Does memorization really prepare medical students for healthcare today?

America's long-standing model of preparing medical students for real-world patient care has been highly criticized on various levels. Primarily, critics argue the model forces students to memorize high volumes of often outdated information with little to no attention to social determinants of health.

"How many times have you used the Krebs cycle lately?" tenured physicians often joke, according to John Henning Schumann, MD. The Krebs cycle, the product of Sir Hans Adolf Krebs', MD, Nobel-prize winning work on cellular metabolism, is a perfect example of the information medical students are forced to memorize but hardly use, Dr. Schumann wrote in an NPR blog.

The biomedical model of medical education, largely centered on the century-old document The Flexner Report does not include non-medical social determinants of health — such as poverty, housing, nutrition and other factors — that are essential for successful population health management. According to Dr. Schumann, Abraham Flexner, who developed the Flexner report, was an educational theorist with no medical training.

According to many professionals and observers in the medical field, "medical students should be taught on their ability to find, assess and synthesize knowledge. And they should be educated in teams to help prepare them for what goes on in the real world," Dr. Schumann wrote.

Dr. Schumann said it took more than a decade for him to realize he should ask patients about hunger, after which he learned many of those he cared for struggled with food security. Many in the medical field may be left wondering what exactly they can do about these social issues without crossing into the field of social work. However, Dr. Schumann said by integrating a social mission into medical education, physicians can attain the awareness and tools necessary for identifying and addressing social determinants of health to create better health outcomes.

At the Beyond Flexner conference held in Albuquerque, N.M., in early April, more than 400 medical educators, activists, policymakers and students were in attendance to discuss ways to change the model of medical education to incorporate social health and team-based strategies. While many medical schools are seriously engaged in this idea, there are obstacles. For one, health systems still largely prioritize quantity of care provided than quality. Despite this, there is a strong sense of optimism that recent changes — such as CMS' decision earlier this year to base future payments off of quality and value over volume — will place the health system and medical education on the tracks toward change.

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