2011 Fall: The Second Flexnerian Report: Implications, Applications and Expectations

Not in the century since Flexner's epic report that reformed medical education, has there been such change in the training of physicians. The Carnegie Foundation again commissioned a blueprint to improve the education of physicians for our times holding a promise to reshape the future for decades to come. It has the promise to also impact medical education for decades to come. To paraphrase the four main findings of the report, the I's have it: 1) individualize the path to standardized learning outcomes; 2) integrate and collaborate in learning; 3) inquiry and improvements should become habits; and 4) identity formation of the physician as a professional should be strengthened. We are privileged to have authors of this report and leaders in medical education present their thoughts on the opportunities and challenges facing changes in contemporary medical education.

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September 1, 2011 at 12:00 pm

1910 and 2010: What’s with these Carnegie reports on medical education?

Presenter: David Irby

David IrbyDr. David Irby is Vice Dean for Education, Professor of Medicine and Director of the Office of Medical Education at the University of California, San Francisco School of Medicine. He is a former Senior Scholar at the Carnegie Foundation for the Advancement of Teaching, where he co-directed a national study on the professional preparation of physicians (Cooke M, Irby DM, O’Brien BC. Educating Physicians: A Call for Reform of Medical School and Residency). San Francisco: Jossey-Bass, 2010). For his research on clinical teaching and leadership in medical education, he has received numerous awards including the 2010 Karolinska Institutet Prize for Research in Medical Education. He earned a doctorate in education from the University of Washington, a Masters of Divinity from Union Theological Seminary and a postdoctoral fellowship in academic administration from Harvard Medical School.

Twice over the past one hundred years The Carnegie Foundation for the Advancement of Teaching has called for the reform of medical education. In 1910, Abraham Flexner stressed the importance of scientific research and educational excellence in the training of physicians, which resulted in a transformation of medical education. In 2010, the Carnegie Foundation called for actions that will transform medical education again: standardization of learning outcomes and individualization of learning processes; integration of formal knowledge and clinical experience; development of habits of inquiry and improvement; and explicit attention to the formation of professional identity (Cooke M, Irby DM, O’Brien BC. Educating Physicians: A Call for Reform of Medical school and Residency). In this webcast. Dr. Irby will describe the Flexnerian legacy and the key recommendations of the report. Subsequent webcasts will deal with the report’s major themes separately.

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September 8, 2011 at 12:00 pm

Educating Physicians: A Focus on Integration, Inquiry, Innovation and Improvement.

Presenter: Bridget O'Brien

Bridget O'BrienBridget O’Brien, PhD is an Assistant Professor in the Office of Medical Education at the University of California, San Francisco where she teaches in the Health Professions Education pathway and the Teaching Scholars Program. She also directs evaluation for the San Francisco VA Center of Excellence for Primary Care Education (EdPACT). Her current research focuses on workplace learning in the context of longitudinal integrated clerkships, continuity clinics, and interprofessional team-based care. She received her BS from Cornell University, her Master’s from the Haas School of Business at the University of California, Berkeley, and her PhD from the Graduate School of Education at UC Berkeley. She was one of the three primary researchers for The Carnegie Foundation’s national study of medical education and is a co-author of Educating Physicians: A Call for Reform of Medical School and Residency.

“Educating Physicians” calls for an integrated approach to medical education and cultivation of habits of mind and cultures that support inquiry, innovation, and improvement. In this session we will discuss the context and impetus for these two recommendations as well as relevant literature from the learning sciences. Then we will delve into practical applications and promising examples of these recommendations in undergraduate and graduate medical education. We will conclude with time for participants to discuss ways of applying these recommendations to educational programs in their own institutions.

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September 15, 2011 at 12:00 pm

Individualization and Standardization in Medical Education: Holy Grail or Third Rail?

Presenter: Catherine Lucey

Catherine Lucey, MD, was recently appointed as the vice dean for education in the UCSF School of Medicine, effective September 1. She is succeeding David Irby, PhD, who will take a well-deserved sabbatical and then return to work on specific educational initiatives. Dr. Lucey was formerly the interim dean and vice dean for education at the Ohio State University (OSU) College of Medicine, and associate vice president for health sciences education for the OSU Office of Health Sciences. She provided the administrative leadership for undergraduate medical education, graduate medical education, and continuing medical education, as well as the schools of allied health and biomedical sciences. As interim dean, she unified the educational programs across the continuum of medical education and advanced interprofessional collaboration in education. She is chair of the American Board of Internal Medicine and a member of the Association of American Medical Colleges MR5 committee, charged with overseeing the revision of the Medical College Admission Test process. Lucey’s areas of expertise include professionalism, clinical problem solving and learner remediation. She is a passionate advocate for using education to advance the quality and safety of patient care and to prepare leaders capable of solving current problems in health care and health care delivery.


  1. Describe drivers of and barriers to the widespread adoption of the principles of individualization and standardization
  2. List current teaching strategies that are compatible with individualization and standardization
  3. Cite pedagogical theories that support an individualization and standardization approach
  4. Describe elements of a successful individualization and standardization program
  5. Give examples of innovative educational programs implementing an individualized and standardized curriculum.

In keeping with a national focus on outcomes measures in health care and education, the 2010 Carnegie Foundation Report on Educating Physicians calls for medical educators and education systems to commit to developing objectively measurable performance standards for learners at all levels and ensuring that these standards are met before completion of the formal educational programs. To achieve these standardized outcomes, educators must prepare to continuously assess their learners across a broad range of complex competencies and to individualize curricula and experiences to the meet the professional developmental needs of their learners. This shift from a time based advancement system to a competency based advancement system poses unique challenges in both classroom and clinical learning environments. The speaker will address these challenges and provide examples of how the goal of individualized learning with standardized outcomes can be achieved in today’s busy health care environment.

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September 22, 2011 at 12:00 pm

Instituting and Using a Holistic Admissions Process

Presenter: Marlene Ballejos

Marlene BallejosDr. Ballejos is the Assistant Dean for Admissions at the University of New Mexico School of Medicine and serves as the Diversity Affairs Officer for the Association of American Medical Colleges (AAMC) Group on Student Affairs, and as the Co-Chair for the SOM Committee on Admissions. Dr. Ballejos completed her dissertation and research on “The Effect of Various Cognitive and Non-Cognitive Weighting Schemes on the Medical School Admissions Rates of Under Represented Minorities” and participated in the 2008 Medical College Admissions Test (MCAT) Graduate Student Research Program sponsored by the Association of American Medical Colleges. She conducted research on the non-cognitive constructs measured for medical school admissions. Her interests include serving diverse populations, research related to educational disparities and workforce training, and issues related to underrepresented minorities.

The Holistic Admission webcast is designed to assist both biomedical science and clinical faculty in exploring the complex dynamics of weighing and balancing applicants’ experiences and attributes with their academic achievements as a means of accomplishing the mission-based excellence they seek. The author provides a background for instituting and using a holistic review process to screen, interview and select applicants for medical school admissions while offering a context for the motivation for change, the challenges faced and the lessons learned.

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September 29, 2011 at 12:00 pm

Professional Identity Formation

Presenter: Kelley Skeff

Kelley M. SkeffDr. Skeff is currently the Vice-Chair for Education in the Department of Internal Medicine at Stanford University, and Co-Principal Investigator of the Stanford Faculty Development Center (SFDC). He received his MD from the University of Colorado and his PhD from the Stanford School of Education. Dr. Skeff’s academic career has focused on methods to assist faculty and residents nationwide to improve their teaching effectiveness, resulting in the development of the Stanford Faculty Development Center. The SFDC uses a train-the-trainer dissemination approach for faculty internationally to become more effective teachers. Dr. Skeff has received several awards for his work including: awards from students and residents at the Stanford University Medical Center, the Stanford University Walter J. Gores Faculty Achievement Award, the first national Award for Career Achievement in Medical Education from the Society of General Internal Medicine, the Joy McCann Mentoring Award, the Association of Program Directors in Internal Medicine’s Distinguished Medical Educator Award, the AAMC/AOA Distinguished Teacher Award in the Clinical Sciences, and the AAMC Flexner Award. He is a Master in the American College of Physicians and an ACP Regent.

The role of the physician in society has always required a broad-based education. However, during the most recent decades, emphasis on the improvement of health care delivery has broadened even further the variety of curricular areas that are important in medical education. In this talk, Dr. Skeff will highlight and discuss a conceptual model to help identify and focus attention on these expanding curricular areas. It is hoped that this model can enable faculty to identify areas for expanded focus and trainees can identify areas of emphasis for their careers.

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