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February 2002 Reporter

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A Word from the President

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A Word From the President

The Legacy of MSOP

Photo of Jordan J. Cohen, M.D. In November 1997, I used the occasion of my address to the AAMC's 108th annual meeting to exhort leaders in academic medicine to heed the urgent call for curricular reform due to my concern that academic medicine was moving away from one of its core missions - quality medical education - under pressure from growing demands for clinical productivity, increasing patient loads under managed care, and mounting budgetary constraints. I also used that occasion to introduce the draft set of objectives from the first report of the Medical Schools Objectives Project (MSOP), an initiative launched by the AAMC in January 1996. MSOP was created in response to mounting evidence that few medical schools had a clearly articulated, comprehensive set of learning objectives for their students. In my address, I asked the fundamental question that drove MSOP's initial phase and has served to guide it over the years: What knowledge, skills, attitudes, and values should each medical student be expected to demonstrate upon graduation?

The four principles articulated by the first MSOP advisory group - that physicians must be altruistic, knowledgeable, skillful, and dutiful - have, I am pleased to say, been invoked countless times by the many medical schools embarking on wide-scale curricular reform over the past six years. Those years have seen an unprecedented flurry of activity in medical schools seeking to reinstate and reaffirm their commitment to quality scientific and humanistic medical education. Educators and administrators have repeatedly turned to the five MSOP reports to guide their efforts in the areas addressed by MSOP's distinguished expert panels: medical informatics, population health, communication in medicine, quality of care, and basic science and clinical research.

Upon hearing about MSOP, many academic medicine leaders contacted the AAMC to express their interest in becoming involved with the project. By the time the first report was issued, an MSOP Consortium consisting of 24 schools was working to develop methods for medical schools to evaluate and share their curricular reform activities.

As we begin to evaluate the impact of the MSOP initiative on medical school education, I am heartened by the indices of its widespread implementation. While it is impossible to accurately gauge the number of students whose medical education experience has been directly or indirectly affected by MSOP, there is overwhelming anecdotal evidence indicating that it is substantial.

In 1998, the AAMC Division of Medical Education, which spearheads the MSOP initiative, quickly ran out of the 10,000 copies it printed of its first report. To appease demand (and save printing costs!), it was printed in Academic Medicine in January 1999, one year after its original issuance. Since then, it has been cited in the pages of Academic Medicine and other peer-reviewed journals more than 20 times. The four subsequent reports also remain in great demand.

In September 2000, before the fourth and fifth MSOP reports on quality of care and basic science and clinical research were published, Academic Medicine published a 460-page "Snapshot of Medical Students' Education at the Beginning of the 21st Century: Reports From 130 Schools." This supplement to the AAMC's peer-reviewed journal on medical education sought to assemble into one comprehensive publication an unprecedented collection of individual institutional reports on curricular structure and change.

Compiled from the answers to a set of questions sent to all U.S. and Canadian medical school deans, the "snapshot" contains frequent allusions by medical schools to MSOP, indicating that they used the reports' objectives as blueprints for formulating desired outcomes for their graduates. Schools from UMDNJ-New Jersey Medical School, which modified and subsequently adopted MSOP's objectives as its template for curricular revision, to Vanderbilt University School of Medicine, which combined MSOP's objectives with its own to identify a total of 30 objectives for its educational program, indicated the central role of the MSOP initiative in their curricular revisions.

The AAMC's use of evolving technology has further facilitated the implementation of MSOP objectives through its Curriculum Management and Information Tool (CurrMIT), an online program that allows individual medical schools to manage their own curriculum databases and combines each school's information into a national data system. By allowing schools to align their curricular objectives with the ones set forth by MSOP, CurrMIT has become a convenient tool for schools to utilize MSOP reports as they are intended - blueprints against which to evaluate their own curricula.

The MSOP initiative is the longest sustained general curriculum reform project ever conducted in the United States. If it has not been the direct catalyst, it has clearly brought to the attention of the medical education community the importance of continually evaluating and improving the curricula that will direct the learning of tomorrow's doctors. To keep pace with the ever-evolving field of medicine, MSOP will continue its work with a report on genetics education scheduled for release in 2002. While this will most likely be the final MSOP report, its continued success will be the legacy of curricular reform it has inspired and continues to direct.

Jordan J. Cohen, M.D.
AAMC President