Recruiting & Training Medical Students for a Realigned, Team- based & Outcome Driven Health Care System Barbara Tobias, MD University of Cincinnati Academic Health Center James Tysinger, PhD UT Health Science Center at San Antonio Beat Steiner, MD, MPH University of North Carolina Chapel Hill

Our Goal: 1)Highlight strategies to better prepare students 2)Use three seminal works as point of departure STFM Conference on Medical Student Education Plenary: Educating Leaders and Followers for Health System Improvement. Kevin Grumbach, 2012 The Commonwealth Fund: Guiding Transformation: How Medical Practices Can Become Patient-Centered Medical Homes: Edward Wagner, Katie Coleman, Robert Reid, Jonathan Sugarman, 2012 The Carnegie Foundation: Educating Physicians The Call for Reform of Medical School and Residency. Molly Cooke, David Irby, Bridget O’Brien, )Draw on creative input from group

Session Outline What do we mean by a “Realigned, Team-based & Outcome Driven Health Care System”? – Tobias How does the admissions process need to change to recruit appropriate students? – Tysinger How does medical school training need to change to adequately prepare students? – Steiner

4 Questions What are they key characteristics of successful clinicians in this changing landscape? How do we identify them in our applicants and learners? How do we build curricula to support these? What are our gold standards?

Part I. A Realigned, Team-based & Outcome Driven Health Care System Seven Joint Principles of PCMH Training in patient-centered team-based clinical systems Alignment on PCMH standards:  Enhance access and continuity  Identify and manage patient populations  Plan and manage care  Provide self-care and community support  Track and coordinate care  Measure and improve performance

Crosswalk PCMH Joint Principles Physician directed medical practice Physician led team? NCQA Standards Enhance Access/Continuity Element G The Practice Team Ohio PCMH Curriculum Students will recognize the imptc of team approach Lead a transdisciplinary team mtg (?)

Part II. Redesigning the Admissions Process Assess applicant’s Intrapersonal and Interpersonal Academic and Personal competencies in admissions Consider Multiple mini-interviews Admit a more diverse group of students by SES  2011 applicants: 76.5% attended a research intense school and most applicants are from high SES Reform MCAT: New sections in 2015  (1) Psychological, Social and Biological Foundations of Behavior and (2) Critical Analysis and Reasoning Skills

Part III. Rethinking Medical Student Education “Flexner II” (Cooke, Irby, O’Brien 2010) Standardization and Individualization Integration Innovation and Improvement Professional Identity

Part III. Rethinking Medical Student Education Entrustable Professional Activities (EPAs)

Part III. Rethinking Medical Student Education Standardization and Individualization IntegrationInnovation and Improvement Professional Identity Enhance access and continuity Identify and manage patient populations Plan and manage care Provide self-care and community support Track and coordinate care Measure and improve performance

Part III. Rethinking Medical Student Education Standardization and Individualization IntegrationInnovation and Improvement Professional Identity Enhance access and continuity Identify and manage patient populations 1 Plan and manage care 2 Provide self-care and community support Track and coordinate care Measure and improve performance 3

Part III. Rethinking Medical Student Education 1:Identify and manage patient populations/ Standardization & Individualization EPA: Combine and prioritize guidelines for patients with multiple chronic illnesses 2:Plan and manage care/ Professional Identity EPA: develop a plan of care with students from other disciplines 3:Measure and improve performance/ Integration EPA: Access and interpret performance data

Recruiting & Training Medical Students for a Realigned, Team-based & Outcome Driven Health Care System: Questions for Discussion How does Family Medicine become the gold standard? What are you doing at your institution? How can Family Medicine take a leadership role at your institution? What are our faculty development needs in this area?