The following is from in interview with Don Berwick in Health Affairs. Its touches on the topic of change in medical education. (Cynic JLR quote: “medical education is always advancing; it is just that it is always a century behind what is needed”)
It’s been a remarkably difficult arena to get changes going in. Partly it has to do with the economics of education—and I don’t mean the money. I mean the budgeting of time. You have a student in your hands for a certain amount of time. And the way educational systems work is to regard that time as if it were currency: It’s doled out among the various stakeholders. There are no internal stakeholders for the processes of improvement and change in the modern medical school. The stakeholders are in biochemistry and physiology and pharmacology and surgery and medicine—in the traditional buckets. So once you’ve taken all the time you’ve allocated out to the buckets, there’s nothing left over for a course on safety or system leadership or physician stewardship and change, often even ethics.
It is not completely true, but true enough to be easily recognisable. Everybody wants a bit of the action, however. One day I will produce an inventory of all the ‘must be included in the undergraduate curriculum’ statements from all and sundry. The most recent ones I have seen relate to ‘resilience’ (just like the army in Afghanistan, the GMC tell us), and of course, ‘big data’ ( future data doctors will look at data, not patients…..I jest not).