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WHY DID THE AMERICAN MEDICAL ASSOCIATION (AMA) NOT CALL FOR A NEW TYPE OF MEDICAL SCHOOL AND CURRICULUM IN 2006, INSTEAD OF JUST A 20 PERCENT INCREASE IN NUMBERS?
Case Study Redesigning Futures: The First-Ever Engineering-Driven College of Medicine Phyllis M. Wise One of society's greatest challenges today is to improve healthcare for more people at lower cost. To meet this challenge, physicians cannot continue to be trained in the same way they have been trained in the past. Instead, biomedical scientists, engineers, physical scientists, innovators, and physi- cians-nontraditional partners - must come together to develop dramati- cally different models of medical education. This collaboration will lead to the modernization of medical education and to higher-quality education, which in turn will lead to better healthcare. During the 1980s and 1990s, few new medical schools were estab- lished in the United States. In 2006, growing concern over physician short- ages led the American Medical Association to issue a statement calling for a 30 percent increase in medical school enrollment. Since then, more than 20 new medical schools have been founded. These new medical schools have addressed the need for more physicians, but none of them has considered the proposition that a different kind of physician will be required to solve the challenges of our global healthcare needs. The University of Illinois at Urbana-Champaign, in partnership with the Carle Health System, has addressed that set of needs by instituting a distinctive, groundbreaking, engineering-driven college of medicine that redesigns the education of doctors and thus the delivery of healthcare. The new college brings together seemingly different disciplines and part- ners in ways that have not been possible in a traditional medical school environment. The bold and innovative vision of the new Carle-Illinois College of Medicine is to establish the first research-intensive college of medicine to focus expressly on the convergence of engineering, technology, Big Data, and healthcare. Because this was not a retrofit or add-on to an existing enterprise, it integrated these elements from the beginning. Both the university and the system were at critical junctures in their strategic plans that made the creation of a new college appropriate at this time in their respective histories. The university is a member of the (continued)
prestigious Association of American Universities, a society of public and private research universities. One-third of the faculty in the university's internationally respected College of Engineering were already involved in biomedical and systems engineering research. Many bioengineers were not actually in the department of bioengineering but spread out in different departments in different colleges across the campus. The system-comprising the Carle Foundation Hospital, Carle Phy sician Group, and Health Alliance Medical Plan- is a vertically integrated healthcare delivery system. It is in the middle of a major recruitment cam. paign, hiring 150 physicians and physician-scientists, many of whom are involved in the Carle-Illinois College of Medicine. The hospital is ranked in the top 10 percent of hospitals in Illinois. In 2016, its combined outpatient and inpatient visits ranked among the highest volumes in the state. The university and the system are the largest and second-largest employers, respectively, in the micro-urban town of Urbana-Champaign. The establishment of Carle-Illinois College of Medicine was the result of a comprehensive and collaborative process. It was a thorough, extensive, consultative, and thoughtful planning process that involved hundreds of university faculty members, system physicians, and external consultants as well as many community leaders in Urbana and Champaign. The first goal is to transform the education of physicians by providing graduates with a distinctive degree in medicine. An inaugural class has been admitted for fall 2018. The university and the system had the opportunity to design a new paradigm for medical education, research, and the delivery of care from the ground up. Faculty and physicians designed a totally new medical curriculum. Each course was developed and will be taught by a team of faculty that includes basic scientists, physicians, and engineers. The new curriculum infuses principles of engineering, technology, Big Data, and innovation into all courses as a road map to the future of medicine. The curriculum emphasizes analytical thinking and problem solving and will include clinical immersion in all four years. This is being done, in part, through interdisciplinary team-based, innovative approaches to achiev- ing improved healthcare outcomes. One of the most important aspects of the curriculum is that students will be introduced to the clinical environ ment from the beginning. Principles of engineering will be introduced into all cases and the treatment of disease. The future physician-discoverers, physician-innovators, and physician-engineers who will train in the college of medicine will be encouraged to cocreate new devices, medications, tech- nologies, and more with faculty mentors while they are students. Thus, this collaboration will create a new culture in medical education and practice.
The future professionals will advance care delivery far beyond what can currently be imagined. Not only will their patients benefit, but the impact they make will also extend to countless others who will be healthier as a result of their medical discoveries. The second goal is to redesign healthcare, taking full advantage of current and future discoveries in engineering, technology, and Big Data. Advances in these areas are driving medical breakthroughs. The future of precision medicine lies in discovering new sensors, materials, and devices as well as new uses for robotics, miniaturized imaging, Big Data, and remote monitoring and then applying these innovations to medicine and healthcare. The complex system for delivering healthcare services will draw on medi- cal systems engineering. Graduates will advance patient care and develop dramatic technologies to deliver higher-quality healthcare to more people at lower cost.