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Advancing Care Transformation: Our Approach to Graduate Medical Education

Sept. 30, 2021

Traditionally, medical education has focused on developing a strong background in basic and clinical sciences, allowing physicians to understand the foundations of disease and to treat specific conditions. But it’s a passive approach: Doctors wait for patients to present themselves with clinical problems, with no active role in the overall health of the community.

Dell Medical School’s goal was to create a new kind of physician. Our mission began with educating leaders to transform care and redesign the academic health environment — physicians with a fundamental understanding of how care is delivered and how the system itself can improve health in order to improve outcomes. To reflect this mission, our unique medical school curriculum, Leading EDGE, was designed to replicate the modern practice of medicine. Emphasizing health systems science — “the principles, methods, and practice of improving quality, outcomes, and costs of health care delivery for patients and populations within systems of medical care” — training includes a focus on value-based health care, team-based learning, health equity, improvement science, space for self-discovery, expanded clinical opportunities, engagement with community partners and more. Our medical students learn how to become better leaders, communicators, collaborators and caregivers.

The next phase of training, graduate medical education (GME), provides in-depth, specialty-specific experience. Once again, the traditional approach focuses on the diagnosis and treatment of specific diseases, with no emphasis on health systems science. In order to fill this gap and align Dell Med undergraduate and graduate learning experiences, we created a longitudinal curriculum, Advancing Care Transformation (ACT), that includes foundational and experiential learning in health systems science for residents and fellows. It is designed to create systems-ready physician leaders, each one prepared to respond to and lead change in an evolving health care system. Originally launched in 2018 as the Dell Med GME Distinction Program, our curriculum offers immersion in value-based health care, quality improvement, equity, leadership and other key competencies in health systems science. Participants learn to effectively perform in dynamic, multifaceted health care systems and identify opportunities to enhance the system and overall population health through discovery, leadership and innovation.

How ACT Works

The ACT curriculum consists of a three-tier structure:

  1. The first is ACT’s Foundations in Care Transformation training, a unique learning series open to all residents and fellows.
  2. Residents and fellows who wish to engage more deeply with concepts of health systems science may pursue honors in the form of a Distinction in Care Transformation, which requires active learning and application of improvement science.
  3. In the future, designation as a Scholar in Care Transformation will require completion of a career track in quality improvement, leadership, clinical research or health entrepreneurship.

ACT fills an important gap in the training continuum for physicians. As health systems science becomes increasingly recognized as a necessary competency for physicians, GME training programs will need to find ways to incorporate these knowledge and skills. At Dell Med, ACT will allow new physicians to transform care through innovation and education, improve the clinical learning environment through team building and communication, gain the skills necessary to perform in, test, and advance new models of care to changing needs within the health system, create opportunities to enhance equitable care, use data and improvement science to drive change, and develop as systems-ready physician leaders prepared to steer the health system into the future.