Friday, May 24, 2013

Future Medical Education in prospect with current and past Healthcare System



 An Overview
Future Medical Education
in prospect with
current and past
Healthcare System


Table of Contents
1.       Abstract
2.       Introduction
3.       Why Medical Education
4.       History of Medication Education
5.       States of Medical Education
a.       Historical Developmental State
                                                               i.       Initial and 18th Century Advancements
                                                             ii.      19th and 20th Century Advancements
b.      Present State of health Care Delivery
6.       Specific Challenges of Medical Education
7.       Medical Education System of Future
8.       American Healthcare Prospects of Medical Education
a.       Healthcare Funding
b.      Current Government Steps towards research and deployment
9.       Conclusion

Abstract
Medical education has entered in new realm due to renewed interest of educators and policy maker professionals who work for flawless health care system. To meet every possible height of competency, a scholarly literature of medical education with identification of broad arguments, clarifications, definitions, ideas and ways can be helpful for preparing the approach of a health professional.
In current report, we have elaborated the developmental phases of Medical Education from the past, till now, discussing the renewed approach which focuses completely on credibility, effects and time-based curricular policies. We have described the evolving approach and its related concepts like challenges of medical education in health sector, identification and analysis of risks in health and care.
Though meeting all criteria of education cannot be easily achieved, but after every theory and research a new chapter of success waits to be accomplished. To fulfill these requirements, researchers cannot work alone, but with the help of government bodies and facility centers which provide a base to make attempts of sequential researches and experiments.
This paper is mostly about American style of medical education, which is rapidly flourishing to serve human kind and is one strong backbone to help people globally.



Introduction:
Whatever the era we discuss, we can never ignore the importance of medical education. Medical treatment which became a specific and priority field from the day human kind came into existence, has crossed many levels of success making a group work with physicians, medicines, researchers, laboratory workers and all other people related to medical.
To let people know about Do’s and Don’ts it was quite necessary to train them for every possible treatment coming into their way in the form of minor and major diseases. In the start, no one focused to medical field, but with the passage of time, when population grew and people death rate arose, medical was implemented with few exceptions on people.
Making things possible which were ever thought as impossible, only caused by medical education.  Medical education is critically important for a system to make it run flawlessly, providing benefits and fixing all issues which arise in its way. For a healthcare consumer, it is quite important for him to understand the history of a healthcare system and about the medical education. It is also necessary to know that how it operates, system participants, legal and ethical issues of system and all the possible defects of the system. (Medical education)
History played a great role in knowing everything about medical treatments which are currently running. If our parents scientists never provided us researches, it was hard to fight the diseases like cancer, hepatitis etc. Though perfection is always lacking in every era of medical field but near to perfection was attained always with utilization of respective era resources.
Medical education became first time official tutelage in 17th Century matured in 21st Century hence becoming the leading and priority field of science to serve mankind in most esteemed and effective way. For this purpose, hierarchy was adopted to make people learn what was supposed hard to learn and practice individually.
Nowadays, there are more than hundred associations working worldwide to spread awareness in people with the help of medical education hence making them experts of their fields like physicians, practitioners etc. Governments are always eager to focus on healthcare issues by eradicating their system flaws and deficiencies. American government is playing actively in training people, conducting researches and eliminating defects of their healthcare system.





Why Medical Education:
Medical is most critical, sensitive and perfection seeking field. Human always linger between life and death due to health issues, and its must to save every mankind with maximum possible endeavors. It is only medical who cure people from worst diseases and bless them with sound health.
Medical education is critically important for a system to make it run flawlessly, providing benefits and fixing all issues which arise in its way. For a healthcare consumer, it is quite important for him to understand the history of a healthcare system and about the medical education. It is also necessary to know that how it operates, system participants, legal and ethical issues of system and all the possible defects of the system.
If we observe the evolution of medical education, we will come to know its generation wise advancements. There was a day when it seemed hard to make any surgery and now its day where automatic machines are placed to perform surgeries. Medicine was not as effective as it is today. Physicians were not much qualified and trained. But now, these all things are possible and only because of medical education.
Methodologies followed by ancient people are useless now but they gave path to new explorations leading to current high tech researches. After people suffered from a contagious disease, it was felt necessary to take action against that, but only few people could do this due to lack of training and awareness. At that time, foundations of medical education were set and it was made necessary for people to get qualified before treating any patient.











History of Medical Education:
History is always a priority of success of anything whether its man, research or any other entity. Considering medical education in realistic and effective way requires appropriate history. Thus, most important role of the history is to provide the viewpoints to today’s issues, and it is particularly suitable in almost every medical education case that history is ever notices before taking any step.

States of Medical Education

For better understanding of medical education, it is divided into two parts.
a.       Historical Developmental State
b.      Present State of health Care Delivery
Historical Developmental States
 Initial and 18th Century Advancements
Deadly spreading diseases in early 17th and 18th centuries dragged people towards well-formed medical trainings which then became a part of medical education after authentication by various governments of that time. At that time, responsibilities of each medical education cell were limited and only few people earned those educational certifications.
During the 18th century, practitioners, for "typical,” or "allopathic,” medical treatments began to turn out to commonplaces for serving people. Few elite practitioners obtained healthcare treatment degrees, primarily by medical education. Though the, mode of way, was not economically possible for all people, but to fulfill needs, medical education grew to develop into the dominant part of education sector, aided them for long time. Student physicians, researchers and practitioners who enabled the students to get opportunity by participating in new researched for finding best solution.  Lot of medicines were discovered, a ratio of doctors were generated who actively performed their practices and shown lot of researches.
19th and 20th Century Advancements
In earlier 19th century, the specialized medical university initiated the domination for health care in America. In 1800, only four healthcare faculties existed: the College from Pennsylvania (founded in 1765), King's College (1767), Harvard (1782), & Dartmouth (1797). Amongst 1810 or 1840, twenty-six new schools ended up established, or in between 1840 or 1876, forty-7 significantly extra. Inside of late 19th century, dozens of additional universities sprouted.
Initially, people capabilities ended up intended to get a supplement towards the educational strategy. Even they could make a great deal with easily produced systematic instructions but from nineteenth century they acquired superseded medical education simply because the principal pathway from wellbeing-linked teaching. (ZUBATSKY, 1979)
The key educational institutions have been developed with lofty ambitions, the quality for instruction on the proprietary faculties rapidly deteriorated, even dependent in regards to the standards within the functioning working day. Entrance necessities ended up nonexistent aside from the possible to pay out again the expenses. Disciplinary issues arising from outrageous scholar conduct ended up staying commonplace. The standard teaching from instruction inside mid-nineteenth century consisted from two four-calendar thirty day period phrases for lectures via the winter months, although by using 2nd expression identical for the 1st. The curriculum usually consisted for 7 plans: anatomy; physiology and pathology; materiamedica, therapeutics, or pharmacy; chemistry or healthcare treatment jurisprudence; theory & apply from medicine; guidelines & demo from surgical process; or obstetrics or also the diseases from women or children.
The mid-nineteenth-century medical universities, for instance Bennett Professional health-related Higher education & Jenner Health-Related College in Chicago, were independent establishments. Higher education or hospital affiliations, from couple of circumstances by which they existed, were nominal. The faculties ended up tiny, typically consisting for six or eight professors. The professors owned the universities or operated them for earnings. An industrial spirit as being to an end resulted pervaded the schools, in direction of the faculty shared the spoils from what was still left of education. The mark for a wonderful well associated education and learning, from any organization, was believed for its profitability. As an amphitheater was fundamentally the sole requirement to operate a medical institution.
Present State of health Care Delivery
Where previously available healthcare facilities were not sufficient to meet the medical requirements, there was desperate need of advanced healthcare facilities including physicians, laboratories and equipment and practice grounds. Population was increasing rapidly, diseases were growing in astonishing speed and some of problems were totally unsolvable. To meet all the requirements and to defeat all the deficiencies, advancement was key point to eliminate entire problems and for that researchers from around the world were working.
Physicians need a broad knowledge base and strong clinical competencies to enter practice. Through lifelong learning, the physician of the 21st century will be a skilled clinician, able to adapt to new knowledge and changing patterns of illness as well as new interventions, personalized therapeutics, and rapidly changing medical science and health care systems. Physicians will need to be independent and critical thinkers, capable of appraising evidence free from personal bias and inappropriate influence. (Howe, 2004)
Considerable consensus on the role of the future physician has already been developed through medical educational project, framework of essential physician competencies (medical expert, communicator, collaborator, manager, health advocate, scholar, and professional) and the four principles of family medicine (skilled clinician, community-based, defined practice population, centrality of patient-physician relationship) as articulated by the College of Family Physicians. Themes from these initiatives are echoed in the World Health Organization’s (WHO’s) “five-star doctor”4 and, most recently, the United Kingdom’s Consensus Statement on the Role of the Doctor.
It is recognized as an essential trait, the highest level of professionalism, a concept that encompasses medical expertise; a deep understanding of the patient, family, and population; excellent communication; compassionate care; and productive interactions with medical colleagues, co-workers, and the public. Physicians will also be expected to work in new and innovative ways with other health professionals, both as team members to explore the scope of their practices and maximize community benefit, and as partners in leadership for health-system management and change. (pagepress, 2012)
Finally, lifelong learning skills will be required to equip future doctors with the capacity to practice for 30 or 40 years in a constantly shifting environment.

Specific Challenges of Medical Education
Federal subsidies keep being the subject of intense debate. The subsidies should support residency training for the physicians. The only funds supplier of graduate medical education is the Department of Health and Human Services through its Medicare Centers and Medicaid Services, and this is where residents have their training. The hospitals that "teach" are more than 1000 nation-wide and their trainees are essential for the labor supply for these units.
The GME, however, faces some efforts of reducing federal spending. Various changes and reductions are possible. To pay for GME, the yearly federal government contribution is about $9.5 billion, covering Medicaid and Medicare. The Obama administration looks to cut back some of the GME funding, in spite of the opposing medical schools, hospitals, and medical associations. These institutions aim to increase funding and to train more doctors by obtaining more residency slots. The burning question remains: are there enough health professionals being trained?
The federal government being the largest and single supporter of medical education for graduates, there is GME support from a number of private and public pots. Children's hospitals have been included in the program for training graduates, as well as community ambulatory settings. The Department of Defense and the Health Resources,, among others, have their contribution. Also, there are private insurers to support the GME through payments which they negotiate with the teaching hospitals. Federal overall support of the GME has been deemed too costly.
Besides, another issue is represented by how exactly the federal support is being used. One matter would be whether more money should or should not be used for raising the competence level of the trainees. Then, the other matter is the insufficient number of physicians. As the Affordable Care Act allows for a greater number of people to be covered, there is a growing need of available physicians to cater to the insured population. The insurance coverage has expanded greatly, and these additional individuals require care as well. The direct and indirect costs for the training add to the topics being up for debate.
Medical Education System of Future
As the role of the physician evolves, so too must medical education. Recognizing the breadth of roles physicians assume, the educational system must ensure that key competencies are attained by every physician while simultaneously providing a variety of learning paths and technologies that prepare students for diverse roles in their future careers. In a nimble and adaptable system, medical education can lay the foundation for physicians to be skilled clinicians, health scientists, researchers, and advocates for health system reform. (Miller, 2010)
American Healthcare Prospects of Medical Education
The graduate medical education field has sensed the impact of the Patient Protection and Affordable Care Act, amended by the Health Care and Education Reconciliation Act. These pieces of legislation, known as ACA, were meant to take care by new provisions of the doctors' activity in less populated regions, such as the rural areas.
To determine the full-time equivalency (FTE) status for residents, the standards were changed by the ACA. For accumulation of FTE status, there are new reimbursement rules, as the residents' type of work has been diversified. For example, residents involved in non-patient care activities, like didactic jobs, are now eligible for reimbursement, which was not possible before the ACA. Besides seminars, conferences are also included in this category. Hospitals can count these activities for the FTE – therefore, the setting in which the resident carries out the activity has to be patient-care related. If the setting is a conference center or a hotel, then it is not counted for the FTE.
Considering the IME purposes, the activities must be the diagnosis or treatment of a patient. The approved settings and activities have also expanded for the IME reimbursements. In the domain of vacation and sick leave, the time spent away counts as long as it is not extending the residents' participation in their assigned graduate medical education program. When more than one institution claims reimbursement for the resident, the eligible one for the FTE status count is considered the institution to which the resident is assigned when the leave period occurs.
Prior to the ACA, the Medicare-reimbursed positions available for resident were at the same level since 1996. The number has not increased nation-wide, but the existent positions are being redistributed based on the usage rates. As some teaching institutions and hospitals have been unable to fill the resident positions, will suffer reductions. Institutions will have to demonstrate the need of additional funding in order to have new resident positions reassigned. The CMS is responsible with the redistribution.



Healthcare Funding
The student insurance plans have been in the spotlight with the new amendments. The Affordable Care Act or ACA has led to real enhancements. Age and income are nowadays the basic criteria on which insurance coverage is being ensured. The healthcare law is said to address college students, yet it does much more than that.
One good example of improved student health plan the possibility to stay on the parent's insurance policy until the young person reaches the age of 26. This is referred to as the parental coverage. Over 3 million people have already taken advantage of this provision of the ACA. Among them, there are also young adult workers and individuals looking for a job, therefore the law does not aim only at students.
For the students already enrolled in an insurance plan provided by their university or college, the ACA ensures free preventative care, prescription coverage, and the possibility to reach $100,000 as maximum annual benefits. Moreover, students can get insurance thanks to these legal opportunities that they did not have before. In addition, those who continue with training as medical professionals will benefit of a better plan for residents to enter the in-demand fields.

Current Government Steps towards research and deployment
The Affordable Care Act, signed by Obama in June 2012, means expanded options of financial aid and healthcare for students. It was said that more ways provided to get a good insurance, ways which were not available before. The most important are the improved health plans for students, the Medicaid eligibility expanded, as well as the possibility to be on the parent's insurance until the age of 26.
A young person is eligible for Medicaid if has the college aid but is not in college. The federal poverty level plays an important role. It is the income that is being taken into account. Starting with January 2014, the need-based healthcare program addresses the individuals who make less than $15,000 yearly, as Van Ostern stated. More categories will qualify for financial aids, such as the college graduates who have low-paid jobs. These will benefit of subsidies for insurance starting with the first day of 2014.
Besides coverage for students, the Affordable Care Act ensures loan forgiveness options and additional funding for those who enter health fields. 3O more million people were estimated by the White house to become insured thanks to the new measures. This means a whole new influx of health sector workers: nurses, primary care physicians. The personnel that fill up these positions can benefit of loan forgiveness, for example. The wide spectrum of healthcare jobs will be included in the new insurance plans.
The parental coverage for individuals under 26 years of age is addressed to anyone studying, working, or looking for work. Concerning the student health plans, the Affordable Care Act states that such plans will offer free preventative care, include prescription coverage, and extend the annual benefits to $100,000. It will be life-changing, as Van Ostern claims, but not for the students in those schools with annual low limits. The ones on insurance plans where the maximum amount can be reached will see the huge consequences. Experts believe this would drive up premiums for the student plans. These, however, will still remain cheaper than the individual plans.

Conclusion
What we require from medical education and training? Rule is simple; know past work in present to make the future bright. We discussed past and historical methodologies to make this sure that our ancestors were working to find all the possible disease for better treatment solutions.
Latest discoveries in medical education are only due to the previous efforts made by researchers who spent their day and night in discovering new and effective medical treatment. It happened not only by giving medicine formulas but by managing a complete hierarchy of every medical related body. Schooling, teaching and medical qualifications are part of medical institutions which are highly observed by number of organizations like WHO and some specifically regional bodies. Elimination of all possible deficiencies is the target, people were suffering in past, still now and will in future but the treatment methods are improving day by day to keep human facilitated with every conceivable solution.



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