She and Texas Tech’s Dr. Berk added that the three-year
programs emerging today, including F-MAT and others pro- posed in the AMA projects, are about more than simply elimi- nating the fourth year in that they include competency-based teaching that was absent in earlier models. AAMC’s Dr. Aschenbrener also cautioned that the trend
toward shortening medical education is not just about time. “The trend is about flexibility.” Fighting physician shortages certainly could be a side benefit of graduating some students earlier. Regardless of when students graduate, however, “our job is to produce the best-trained and most people-oriented physicians that we possibly can.” She acknowledges it could take the next decade to realize
systemic change in medical education, adding that part of the problem is a lack of federal funding dedicated to medical edu- cation research. “Even though we don’t know how to assess all of this yet, there’s a lot of good work going on. It will give us more information than we currently have.” Eventually, educators say accrediting bodies would have to allow for more flexibility in granting medical schools excep-
tions to try new programs, while at the same time maintaining their standards for what makes a good medical school. Dr. Kirk, an advisor to the AMA initiative, says the experi-
ments also could start to provide answers to some of those questions by giving schools seed money to experiment and then share best practices. Schools around the country are discussing the issues “and this is all a work in progress,” she said. Because every medical school is unique, however, “I don’t think there’s a one-size-fits-all answer.” Nor do medical educators imply that the current system has been turning out less-than-prepared physicians. Dr. Shine said the Flexner model worked “very well for 100
years, and there’s nothing to be unhappy about. Only in the last several years did it become clear the model is no longer applicable in the 21st century. Science has to be connected with how we take care of patients.” n
Amy Lynn Sorrel is an associate editor of Texas Medicine. You can reach her by tele- phone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at
amy.sorrel@
texmed.org.
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