Changes in Medical Education

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Community College of Allegheny County *

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FPX4003

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Medicine

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Dec 6, 2023

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1 Changes in Medical Education Connie Osiecki Capella University BHA-FPX4002: History of the United States Health Care System Dr. Shad Smith November 2023
2 Changes in Medical Education The landscape of medical education has dramatically changed from the 1800s to today. In the 1800s, most medical students never attended college, and some barely knew how to read or write. Medical support staff was non-existent; therefore, doctors practiced alone and collected payments themselves. By the mid-century 1900s, medical schools grew, but their diplomas were considered licenses (Young, 2017). There were support staff as well, such as nurses and secretaries. Fast forward to the 2000s, we have multiple types of physicians, specialists, and medical support staff, and the education dramatically differs depending on the level of the support staff. Apprenticeship Model vs. Academic Model Description and Comparison of Both Models Most of our early history of the healthcare profession had few regulations for education. Providers were primarily "learned gentlemen" with few effective practical skills (Groccia & Ford, 2020). After the war in 1812, medical schools were rapidly increasing, but education needed to be more consistent. Moving into the 1900s, the American Medical Association (AMA) helped restructure medical education as physicians had to complete apprenticeships. The apprenticeship system incorporated hands-on instruction from a practitioner and involved supervision as they learned as medical students. The apprenticeship system grew due to the World Wars, as there were shortages of medical staff due to men being out fighting for the country. The AMA suggested students complete a minimum of one year in college (Numbers, 2014). Despite the efforts of the AMA's attempt to standardize medical education, it was Flexner
3 who helped reform medical education. Apprenticeships were just the building block of the academic model. The academic model was an era where strict adherence to medical education was a must. Doctors wanting the ability to practice medicine came with having to do four years of a medical school curriculum, two years of basic science education, followed by two requirements, including a high school diploma and a minimum of two years of college science (Groccia & Ford, 2020). Flexner proposed this medical school curriculum, and only 66 medical schools survived the reform. In addition to medical schools being reformed, they also partnered with hospitals, enhancing the student experience. Once the academic model was in place, medical schools started standardized testing for admission. The standardized testing was called the Medical College Admission Test (MCAT). The development of the MCAT was a significant step in the beginning of the quality of medicine (Groccia & Ford, 2020). Analysis of Evolution and Impact The apprenticeship model, being the backbone of the academic model, proves the quality of medical education has grown very strictly as healthcare demands continue to grow exponentially. Healthcare, from no medical education to strenuous and vigorous training of years of ongoing medical education, has an enormous impact on the survivors of sickness and diseased patients. In the 1900s, an apprenticeship with another practicing physician was better than no medical education in the early 1800s, proving that science education helped sustain and keep patients alive. The evolution of medical education continues to address the vulnerabilities and inefficiencies in healthcare. Continuous medical education is essential to caring for complex patients, as well as non-complex patients. Once medical schools became standardized and a high school diploma, as well as a higher education, was mandatory, the quality of healthcare became considerably better, and deaths became significantly lower. The academic model has continued to
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4 have a considerable impact in modernizing medical education. As we move forward into the future, the healthcare industry is doing more scientific research. The healthcare field continues to learn and grow from this research, allowing those going into the medical field to learn and grow. Importance of Understanding History of Medicine It is essential to learn and understand the development of medicine to improve upon the mistakes and achievements that happened in the history of science. Understanding how the history of medicine has paved the way to some of the most critical aspects of healthcare is eye- opening. Learning the history of medicine broadens our knowledge and helps us make better judgments on our future in the healthcare field. In the healthcare field, there are always different perspectives, strengths, weaknesses, and achievements, but the main focus of medicine stays the same. Learning and understanding the history of medicine, where many developments from prevention to medical equipment used for treatment have occurred, only makes the clinician more knowledgeable. This knowledge is powerful as clinicians have done research and studies to bring modernization to the history of medicine and continue to learn new strategies to care for patients. Conclusion In conclusion, the history of medical education has shown how we have gone from having physicians with no training caring for patients to an apprenticeship to in-depth, ongoing training for as long as the physician holds a license. The American Medical Association (AMA) and Flexner proved that education was crucial and helped reform and standardize medical education. The more knowledge we have, the better patient outcomes there are. Having trained support staff in the healthcare field has also proven vital as it enables physicians to be more
5 efficient in handling the volume of patients we see today. The support teams involved with patient care continue to make a massive impact on the population's health, as well as the trust and commitment you need between the patients and clinicians. Continuous learning for all support staff, clinical or non-clinical, is important to stay current on the improvements in medicine, new equipment, and research developments that consistently happen in the medical field.
6 References Numbers, R. L. (2014). Medical Education. In H. Slotten (Ed.), The Oxford Encyclopedia of the History of American Science, Medicine, and Technology. Oxford University Press. Retrieved October 31, 2023, from https://search.credoreference.com/articles/Qm9va0FydGljbGU6NDgxODE5Ng==? aid=107300 . Groccia, J. E., & Ford, C. R. (2020). Preparing the Academy for the Evolution of Healthcare Education. New Directions for Teaching & Learning, 2020(162), 13–30. https://doi-org.library.capella.edu/10.1002/tl.20388 Flexner, A. (2002). Medical education in the United States and Canada. Bulletin of the World Health Organization, 80, 594-602. http://www.carnegiefoundation.org/eLibrary/docs/flexner_report.pdf Young, K. M. (2017). Sultz & Young's Health Care USA (9th ed.). Jones & Bartlett Learning. https://capella.vitalsource.com/books/9781284142099
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