medical education

UAB Medicine introduces Web-based learning and continuing medical education for physicians

UAB Medicine, in collaboration with BroadcastMed, Inc. has launched MD Learning Channel, an online resource that enables medical professionals worldwide to tap into the knowledge and expertise of University of Alabama at Birmingham physicians.

The website at learnmd.uabmedicine.org offers free Web-based learning and continuing medical education for physicians and other medical professionals. It includes video presentations from UAB physicians discussing new research findings, new procedures and changes and developments in diagnosis or treatment of disease. The site primarily focuses on cancer, neurosciences, pulmonary medicine, women and infants services and cardiovascular medicine and will expand to include additional medical specialties in the future.

“UAB physicians and scientists are at the forefront of medicine, scientific research and discovery and advancement of treatments and patient-focused care,” said Physician Marketing Manager Whitney McDonald. “This site provides an easy, convenient way for UAB to help disseminate its incredible wealth of expertise to medical professionals around the world.”

McDonald says the site’s on-demand service enables physicians and medical professionals to learn as their schedule permits.

“By making the information readily available, we hope to further the mission, vision and successes of the UAB Medicine team, while sharing techniques, procedures and evidence-based care in use here to help others care for their patients,” said McDonald. “We hope that the MD Learning Channel will serve as a platform to foster many growth and development opportunities for health-care providers.”

Source: News Medical

Many Parents Unaware About Medical Research Opportunities for Their Children

A recent poll shows that roughly 44 percent of parents polled claimed they would enroll their child into medical research involving the testing of new medications or vaccines if their child suffered from the disease being studied.

That figure jumped to over 75 percent when the research being conducted involved questions on mental health or diet and nutrition. So why is it only five percent of parents claim they have signed their children up for medical research?
It’s a no-brainer that children’s healthcare can only improve through medical research. The University of Michigan C.S. Mott Children’s Hospital National Poll on Children’s Health, which surveyed 1,420 parents with a child or children between birth and 17 years of age, claims awareness of medical research opportunities accounts for the low percentage of participants.

Greater than 66 percent of parents polled stated they were not aware of research opportunities for their children. In fact, the poll shows parents who are aware of medical research opportunities are far more likely to have their children take part.
“Children have a better chance of living healthier lives because of vaccinations, new medications and new diagnostic tests. But we wouldn’t have those tools without medical research,” says Matthew M. Davis, MD, MAPP, director of the National Poll on Children’s Health and professor of pediatrics and internal medicine in the University of Michigan Health System.
“With this poll, we wanted to understand parents’ willingness to allow their children to participate in medical research. The good news is that willingness is far higher than the current level of actual engagement in research. This means there is great opportunity for the medical research community to reach out to families and encourage them to take part in improving medical care.”

As mentioned above, the poll differentiated between types of studies and found the willingness of the parents to allow their children to participate was affected by this differentiation. Studies aimed at nutrition and mental illnesses were more positively favored by the parents. However, parents were more reticent about subjecting their children to studies which involved exposure to new medicines or vaccines.
This poll specifically targeted the level of participation by children in medical research since 2007. Over the previous 5 years, the proportion of families where the children have actually taken part in medical research has basically remained unchanged. The figure was four percent in 2007. In both last year’s results and the results reported this year, that figure was only at five percent.
“Five percent of families with children participating may not be enough to support important research efforts that the public has identified in previous polls – things like cures and treatments for childhood cancer, diabetes and assessing the safety of medications and vaccines,” says Davis, who also is professor of public policy at the Gerald R. Ford School of Public Policy.
“But the results indicate that a much bigger percentage of the public does understand the importance of medical research to advancing healthcare for children.”
Though parents in the poll claim they would be willing to allow their children to participate in studies, researchers are too often at a loss of obtaining a significant sample size that could lead to a real difference in healthcare discoveries. If the poll is to be believed, it seems the medical research community needs to focus as much energy on marketing their studies as they do carrying them out.
“This poll shows that the research community needs to step up and find ways to better reach parents about opportunities for children to participate, answer parents’ questions about benefits and risks of participation, and potentially broaden the types of studies available,” Davis says.
Source: Red Orbit

 

Big Changes Ahead in Medical Education

The U.S. should be prepared for massive changes in the next few years in the way physicians are trained, experts said here Thursday.

Change will have to start with inter professional education, George Thibault, MD, president of the Josiah Macy Jr. Foundation in New York, said at an event sponsored by Health Affairs to promote its theme issue on medical education. “We know all health professionals are going to work together in formal and informal teams, yet we educate them separately and then are surprised when they don’t work together well.” Instead, professionals should be educated together so they are prepared to work together as teams, he said.

In addition, a new model of clinical education is needed, Thibault continued. “The [current] model is very fragmented and still too hospital-based to take care of a population with chronic illnesses who are largely outside the hospital. The model needs to be more longitudinal and community-based.”

Then there is the content of the curriculum. “Since [the Flexner report], biological sciences have been the basis for medical education,” he noted. “We need to add social sciences, systems management, economics, and medical professionalism.”

Thibault also suggested that medical schools move away from time-based education and toward education based on development of competencies, “so learners move through as they are ready to move through. We cannot continue to have a locked-up approach determined by everybody doing the same thing or determined by just time and place. This can lead to a more efficient system … and to professionals who are specifically prepared for the careers they’re going to take on.”

Several speakers lamented the lack of medical students willing to go into primary care. “Part of that is the culture of medical school — what’s conveyed to students plays a major role,” said Uwe Reinhardt of Princeton University in New Jersey.

“You come home and you say, ‘I’m a pediatrician,’ or you say you’re like Sanjay Gupta — a neurosurgeon. What gets you the date?” he said.

Although people often point to medical education debt as a barrier to pursuing the lesser-paid primary care specialties rather than the more well-paid specialties, Reinhardt disagreed that it’s a major problem. “Look at medical school indebtedness — on average it’s about $220,000,” he said. “I always tell physicians who bellyache, ‘you know that guy who just opened a restaurant — what do you think they pay on a mortgage?’ It’s probably close to your [loan], and somehow they make do.”

“Debt is a nuisance, but not prohibitive,” he added, noting that the Association of American Medical Colleges is trumpeting record medical school enrollment despite students’ debt problems.

For the primary care situation to change, “we need accountability,” said David Goodman, MD, of the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire and a co-principal investigator of the Dartmouth Atlas of Health Care. “The best way is with public guidance leading to peer review that leads to public funding,” with priorities that are set annually. “That might [include] increase in primary care [residency] funding — putting a thumb on the scale allows being a priority.”

Goodman proposed a scheme in which each year, 10% of physician training programs would need to reapply for their funding. Programs that are reapplying would be competing with other established programs as well as new residency programs. Applications would be peer-reviewed, and successful applicants would get an interim review to make sure they were on track.

Under such a system — which would mean that each program would be reviewed once per decade — meritorious training programs would be able to expand, while weaker programs would lose 10% to 15% of their funding. And because the awards would be made every year, it would give the system “the ability to change priorities with each succeeding year, over time,” he said. “Sure, we’ll make mistakes, but they’ll be smaller mistakes.”

Audience members also heard from Reps. Aaron Schock (R-Ill.) and Allyson Schwartz (D-Pa.)who are co-sponsoring the “Training Tomorrow’s Doctors Today Act,” a bill that would increase the number of graduate medical education (GME) slots by 15,000 over a 5-year period. “This is an issue that’s uniting [Republicans and Democrats] on Capitol Hill,” Shock said.

Both Schock and Schwartz also expressed support for legislation that would repeal and then replace Medicare’s much-maligned sustainable growth rate (SGR) formula for physician reimbursement. Schock noted that one reason the House Energy and Commerce Committee was able to get unanimous support among its committee members for its SGR repeal proposal, which would cost an estimated $179 billion, was that “they didn’t say how they’re going to pay for it.”

Rep. Dave Camp (R-Mich.), chair of the House Ways and Means Committee — which is charged with coming up with ways to pay for legislation such as an SGR fix — has been briefing committee members on possible “pay-fors,” said Schock, who is a member of the committee. “So stay tuned” to see what happens, he added.

Schwartz said she hopes that GME reform may eventually be included in an SGR fix bill should one be passed. “When we do something about the SGR, there might be a moment when we could slip this [GME] legislation into our discussion,” she said.

Source: Med Page today

 

Medical education is still worth the cost

 

In 2000, the soaring dot.com industry crashed. Seven years later, the housing boom ended abruptly. With tuition rates swelling, could the medical education market be the next bubble to burst?

Probably not, concludes a paper published Oct. 30 in the New England Journal of Medicine and co-authored by Cornell health economist Sean Nicholson, since such a collapse would occur only if doctors’ incomes dropped sharply and before medical schools could act to rein in costs. However, for veterinarians, optometrists, pharmacists, dentists and certain types of newly minted M.D.s, the prognosis is not so encouraging.

The article, “A Medical Education Bubble Market?,” is co-authored by David A. Asch, M.D. ’84, professor of medicine at the University of Pennsylvania, and Marko Vujicic of the American Dental Association.

A bubble market occurs when a good becomes overvalued because buyers are willing to pay higher prices in hopes of selling it for a greater payoff. The bubble deflates when the asset suddenly returns to a more reasonable intrinsic value, leaving buyers from the peak of the boom with something worth far less than what they paid.

In U.S. health care, medical education costs have risen sharply in recent decades, but medical school slots remain competitive in part because applicants believe their lucrative future wages justify taking on significant debt. But the economics have become much less favorable in the past 15 years, the authors found, based on debt-to-income ratio – the average debt of a graduating student compared to the average annual income of a newly employed physician in that field.

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“Debt-to-income ratios reflect what students must borrow rather than what they must pay and, given whatever other assets they may have, how much into the hole they have to go,” the authors write. “Thus, these ratios may better reflect how students actually feel about buying education.”

Family physicians and psychiatrists are the worst off their first year out of school: In 2010, their debt equaled about 85 percent and 80 percent of their yearly income, respectively. That’s roughly double the ratio new doctors in those same fields faced in 1996. Doctors in specialized fields fared much better: Orthopedists, cardiologists and radiologists held a debt-to-income ratio under 35 percent – only a slight rise from 1996 levels.

But the picture is far more troubling for other doctors. The ratio for new veterinarians climbed above 160 percent in 2010, with optometrists (130 percent), pharmacists (110 percent) and dentists (95 percent) not far behind. In fact, veterinary medicine may already be in a bubble market, the authors argue.

As long as physician salaries remain high enough to justify their debt burden, medical education should avoid a similar fate. But, the authors warn, “there are strong signs that we can’t or won’t … keep paying doctors a lot of money.”

The Affordable Care Act is funded largely by reduced Medicare payments to hospitals, part of a growing demand to cut U.S. health care costs. Doctors’ incomes, though sluggish, have been spared so far but could be targeted soon as more savings are sought.

“The main point we are trying to make is the connection between what we as a society are spending on physician services and how much medical schools can charge for tuition,” said Nicholson, professor of policy analysis and management in the College of Human Ecology. “If we are serious about reducing health care spending, then that means we also need to cut the cost of creating new doctors if we want to continue to attract the most promising applicants into the profession.”

The study was funded, in part, by the American Dental Association.

Source; Cornell Chronicle

Is Medical Education in a Bubble Market?

The costs of medical education must be reduced as part of efforts to rein in health care costs more generally, according to a Perspective published online this week in the New England Journal of Medicine. The currently high costs of medical education – which at some schools rise above $60,000 per year – are sustainable only if physician salaries remain high, which the authors, led by a physician from the Perelman School of Medicine at the University of Pennsylvania, say is less likely because of efforts to reduce health care costs.

 

Noting that students leave medical school with debt that often exceeds $150,000, the authors argue: “If we want to keep health care costs down and still have access to well-qualified physicians, we need to keep the cost of creating those physicians down by changing the way that physicians are trained. From college through licensure and credentialing, our annual physician-production costs are high, and they are made higher by the long time we devote to training.”

 

“People wonder whether we are in a bubble market in medical education,” says lead author David A. Asch, MD, MBA, Professor of Medicine and Director of the Center for Health Care Innovation at Penn Medicine.  In bubble markets, such as the recent US housing market and the dotcom bubble of 2000, prices rise based on speculation rather than intrinsic value, as people buy houses or stocks with the hope of reselling them to those with even more optimistic views of their valuation. When clearer thinking returns, those who haven’t sold are left having overpaid, holding an asset they cannot unload.  “In the case of medical education, students buy their education from medical schools and resell that education in the form of services to patients.  Medical education can remain expensive only so long as there are patients, insurers, and employers who are willing to pay high prices for health care. But if prices for physician services decline, then the cost of medical education will have to decline too, or people won’t be willing to pay for medical school in the first place,” Asch says.

 

The authors warn that high debt-to-income ratios drive students away from less financially rewarding fields.  “Debt-to-income ratios reveal how much a student has to go into the hole financially for education compared to what a graduating student might earn,” says Asch.  “For example, it costs approximately the same to become an orthopedist, psychiatrist, or primary care physician, but orthopedists earn much more.”

 

That might suggest that there is already a medical education bubble for psychiatry and primary care, but as bad as the debt-to-income ratios might be for those fields, they are even worse for some other fields outside of medicine.  The authors note that veterinary medicine is closer to a bubble market situation, which could burst when potential students recognize that the high costs of becoming a veterinarian aren’t matched by high income later.

 

Source: Penn News

Medical school program trains doctors for the future of medicine

Health care in America has changed drastically over the last decade – but the way doctors are trained has been the same for over 100 years. Now, some of the nation’s top medical schools are revamping their programs.

“Probably the single biggest reason was trying to prepare students for what health care was going to be like in a decade,” Dr. Charles Lockwood, dean of The Ohio State University (OSU) College of Medicine told FoxNews.com. “Because if you think the last 10 years have been quite a change, really when we begin to be able to sequence people’s entire DNA, and identify every conceivable illness that they’re going to have, and begin to design prevention along those lines ― it’s going to require a very different mindset for docs.”

Typically, medical students spend their first two years of medical school hitting the books, but at OSU’s College of Medicine, they’re trained as medical assistants in the first six weeks, and within eight weeks, they are seeing patients as health coaches.

“Working with patients in a service-type fashion early on in the curriculum is extremely valuable to the students ― it keeps them grounded in why they came to medical school,” Dr. Daniel Clinchot, vice dean for education at OSU’s College of Medicine said of the school’s new Lead. Serve. Inspire program. “Having your patient population that you work with over the course of 18 months is very unique, and I think really is inspiring for many of our students.”

Historically, American medicine has always centered around doctors, but a growing shift in health care delivery has put more emphasis on ensuring quality outcomes for patients.

“You have to do a lot more teaching of patients, you have to explain their illness, you have to explain all the options available for their therapy, you have to spend a lot of time talking about prevention,” said Lockwood. “Communication skills are something that are going to be critically important for the future doc, and that’s not something we’ve emphasized before in medical education.”

Advances in technology and a focus on prevention are just two of the health care changes that helped shape the new Lead. Serve. Inspire curriculum. All incoming medical students are given iPads and classes are available as traditional lectures, podcasts and e-learning modules.

In a state-of-the-art clinical skills center on campus, students can practice virtual laparoscopy and robotic procedures. And there are four critical care simulation bays with life-like mannequins that can mimic human illnesses and medical emergencies. From a control room outside the simulation area, instructors create scenarios that test the students’ ability to treat patients under pressure in the emergency room, operating room, trauma center and labor and delivery wing.

“I think the best thing about the simulations is that it helps you practice in a lower-stress environments than when you’re actually working with patients,” Shannon Emerick, a medical student at OSU’s College of Medicine, said. “You can kind of get the jitters out, and by pretending these are real patients, you can make sure you have everything straight by the time you’re working with actual people.”

Learning the business of health care is also at the core of the Lead. Serve. Inspire program. Health care economics classes are built into the curriculum, and students also have the option to minor in business or take time off to get their MBA to help them prepare to run a successful practice in the future.

“It’s crucial that they understand the cost of health care,” said Lockwood. “Every test that they order, they need to understand exactly what that costs, every imaging procedure, every test that they do has a cost, and they need to understand what it is, and is it absolutely necessary or is there another way to get that information?”

Source: Fox News

 

Five new paramedical courses started in Goa medical college

Goa chief minister Manohar Parrikar on Monday launched five paramedical courses in the Goa medical college and announced plans to set up an independent institute for these courses in the near future. Parrikar said paramedical courses are the government’s positive step in providing job-oriented education to Goan youth.

Shri Parikar was speaking after inaugurating the allied health science courses, affiliated to Goa University such as bachelor of physiotherapy, bachelor of occupational therapy, bachelor of optometry, BSc in medical imaging technology and BSc in anesthesia technology at Goa medical college and hospital, Bambolim. BSc in anesthesia technology will have 20 seats while the rest four courses have 10 seats each.

Parrikar said that better job prospects await graduates of such courses both within the country and outside, offering equal or more pay package than doctors. Paramedical personnel are very important now as doctors need to handle machinery that requires repairs at regular intervals, he said

Parrikar said he has been monitoring various problems affecting the GMC and that these problems will be sorted out within three to four months, adding that the 4-MLD effluent treatment plant will take care of the water woes of GMC.

Source: Times of India