Innovations in Medical Curricula

Today's new physicians are faced with an awesome array of often conflicting challenges: assimilating the vast and everincreasing base of scientific knowledge, coping with societal concerns over the cost of medical care, dealing with ethical dilemmas surrounding life-sustaining technology, and recognizing the changing nature of the physician-patient relationship. To better equip physicians in training for the professional challenges that lie ahead, some medical schools have studied and experimented with innovations in curricula. In this article, the authors present a survey of the literature concerning medical school curricula innovations for the past ten years. The conclusion which emerges from this study is that "short-term programs not integrated into the medical school environment are not worth pursuing. A more radical restructuring of medical education is needed," said Albert L. Siu, internist and Robert Wood Johnson Foundation Clinical Scholar at the University of California, Los Angeles (UCLA). In addition, Siu recommended that many of the innovations and experiments taking place in U.S. medical schools need to be more agressively studied. Coauthor S. Allison Mayer-Oakes is also an internist and Robert Wood Johnson Clinical Scholar at UCLA. Robert H. Brook is Senior Health Services Researcher at the Rand Corporation and professor of medicine and public health at UCLA. A member of the National Academy of Sciences' Institute of Medicine, Brook is well-known for his research in measurement of quality of care and was one of the original participants in the Clinical Scholars program. The authors are well equipped to discuss innovation in the medical school setting. UCLA's medical school has developed a number of innovative alternatives for young physicians in training and was an original site of the Johnson Foundation's Clinical Scholars program, which has trained clinicians in the conduct of health services research.