Letters to the Editor
To the Editor: Steven Kanter’s1 compelling editorial, “Advancing the education mission,” highlights the importance of medical educators’ commitment to their mission. His proposed framework to guide the advancement of medical education reinforces the academic health center’s social contract and dedication to public service. However, he downplayed the importance of finding and committing funds to finance the provision of educational programs, especially in light of the Association of American Medical Colleges’ call for a 30% increase in U.S. medical school enrollment by 2015.2 The 2010 Patient Protection and Affordable Care Act will likely result in the need for additional learners and will further tax medical education and academic health center resources. Without funding to support these increases, how can we sustain the medical educational mission, let alone advance it?
As a junior faculty member working in the realm of standardized patients (SPs), I am challenged by a flat or decreasing budget as I seek to accommodate the ever-increasing numbers of learners in our medical school. The irony is that demand for SPs has increased because fewer clinicians have the time to directly interact with and assess learners. Furthermore, accrediting agencies such as the Liaison Committee for Medical Education hold the expectation that medical students will all participate in clinical skills examinations, for which SPs are heavily used. All uses of SPs cost money, and these costs increase when accommodating additional learners. In the short run, we are doing more with less, but ultimately that approach is not sustainable.3 Without addressing this key issue, our learners, and ultimately patients, will suffer.
Medical education is at a critical point. Medical schools are bursting at the seams in attempts to accommodate new learners. Faculty dedicated to education are on the edge of burnout. We must act now! As we move toward competency-based education and assessment, which require more and better-targeted resources,4 I call on our deans and department heads not only to participate in educational activities but also to invest adequate resources into our educational programs.
Anita J. Richards
Instructor of clinical medical education, Keck School of Medicine of the University of Southern California, Los Angeles, California; firstname.lastname@example.org.
1. Kanter SL. Advancing the education mission. Acad Med. 2012;87:991–992
2. AAMC Statement on the Physician Workforce. 2006 Washington, DC: Association of American Medical Colleges
3. Schieffler DA Jr, Azevedo BM, Culbertson RA, Kahn MJ. Financial implications of increasing medical school class size: Does tuition cover cost? Perm J. 2012;16:10–14
4. Holmboe ES, Sherbino J, Long DM, Swing SR, Frank JR. The role of assessment in competency-based medical education. Med Teach. 2010;32:676–682