Creating a Continuous Learning Foundation for the Medical School of the Future

By James L. Madara
September 12, 2014 | Commentary


Is there a more fertile setting to instill and advance continuous learning than in our nation’s medical schools?

After all, these schools are where ambitious, bright young minds assemble to begin the climb toward becoming a physician and hopefully obtain the initial knowledge and competencies that the privilege of caring and healing demand.

Given such stakes, it is critically important that we rethink how we educate and train the next generation of physicians to ensure they are well prepared for meeting evolving practice demands, patients’ heightened expectations, and a rapidly changing delivery system that has a team orientation and population-based outcomes perspective.

Meeting these ambitious goals is the driving force behind the American Medical Association’s (AMA’s) initiative to envision the medical school of the future. In 2013, the AMA awarded $11 million in grants to eleven medical schools to develop and implement progressive curricula that can bridge gaps in physician training, address the needs of an evolving health care system, and perhaps most importantly, develop measured competencies. More than 80 percent of accredited schools responded to our response for proposal, revealing a substantial appetite for change.

These curricula focus on key areas and disciplines that are critical cornerstones in the future delivery system, including chronic health management, population health, team-based care, and widespread use of health information technologies.

The eleven grant-recipient schools are working as a consortium through the AMA so that learnings from their experiences can be shared and successful innovations implemented nationally.

A few examples of such innovations:

  • Indiana University and New York University are using new technologies to create virtual patient panels and medical records from actual, but de-identified, cases. Advanced teaching tools to enhance clinical decision making are emerging from these activities.
  • Penn State University and Vanderbilt University are developing new models of earlier clinical immersion and more realistic outpatient exposures with continuity.
  • East Carolina University is creating a core curriculum in patient safety.
  • University of California, San Francisco and the Mayo Clinic will measure the progress of students in the areas of quality improvement, team-based care, and systems-based practice.
  • The University of Michigan and Oregon Health and Science University are defining programs that shape training uniquely to each individual student.
  • Three schools (Brown University; University of California, Davis; and East Carolina University) are working together to explore novel angles in education focused on health disparities and underserved populations.
  • Most of these schools are adopting competency-based assessments, offering faster-moving students the opportunity to graduate in fewer than the traditional four years.


These are all groundbreaking ideas, but more powerful than any one is the consortium itself bringing together several diverse innovations into one view and construct: creating the foundation for the medical school of the future—one that continuously learns.

Scale is already emerging: Around 2,000 medical students are being exposed to these activities within the eleven participating schools. The 2,000 physicians ultimately produced should provide care for more than 3.5 million patients each year.

While quanta of new knowledge has been routinely added to curricula, the general time-based overarching structure of undergraduate medical education has not really changed much in almost a century. It is time.



Suggested Citation

Madara, J. L. 2014. Creating a Continuous Learning Foundation for the Medical School of the Future. NAM Perspectives. Commentary, National Academy of Medicine, Washington, DC.

Author Information

James L. Madara, MD, is the Chief Executive Officer and Executive Vice President of the American Medical Association and member of the IOM Roundtable on Value & Science-Driven Health Care.


Note: Authored commentaries in this IOM Series draw on the experience and expertise of field leaders to highlight health and health care innovations they feel have the potential, if engaged at scale, to foster transformative progress toward the continuously learning health system envisioned by the IOM. Statements are personal, and are not those of the IOM or the National Academies.

In this commentary, James Madara, Chief Executive Officer and Executive Vice President of the American Medical Association (AMA), underscores the importance of rethinking medical education to meet new opportunities and challenges, and discusses the grants eleven medical schools have received from the AMA to provide innovative physician training. As the IOM Roundtable on Value & Science-Driven Health Care strives to foster a continuously learning health system that innovates and improves, these awards and recipient medical schools contribute to this vision by:

  • Stewarding the development and implementation of progressive curricula to bridge gaps in care and address the needs of the evolving health system;
  • Reorienting graduate medical education toward chronic health management, population health, team-based care, and widespread use of health information technologies;
  • Creating a consortium of medical schools to lay the groundwork for the medical school of the future.


Information on the IOM’s Learning Health System work may be found at


This individually authored perspective was developed as a contribution to the Learning Health System Series of the IOM Roundtable on Value and Science-Driven Health Care. The views expressed are those of the authors and not necessarily of the authors’ organizations or of the Institute of Medicine. The paper is intended to help inform and stimulate discussion. It has not been subjected to the review procedures of the Institute of Medicine and is not a report of the Institute of Medicine or of the National Research Council.

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