Letters to the Editor
To the Editor: The recent article in Academic Medicine by Alper and colleagues1 revealed that as of 2006, in spite of increased attention and educational mandates, only 25% of the internal medicine clerkship directors of U.S. and Canadian medical schools reported having a formal curriculum in patient safety. The authors acknowledged that because their study's data were from 2006, their findings may underrepresent the actual number of programs with formal patient safety curricula now in place.
Unfortunately, these findings are in stark contradiction to work previously published and may overestimate the actual number of U.S. medical schools with patient safety teaching programs in place, not only in 2006 but also as recently as 2008. Using the Association of American Medical Colleges' Curriculum Management and Information Tool (CurMIT), curricula from 125 U.S. MD-granting medical schools were queried.2 The resulting information indicated that from 2004 to 2008 there was an increase in the number of programs reporting any patient safety curricula; however, as of 2008, only 10.4% of U.S. M.D.-granting medical schools reported any patient-safety-specific curricular content. Furthermore, when analyzed for patient safety content as defined by the Institute of Medicine's report on patient safety,3 less than 8% had qualifying curricula.
It is clear that U.S. and Canadian medical schools have not fully incorporated patient safety material into core preclinical or clinical curricula and that there is a large discrepancy between physicians' training and the safety mandates placed on practicing physicians. Additional emphasis on patient safety in all areas of medical education is necessary before the Institute of Medicine's recommendations regarding patient safety can be fully realized.
Jason M. Kane, MD, MS
Assistant professor of pediatrics, Feinberg School of Medicine, Northwestern University Children's Memorial Hospital, Chicago, Illinois; firstname.lastname@example.org.
1Alper E, Rosenberg EI, O'Brien KE, Fischer M, Durning SJ. Patient safety education at U.S. and Canadian medical schools: Results from the 2006 Clerkship Directors in Internal Medicine Survey. Acad Med. 2009;84:1672–1676.
2Kane JM, Brannen M, Kern E. Impact of patient safety mandates on medical education in the United States. J Patient Saf. 2008;4:93–97.
3Kohn L, Corrigan J, Donaldson M, eds. To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press; 2000.