Evaluation of effects of the W.K.Kellogg Foundation's five-year (1991-1996) primary care curricular change initiative involving 27 medical schools found 199 courses were revised or developed, involving 141 interdisciplinary faculty. There were significant increases in the number of students choosing to specialize in primary care. Results support…

Reviews the literature on educational curricular change and applies findings to change in medical school settings. Found a consistent set of characteristics in the following areas associated with successful curricular change; these include: organizational mission and goals, history of organizational change, politics, organizational structure, need…

Case studies explored issues between medical schools and parent universities and strategies used to resolve them, including changes in governance, organization, and management of medical schools (such as unified authority for health affairs, reengineered administrative systems, and increased autonomy in decision making). Concluded these strategies…

A project entitled Assessing Change in Medical Education at the Association of American Medical Colleges will study the degree and direction of changes occurring in medical education and compare them with recent recommendations made for change, examining the obstacles to change and assuming new strategies to promote innovation and improvement.…

Explores factors causing greater emphasis on qualitative variables in selecting medical students and assessing physician conduct. Outlines an admission model to aid in making this or other shifts in emphasis in a school's admission process, and to deal with the difficult issue of diversity in admissions. Last, gives an extended hypothetical…

A discussion of the McMaster University Doctor of Medicine program reviews key elements of its history and distinctive approach, describes the process and substance of curriculum change over the past decade, summarizes follow-up studies of graduates, and analyzes the current program context. (MSE)

The economic, social, and educational forces that have led to current health care reform proposals are outlined, the main proposals made to respond to these forces are noted, and ways in which academic medicine can change effectively to meet the reforms are examined. Risks to academic medicine are also considered. (Author/MSE)

It is proposed that the need for collaboration between physicians and nurses is increasing with new health care needs and delivery systems, and that practitioners and educators must help improve the relationship. The phenomenon of collaboration, reasons for promoting it, barriers to achieving collaborative relationships, and change strategies are…

Issues in balancing health services and costs in a changing society, where groups have differential access to health care, are discussed, including need for a universal health care system, growing cost of health care for the elderly, prolongation of life among older adults, and the claims of children on services. (MSE)

A discussion of the role of academic health centers in health care reform efforts looks at the following issues: balancing academic objectivity and social advocacy; managing sometimes divergent interests of centers, faculty, and society; and the challenge to develop infrastructure support for reform. Academic health centers' participation in…

Examines the alimentary metaphor (learning as ingestion) as applied to medical education, and suggests a different educational philosophy. Despite the "full plate" served to medical students, they are starving; fundamental curriculum reform should help physicians become healthy eaters, who feed themselves in appropriate amounts, maintain a healthy…

Students in a problem-oriented alternative medical curriculum at Michigan State University used the same problem-based methods for curriculum improvement that are used to solve clinical problems. Students worked with faculty toward constructive curricular revision. (MSE)

Examines the advice offered by David Cathell in his popular 1882 book, "The Physician Himself," and looks at parallels in more recent medical education history, including physician overcrowding, medical education, technological advances such as the telephone and automobile, and the sensitive issues physicians must address. Concludes that in any…

Further work is needed in identifying strategies to improve rural health services that are most appropriate and cost effective in regions with differing circumstances and needs. Substantial reform of payment systems favoring rural and primary care is essential to the effectiveness of educational reform. (Author/MSE)

Current problems in health care delivery, including inadequate access to care and high costs, and potential solutions are examined. Additional emphasis on health promotion and disease prevention, increased biomedical research, the dissemination and implementation of findings, and better physician preparation to deal with the problems are…