From Ana Berlin MD, Class of 2012:
In his 2011 address to Harvard Medical School graduates, Atul Gawande emphasized the importance of team-based performance skills and attitudes for young doctors entering the workforce. In order to adapt to the complexity and resource constraints of the health care environment, the long-held hallmarks of the physician—exhaustive factual knowledge, autonomy, self-sufficiency, individual performance, hierarchical world-view, and tireless devotion to work—must make way for problem-solving and interpersonal skills, humility and self-reflection, the ability to communicate and collaborate with others, a keen sense of empathy, and a healthy balance of life and work.
The undergraduate and graduate medical education communities have responded to the need to turn out practitioners prepared for their roles in a changed, and changing, health care system. Examples include competency-based educational requirements focusing on professionalism, systems-based practice, and interpersonal and communication skills; the use of learning portfolios to catalogue and critically examine the learning experiences that pave the way to competency; and the reframing of institutional learning objectives to include a more comprehensive and modern view of the functions and attributes that define effective practitioners in an increasingly complex, advanced, and resource-constrained system.
Now, at long last, the educational community’s responsiveness to the evolution of health care is extending to the undergraduate premedical level. Recognizing that the selection and training of doctors begins before they even set foot in a medical school, the Association of American Medical Colleges announced in February its final plan for overhauling the medical college admissions test (MCAT) that has been the gateway to medical school since the mid-20th Century. The thinking behind this change, due to take effect in 2015, is that added content on social and behavioral sciences, including measures of analytical ability related to ethical dilemmas and cross-cultural issues, will help medical schools select students with aptitude for success in the socially and organizationally complex health care system that is evolving around us—and that we, as public health professionals, are helping to shape.
The health care community and the public at large alike eagerly await the consequences of this shift. We hope that colleges and students will not get mired in the reactive, rather than reflective, mentality that continues to dog medical education, in which they teach, and study, to the test. At stake is the privilege of having the sort of physician workforce we all want to take care of us into our old age.
Ana Berlin, MD
Executive MPH Class of 2012
April 16, 2012