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ACGME Duty Hours Standard Spark Regulatory Debate What's in a Name? Philanthropists' Donations Giving New Names to Medical Schools Proposed New Clinical Exam Draws Cost, Efficacy Concern Leadership Q & A: A Pioneer Looks Back - And Ahead
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Leadership Q & AA Pioneer Looks Back - And Ahead
Norma E. Wagoner, Ph.D., led the group that started the AAMC's Women in Medicine Program in 1977.Q: How has medical education changed since you began your career?A: From 1972, when I began my career, to the present, the diversity of the student body has altered significantly, including a much greater number of women and minorities. The number of students entering medical schools has increased dramatically. In addition to the sheer numbers of women in medical school, we have observed several specialties - obstetrics and gynecology being the most evident - shift from being male- to female-dominated. In the mid-'70s, the Bakke case set precedence for minority admissions, and the challenges to affirm- ative action issues have varied over the past thirty years. As the applicant pool brought in three candidates for every medical school slot, many U.S. students went abroad for their medical education. The National Board of Medical Examiners (NBME) has gradually shifted to testing conceptual knowledge rather than memorized information. As these changes occurred, more students began to fail. Q: What are your perceptions of the major trends in medical education over the last 30 years?A: With the massive infusion of knowledge created by the revolution going on in science, more and more information has been added to the curriculum. Unfortunately, schools have had little success in discarding the old curricular material, and the trend has been to place more burden of responsibility on the student to acquire new knowledge. Advances in technology have by far outstripped medical school's abilities to creatively use it as a tool for educational purposes. While students can obtain many lectures online and access any number of computer assisted educational programs, there is still have a long way to go in providing a full range of e-learning tools for students. Q: How have medical students' values and characteristics evolved, and what is important to students today?A: I believe medicine and medical education in the U.S. were founded on the Christian work ethic: a delayed gratification and unremitting toil model. Clearly, young people entering medicine today with changed values find themselves in substantial conflict with medical school faculty who still operate on that 200-year-old model. The LCME and now the ACGME have lent support to the importance of teaching and assessing professionalism. Many of us who have worked to promote the values of professionalism have found that words like "altruism" and "commitment," which are at the very heart of the definition of professionalism, don't carry the same meaning across generations. This is a conundrum yet to be solved. Q: How can medical schools ensure they are meeting the needs of their students?A: Unfortunately, schools make the assumption that there is only one way to learn, while the literature tells us that at least a half dozen methods of learning exist. Giving the student a chance to learn using his or her preferred style will ensure greater mastery of material. Because many students enter with limited experiences in holding positions of responsibility, medical schools need to encourage them to assume responsible roles in school and community-based programs, where they can work alongside administrators and faculty. Bringing them into partnership as professional colleagues is more important now than ever. Q: Women are assuming more prominent roles in medical education. Are you encouraged by women's progress?A: We have seen an impressive number of women faculty members populating medical schools at both the basic science and clinical levels. Many women now hold positions as assistant and associate deans, which is encouraging. But there are an ever- decreasing number of medical schools who report no women chairs. The ranks of women at the full dean's level remain around the 10 percent level and have done so for many years. I have often asked myself if more men or women will want to invest the time, energy and sacrifice that is required to become a dean. The myth of "having it all" is dying hard, and when it comes down to making a choice, I believe that women (and many men as well) may full well opt for time with their families rather than the "prestige" of being a dean. |
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