Barzansky Barbara, Etzel Sylvia I
Division of Undergraduate Medical Education Policy and Standards, American Medical Association, Chicago, Ill 60610, USA.
JAMA. 2003 Sep 3;290(9):1190-6. doi: 10.1001/jama.290.9.1190.
To better provide medical students with the knowledge, skills, attitudes, and values they will need as physicians, US medical schools continue to make ongoing changes to their staffing and curricula.
To review the status of US medical education in the 2002-2003 academic year, compared with 1997-1998.
The Liaison Committee on Medical Education (LCME) Annual Medical School Questionnaire, the Association of American Medical Colleges (AAMC) Databook, and the AAMC Data Warehouse: Applicant Matriculant File. Data evaluated included those on medical school faculty, applicants, and students; curriculum hours devoted to new multidisciplinary or nontraditional subject areas (eg, cultural diversity, evidence-based medicine, medical ethics, medical informatics); and methods used to evaluate student learning.
The number of full-time faculty members in the 126 LCME-accredited medical schools increased from 96 773 in 1997-1998 to 109 526 in 2002-2003 (+13.2%). The number of applicants entering decreased from 43 016 in 1997-1998 to 33 625 in 2002-2003 (-21.8%). The number of enrollees remained virtually unchanged from 1997-1998 (66 748) to 2002-2003 (66 677). Most medical schools have incorporated new subject areas into their curricula, although time devoted to these areas varies across schools. Schools typically use written examinations (National Board of Medical Examiners subject tests and/or internally prepared examinations) to assess factual knowledge, and observations by faculty members and residents to assess clinical skills. Use of standardized methods (eg, an objective structured clinical examination [OSCE]) to assess clinical skills is variable; 82 schools use a final third- or fourth-year comprehensive OSCE; 53 require a passing OSCE score for graduation.
While the number of applicants to US medical schools has continued to decline, student numbers are constant. The number of full-time faculty members has increased. Schools are incorporating new subject areas into their curricula, and the use of standardized methods of assessing clinical skills, while variable, is generally increasing.
为了更好地向医学生提供他们未来作为医生所需的知识、技能、态度和价值观,美国医学院校持续对其师资配备和课程设置进行调整。
与1997 - 1998学年相比,回顾2002 - 2003学年美国医学教育的状况。
医学教育联络委员会(LCME)年度医学院调查问卷、美国医学院协会(AAMC)数据手册以及AAMC数据仓库:申请人录取档案。评估的数据包括医学院教员、申请人和学生的数据;用于新的多学科或非传统学科领域(如文化多样性、循证医学、医学伦理学、医学信息学)的课程时长;以及用于评估学生学习的方法。
126所经LCME认证的医学院全职教员数量从1997 - 1998年的96773人增加到2002 - 2003年的109526人(增长13.2%)。入学申请人数量从1997 - 1998年的43016人减少到2002 - 2003年的33625人(减少21.8%)。从1997 - 1998年(66748人)到2002 - 2003年(66677人),入学人数基本保持不变。大多数医学院已将新学科领域纳入其课程设置,尽管各学校用于这些领域的时间有所不同。学校通常使用书面考试(美国医学考试委员会科目考试和/或校内自行组织的考试)来评估事实性知识,通过教员和住院医师的观察来评估临床技能。使用标准化方法(如客观结构化临床考试[OSCE])评估临床技能的情况各不相同;82所学校在三年级或四年级末使用综合OSCE;53所学校要求毕业时OSCE成绩合格。
虽然申请进入美国医学院的人数持续下降,但学生人数保持稳定。全职教员数量有所增加。学校正在将新学科领域纳入课程设置,并且评估临床技能的标准化方法的使用虽然各不相同,但总体上呈增加趋势。