March 18, 2011
David Mou, Aartik Sarma, Roshan Sethi, and Reid Merryman
D. Mou, A. Sarma, R. Sethi et al., "The State of Health Policy Education in U.S. Medical Schools," New England Journal of Medicine, March 10, 2011 364:e19.
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During their first year of medical school, the authors completed a comprehensive, mandatory course on health policy. However, they learned theirs was not a common experience. To learn more about the current state of health policy education, the authors—with support from The Commonwealth Fund—surveyed U.S. medical school deans.
What the Study Found
- Ninety-four percent of schools reported some form of policy education, but there was significant variation in the amount of coursework; over four years, the average amount of instruction was 14 hours.
- Nearly 24 percent of schools required students to take a class whose primary topic was health policy, while the remainder offered health policy education in a mandatory class with a broader focus.
- Most deans (58%) reported their school currently has "too little" health policy education.
- Deans considered quality improvement to be the most important health policy topic related to medical education, followed by health costs, Medicare and Medicaid, health care reform, and physician reimbursement and insurance design.
- Barriers to integrating health policy into medical education included curricular flexibility and faculty interest.
- More than half (52%) of schools reported they are currently in the process of increasing health care policy education.
Based on their experience, the authors recommend case-based, small-group discussions as a complement to lectures to promote dialogue among students. "Health policy literacy," they conclude, "should no longer be considered an ancillary skill, but rather a core competency of a 21st-century physician."