Transformation in Medical Education (TIME):
A multi-institution initiative within the UT System
TIME INITIATIVE
Inception
UT System President’s Retreat in 2009 Presentation by George Thibault, MD,
President, Josiah Macy Jr. Foundation
AIM
To increase the effectiveness and relevance of predoctoral physician education
while shortening its duration.
TIME INITIATIVE - WHY NOW?
The current physician education continuum is:
- Long
- Expensive
- Average medical school debt >$140K
- >40% have premedical + medical debt >$150K
- Restricted in focus
- Science firmly established
- Additional knowledge, skills needed
- Discontinuous
- Poor coordination among premedical, UGME, GME, CME
Calls/blueprints from multiple national organizations:
- Institute of Medicine (2003)
- AAMC–Macy Foundation (2008)
- HHMI–AAMC science competencies (2009)
- Carnegie Foundation, Flexner Centennial (2010)
Other changes afoot:
- Fifth MCAT review (MR5) Current
- Comprehensive Review of USMLE Current
TIME INITIATIVE - New model of predoctoral physician education
Four principal elements:
1. Pre-Health Professions Program
- Early college year(s)
- Interprofessional education
- Work in teams
- Science and healthcare delivery content
- Academic, clinical, community service
- Assessment of non-cognitive characteristics
2. Competency-based education
- Advancement: demonstration of competencies
- Application of knowledge
- Clinical skills
- Procedural skills
- Allows multiple entry points
- Key role of assessment
- Frequent
- Formative and summative
- Reliable, valid
- “Nominal” duration: 6 or 7 years
3. Professional identity formation
- Not strictly a competency
- Developmental / maturational
- Intentional development:
- Experiences
- Reflection
- Mentoring
- Assessment?
4. "Non-traditional” topics
- Medically-related, eg:
- Humanities
- Patient Safety & Effectiveness
- Public health
- Evidence-based practice
- Non-medical, eg:
- Philosophy
- Economics
- Language and culture
- Engineering
TIME INITIATIVE - Regental "jump-start"
Funding provided for development, proof of concept
Two RFP's:
1. Pilot Curriculum Development
- Undergraduate—Medical School partnerships
- Parallel, comprehensive curricula
- Proof-of-concept implementation, data gathering
- Pilot curricula launch by Fall 2013
2. Shared Resources Development
- Instruction, assessment tools
- Related to common needs across pilots
TIME INITIATIVE - Pilot program partnerships
Six General Academic Institutions
Four Health-Related Institutions
Four partnerships:
A-PRIME: Accelerated Professional, Relevant, Integrated Medical Education
UT Brownsville—UT El Paso—UT Pan Am—UTMB—UTMS-H
FAME: Facilitated Acceptance to Medical Education
UT San Antonio—UTHSC-SA
PACT: Partnership in Advanced Clinical Transition
UT Dallas—UT Southwestern
SHAPE: UT-Southwestern, Houston, Austin Professional Education
UT Austin—UT Southwestern—UTMS-Houston
TIME Initiative - Directions
- Each pilot program & curriculum will be unique
- Educational priorities of partner institutions
- Institutional values and practicalities
- Adopt a common competency framework
- Facilitate sharing of assessment, instructional materials
- Identify common milestones at undergrad—medical school transition
- Promote scalability across schools beyond pilot stage
- Continued consultation with national, international thought leaders
- External evaluation
TIME Initiative - Steering Committee
Mike Ainswort, Associate Dean, Educational Affairs (UTMB-Galveston)
Andy Blanchard, Vice Provost (UT Dallas )
Don Bobbitt, Provost and Vice President, Academic Affairs (UT Arlington)
Patricia Butler, Senior Associate Dean, Educational Programs (UTMS-Houston)
C. Nanette Clare, Senior Associate Dean, Academic Affairs (UTHSC-San Antonio)
Luis Colom, Vice President of Research (UT Brownsville)
Susan Cox, Associate Dean for Medical Education (UTSWM)
M. Lynn Crismon, Dean, College of Pharmacy (UT Austin)
Donna Ekal, Associate Provost (UT El Paso)
Susan Franzen, Director (UT System Leadership Inst.)
George Perry, Dean, College of Sciences (UT San Antonio)
Gary Rosenfeld, Assistant Dean, Educational Programs (UTMS-Houston)
William Sage, Vice Provost, Health Affairs (UT Austin)
John Trant, Dean, College of Science and Mathematics (UT Pan American)
Co-Chairs:
Steve Lieberman, Vice Dean, Academic Affairs (UTMB-Galveston)
Pedro Reyes, Associate Vice Chancellor, Academic Planning (UT System)