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Applying the Hedgehog Concept to Transform Undergraduate Medical Education

Ginzburg, Samara B., MD; Willey, Joanne M., PhD; Bates, Carole, MPH, MBA; Santen, Sally A., MD, PhD; Battinelli, David, MD; Smith, Lawrence, MD

doi: 10.1097/ACM.0000000000002564
Invited Commentary: PDF Only

As the U.S. health care system changes and physician responsibilities shift, medical educators must reconsider how best to prepare medical school graduates for the future practice of medicine. Thoughtful reexamination of the goals of undergraduate medical education (UME) and the roles of educators, medical students, and physicians is warranted to ensure they align with evolving health care environments and delivery systems. In this Invited Commentary, the authors apply Jim Collins’ Hedgehog Concept from Good to Great—a business-world framework, designed to transform companies—to UME. The Hedgehog Concept is defined by the intersection of an organization’s passion, area of expertise, and economic and resource engines. Focusing on this single concept can guide key decisions, reject what does not align conceptually, and drive overall organizational success. The authors use the Hedgehog Concept to frame the programmatic development of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (Zucker SOM), a millennial medical school, as an organization with the passion to develop innovative UME curricula by challenging the status quo; the drive to be the best at leveraging health system resources to train graduates to excel in systems-based care; and the economic and resource engines of faculty time, financial and infrastructure support, and reputation building. The success of this approach is assessed at Zucker SOM through student and graduate outcomes data. The authors suggest this Hedgehog Concept is generalizable to other UME programs whose leaders seek to transform medical education to meet 21st-century workforce and health care delivery needs.

S.B. Ginzburg is associate dean for case-based learning, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; ORCID: https://orcid.org/0000-0003-0466-0316.

J.M. Willey is Leo A. Guthart Professor of Biomedical Sciences and chair, Department of Science Education, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; ORCID: https://orcid.org/0000-0003-4544-4417.

C. Bates is assistant dean for curricular affairs and special projects, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.

S.A. Santen is senior associate dean for evaluation, assessment, and scholarship of learning, Virginia Commonwealth University School of Medicine, Richmond, Virginia; ORCID: https://orcid.org/0000-0002-8327-8002.

D. Battinelli is senior vice president and chief medical officer, Northwell Heath, and dean for medical education and Betsy Cushing Whitney Professor of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.

L. Smith is executive vice president and physician-in-chief, Northwell Health, and dean, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.

Acknowledgments: The authors would like to thank Seetha Monrad, MD, John Young, MD, PhD and David Hirsh, MD, for carefully reading the manuscript and providing invaluable advice; Elizabeth Armstrong, PhD, and the Harvard Macy Institute for their instrumental role in cultivating the concept for this paper; and Saori Wendy Herman, MLIS, AHIP for helping with literature searches and citations.

Funding/Support: None reported.

Other disclosures: Dr. Santen receives funding for Accelerating Change in Medicine Education from the American Medical Association.

Ethical approval: Reported as not applicable

Correspondence should be addressed to Samara Ginzburg, 500 Hofstra University, Hempstead NY 11549; telephone: 516-463-7501; email: samara.ginzburg@hofstra.edu.

© 2019 by the Association of American Medical Colleges