Ensuring Educational QualityEnsuring Educational Qualityin a Universe of in a Universe of Expanding COMsExpanding COMs

Bruce Dubin, DOBruce Dubin, DOAssociate Dean for Medical EducationAssociate Dean for Medical Education

UNTHSC - TCOMUNTHSC - TCOM

Goal of Medical EducationGoal of Medical Education

The overall goal of basic medical education is toThe overall goal of basic medical education is to

produce broadly educated medical graduates withproduce broadly educated medical graduates with

an appropriate foundation for further training in anyan appropriate foundation for further training in any

branch of medicine including family medicine branch of medicine including family medicine

medical, surgical, investigational or other medical, surgical, investigational or other

specialties, as well as for careers in medical specialties, as well as for careers in medical

research, public health medicine or health serviceresearch, public health medicine or health service

administration.administration.

Has our quest for growth begun to Has our quest for growth begun to obscure our quest for quality?obscure our quest for quality?

1.1. What are we now and what do we want What are we now and what do we want to be in the future?to be in the future?

2.2. What are we known for?What are we known for?3.3. What do we want to be know for?What do we want to be know for?4.4. How will we know when we have How will we know when we have

arrived?arrived?5.5. How will the public and the people who How will the public and the people who

judge us know we have arrived?judge us know we have arrived?

ConcernConcern

Some may say that:Some may say that:

“ “ We’ve followed the money...and We’ve followed the money...and

the money has certainly been the money has certainly been

there”there”

Jordan Cohen, MDJordan Cohen, MD

AAMC Annual Meeting AAMC Annual Meeting

Washington, D.C., Washington, D.C.,

November, 2003.November, 2003.

Concerns about Opening New SchoolsConcerns about Opening New Schools

1.1. Do we really need Do we really need them?them?

2.2. Are we really looking at Are we really looking at the quality of the new the quality of the new programs?programs?

3.3. Are they just there as Are they just there as diploma mills?diploma mills?

4.4. Will they steal important Will they steal important resources from existing resources from existing schools?schools?

5.5. How will we judge new How will we judge new schools?schools?

6.6. How will the public and How will the public and others judge our new others judge our new schools?schools?

7.7. What value do new What value do new schools bring to the schools bring to the profession?profession?

8.8. Who is opening them up Who is opening them up and why?and why?

Mission and ObjectiveMission and Objective Measures of Quality Measures of Quality

1. What is the educational program designed to produce?1. What is the educational program designed to produce?2. How are students selected? What type of students are 2. How are students selected? What type of students are

they?they?3. How are the faculty and administrators selected?3. How are the faculty and administrators selected?4.4. What are the educational resources? Is education their What are the educational resources? Is education their

primary “business” or does the school merely exist to primary “business” or does the school merely exist to support a practice plan?support a practice plan?

5.5. How is the program evaluated and by whom?How is the program evaluated and by whom?6.6. What is the governance and the administration?What is the governance and the administration?7.7. How is the assessment of students carried out? What How is the assessment of students carried out? What

standards are used to carry out the assessment?standards are used to carry out the assessment?8.8. Is there a process for continuous quality improvement?Is there a process for continuous quality improvement?

What are the What are the Educational Resources?Educational Resources?

1.1. Do we really put our Do we really put our money where our money where our priorities are?priorities are?

2.2. Clinical training Clinical training spots in years III and spots in years III and IV?IV?

3.3. Post graduate Post graduate training spots?training spots?

How are the faculty andHow are the faculty andadministrators selected?administrators selected?

1.1. Are we relying on Are we relying on the “old boy the “old boy network” or are we network” or are we really selecting the really selecting the best faculty and best faculty and administrators to administrators to meet the educational meet the educational mission?mission?

2.2. Do we really train Do we really train our future faculty our future faculty and administrators and administrators for both our old and for both our old and new schools? If so, new schools? If so, How?How?

What is the educational program What is the educational program designed to produce?designed to produce?

1.1. Different schools Different schools have different have different missions and are missions and are designed to produce designed to produce different things. Do different things. Do we really understand we really understand that?that?

How are students selected? How are students selected? What type of students are they?What type of students are they?

1.1. The mission may The mission may reflect the type of reflect the type of student accepted.student accepted.

How does this How does this translate to translate to academic rigor?academic rigor?

2. Minority and 2. Minority and underserved underserved populations?populations?

What is the governance What is the governance and the administration?and the administration?

1.1. Is the governance Is the governance and administration and administration designed to meet designed to meet the current and the current and future needs of the future needs of the schools educational schools educational mission?mission?

What standards are used What standards are used to carry out student assessment?to carry out student assessment?

1.1. COMLEXCOMLEX

2.2. USMLEUSMLE

3.3. Residency programsResidency programs

4.4. Success of Success of graduatesgraduates

5.5. Location of Location of graduatesgraduates

6.6. How do we really How do we really measure success?measure success?

Is there a process for continuous Is there a process for continuous quality improvement?quality improvement?

How is the program evaluated, How is the program evaluated, and by whom?and by whom?

1.1. Should we have an Should we have an evaluation body evaluation body independent of the independent of the AOA? AOA?

2.2. Is the evaluation Is the evaluation process all that it should process all that it should be?be?

3.3. Is the evaluation Is the evaluation process as transparent process as transparent and as public as it and as public as it should be?should be?

Who Will Define Quality?Who Will Define Quality?

1.1. Our studentsOur students

2.2. Our patientsOur patients

3.3. Our communitiesOur communities

4.4. Local, State, and Local, State, and National accrediting National accrediting associationsassociations

5.5. HospitalsHospitals

6.6. The militaryThe military

7.7. Malpractice carriersMalpractice carriers

8.8. The Joint CommissionThe Joint Commission

9.9. The AOAThe AOA

10.10. AACOMAACOM

11.11. State legislatorsState legislators

12.12. Newspapers and the Newspapers and the MediaMedia

13.13. And the list goes on And the list goes on and on and on and on.and on and on and on.