Just Imagine: New Paradigms for Medical Education

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Another great article from the same issue of Academic Medicine as “Medical Education Reimagined.” This article focuses on the shortcomings of our current system of medical education and offers a review of the current “disruptive innovations.”

The “second Flexner report”

The authors cite the 2010 publication “Educating Physicians: A Call for Reform of Medical School and Residency” as identifying 4 goals to improve medical education:

  1. Standardization of learning outcomes and individualization of the learning process
  2. Integration of formal knowledge and clinical experience
  3. Development of habits of inquiry and innovation
  4. Focus on professional identity formation

Shortcomings and problems

“For all of it’s traditional successes, the current model of medical education in the United States and Canada is being challenged on issues of quality, throughput, and cost, a process that has exposed numerous shortcoming… A radical change in direction is required because the current path will not lead to a solution.”

This article doesn’t hold back any punches and list several key shortcomings in the current system including:

  • “Arcane assessment methods
  • Learning focused on test performance
  • Lack of direct observation
  • Lack of knowledge assessment or problem-solving ability
  • Productivity pressures faced by faculty
  • Inattention to improving residents’ teaching skills
  • Gaps in trainees’ clinical exposure
  • Unmet need to train more physicians
  • Medical student debt

Disruptive innovations

“In an ideal future state, all students would experience every essential inpatient and ambulatory clinical experience, would be observed during these encounters, and would receive formative feedback on such interactions to guide them in improving their knowledge, skills, and socialization to the profession.”

Several of the disruptive innovations now available to use are:

  • Flipped classrooms – eLearning content frees up class time for active learning
  • Massive open online courses (MOOCs) – 24/7 access to low cost, collaborative courses forstering “knowledge duplication”
  • Digital badges – electronic images and tracking that can follow learners through their lifetime

The authors’ vision is to achieve the goals set forth by the “second Flexner report” by transforming medical education with disruptive technologies. 

We are living in exciting, “disruptive” times and I look forward to see how the re-imagining of medical education will change us.


Cooke, et al. “Educating Physicians: A Call for Reform of Medical School and Residency.” San Francisco, CA: Jossey-Bass; 2010

Mehta, et. al. “Just Imagine: New Paradigms for Medical Education.” Academic Medicine. 2013; 88(10)

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