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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