effective means by which a student can learn the complexities of clinical and translational science is through exposure to actual research studies and to the physician scientists who pursue translational research.

Students must learn to amass, synthesize, critique and apply new scientific data to the care of an individual patient. How we provide our students with the skills to amass this data both in the short term and over a lifetime of learning will have a major impact on their clinical capabilities, they write.

"Research is just as important for the student who plans to pursue primary care as it for the physician-scientists in training," said Dr. Rubenstein, who also served as dean of Penn's Perelman School of Medicine from 2001 to 2011. "It is becoming increasingly important for all students to be in an environment where both attending physicians and trainees take the opportunity to explore at the bedside how the bi-directional highway of translational science can be taken advantage of to inform clinical decision making."

Dr. Feldman, Dr. Rubenstein and the authors write that it is not surprising that many new medical schools do not, or cannot, support basic or clinical research. The 2013 National Institutes of Health (NIH) budget was 21.9 percent below its 2003 level when adjusted for inflation, pharmaceutical support for research has diminished, changes in reimbursement policies make it problematic to support research with clinical revenues, and proposed cuts to direct and indirect medical education payments threaten funding for residents and teaching faculty. In addition, due to the high cost of maintaining research programs, many schools find it more advantageous to shrink or eliminate these programs.

"Without question, omitting research improves the finances of a school of medicine," write the authors. "Indeed, a 2011 report from the Association of American Osteopathic Colleges demonstrated that a medical school achieves a positive margin when it does not have to support basic or translational research or a research-oriented clinical program. There is the very real threat that at a time of decreased NIH funding, some medical schools and/or their parent universities will meet their budgetary goals by decreasing their support for medical research, shrinking the size of the medical school faculty and divesting their research-oriented hospitals."

The authors suggest several steps to ensure that the changes taking place in medical education do not have unintended consequences.

These include objective evaluation of these new models by academic organizations and regulatory bodies; a commitment from universities to bear the significant cost of maintaining basic science faculty members and a quality medical education; public education about the value inherent in a scientifically based education; and enhanced support from the NIH for new physician-scientists in order to ensure that there will be an adequate supply of instructors and mentors to train the next generation of medical students.

"We need to continue to educate highly competent physicians and assiduously avoid the creation of a group of physicians who will be unable to apply the scientific advances of medicine for the benefit of their patients," the authors say.

The politics of establishing a second medical school shouldn’t impede efforts to ramp up medical education in Spokane this year. The University of Washington and Washington State University both agree that many more students are needed. The state can’t wait.

The Legislature passed a bill that allows WSU Spokane to seek accreditation for its medical school, and the governor signed it. However, that process will take time, and the first graduates of the new school won’t materialize for at least a decade. In the meantime, the Legislature shouldn’t back away from its commitment to the WWAMI program run by the University of Washington.

WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) wants funding for 60 students, up from the 40 now enrolled for each of the first two years. But the House and Senate budgets diverge dramatically in funding medical school slots.

Over the next biennium, the Senate budget allots $2.5 million to WSU to pursue accreditation and the same amount to the University of Washington. But as UW leaders note, that isn’t enough to fund the current 40-student load, let alone a desired increase. The university can’t simply shift the students over to Seattle. If medical education in Washington is going to expand, it’s going to expand in Spokane.

That’s heartening, and the House budgets $9.4 million for UW in Spokane, which would fund the 20-student increase for two years.

WWAMI’s goal is to reach 120 medical students in Spokane, but if the Senate proposal stands UW officials say the number of slots would actually decline.

Not to worry, say Senate leaders. The lowball amount is merely a prod to force the schools back into a relationship. This will all get worked out during final budget negotiations.

That’s somewhat encouraging, but if this attempt at marriage counseling fails, the state will still need the slots. The two schools initially talked about teaming up on a request to dramatically increase medical education funding, but that alliance broke apart when WSU decided to seek its own school.

UW officials told the editorial board recently that they don’t want to monopolize medical education, and they point out that they did not try to block the bill that allowed for a second school. They reiterated that Spokane is important to WWAMI’s future plans.

The need for more students, wherever they train, has been well-documented.

By 2030, the state will need 4,000 more doctors, including 1,700 in primary care. WWAMI rejects about 85 percent of Washington applicants. Twice as many Washingtonians study out of state than in-state. The paucity of slots, along with a shortage of post-graduate internships, makes it difficult for rural counties to draw physicians.

UW officials worry that a rivalry narrative will damage the overall cause of medical school expansion. Apple Cup partisanship is fine for football, but not medical education.

We agree, and hope lawmakers don’t use the “divorce” as an excuse to shortchange an urgent need.

source: spokesman

Innovaacom, a leading provider of medical education and training for healthcare professionals worldwide, today announced it is expanding its services into Asia in 2015. Innovaacom’s focus on innovative solutions for this area of the world comes at a time when Asia’s strengthening economy and leadership are rallying around consumer demand for better healthcare. A rapidly growing aging population and changing socio-economic environment is driving healthcare system improvements and advances in medicine in Asia. “We are excited to be a part of the reinvention of healthcare and renaissance of high science and emerging medicine in Asia,” said Innovaacom CEO Ornella Vincenzino.

In particular, new patterns of healthcare needs are emerging in this area of the world which will soon house the world’s largest aging population. According to the World Health Organization, Asia’s elderly population will hit 922.7 million by 2050 challenging the healthcare system’s ability to treat dementia and provide palliative care for senior patients. As the Asia economy grows more prosperous, area residents are also exhibiting diseases more commonly seen in developed nations. For instance, 191 million people in Asia-Pacific are now living with diabetes according to the International Diabetes Federation.

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While Asia is overflowing with great scientific research today, communicating its value isn't always easy especially when the expectation is that it be done in medical English. Innovaacom understands the special challenges this presents and offers innovative communications strategies for this area of the world to share the impact of its contributions. Innovaacom is a global company that provides medical education and training for physicians and pharmacists around the world. To date, Innovaacom has collaborated with industry leaders to train more than 8,000 physicians and pharmacists in Europe, Latin America, Africa, China and the Middle East in medical communications and clinical best practices.

Innovaacom programs will support the dissemination of new research that is flooding out of Asia with communications strategies that allow for maximum sharing of high science and aim to standardize the quality of care across the region. For more information, write This email address is being protected from spambots. You need JavaScript enabled to view it. or visit http://www.innovaacom.com.

About Innovaacom
Founded in 2007, Innovaacom is a global agency providing medical education and training for healthcare professionals worldwide that applies globally and empowers locally. Innovaacom courses combine science with leadership and communications skills training that helps translate the latest scientific and medical innovation into real clinical practice. Program design and delivery includes CME and non-CME training programs for physicians and community pharmacists that enhance the quality of scientific exchange to advance science and medicine.

source: prweb.com