Medical Education Challenges in Academic Health Centers

Learning is nothing more than discovering that something is possible. To teach is to show someone that something is possible.  – Fritz Perls

Academic Health Centers (AHCs) represent multifaceted ecosystems where education, healthcare, and research intersect. However, their overarching mission extends beyond these pillars to encompass knowledge dissemination, innovation, community involvement, and policy shaping as dimensions that interact continuously with medical education, healthcare, and research. Within Latin America, AHCs must embrace a broader vision, aiming to propel medical advancements that directly benefit their communities' well-being.

Alignment of objectives and visions within AHCs is paramount to ensure equitable prioritization of quality treatment, professional training, and research. Yet, achieving seamless integration among these components poses considerable challenges. Crafting an exemplary medical education model demands not only high-caliber classroom instruction but also the fusion of technology and hands-on methodologies within the academic health center environment.

AHCs wield significant influence, not merely as providers of superior medical care but also as crucibles for healthcare professional education and medical research advancement. Opportunities flourish for AHCs to forge partnerships with regional and international counterparts, enriching their grasp of global medical contexts, fortifying health education, and fostering interactive learning experiences.

The Alliance of Academic Health Centers International (AAHCI) serves as a nexus for global collaboration, empowering AHCs to spearhead healthcare innovation, biomedical research, and future healthcare professional education through effective networking and partnerships. The AAHCI Latin America and the Caribbean (LAC) Regional Office, hosted by TecSalud, Tecnológico de Monterrey, recently organized a webinar cluster titled, Through the Glass: Challenges in Med Ed at Academic Health Centers.

Key challenges discussed included the quality assurance of AHCs and the educational prospects they offer to medical students. Medical education struggles to adapt to the rapidly evolving healthcare landscape, delayed by traditional curricula, inadequate funding, and lax accreditation practices, resulting in graduates who are ill-prepared for contemporary medical demands.

Medical education stands at a pivotal juncture, with undergraduate, graduate, residency, and continuing education levels facing shared obstacles necessitating an integrated approach. Addressing 21st-century health challenges mandates the adoption of novel paradigms in medical and public health education, with AHCs positioned as vanguards in evidence-based curricular innovation, technology integration, and promoting innovative programs.

External challenges, including the deluge of knowledge, health inequalities, aging demographics, chronic illnesses, specialized medical practices, lifestyle factors, and evolving healthcare landscapes, compound the complexity of medical education; however, internal challenges are even more daunting. There is an overemphasis on the cellular and subcellular domains of basic sciences with little current clinical application. Medical education predominantly focuses on biological aspects, yet 60% of premature deaths have non-biological causes. Approximately 80% of clinical education takes place in hospital settings, while 80 to 90% of care occurs in outpatient settings. Less experienced individuals are often placed in the most complicated environments and can be displaced by those with more experience.

Contemporary trends in medical education are influenced by adult learning principles, advocating for a shift toward student-centered, workplace-oriented, and actively engaged pedagogies, alongside competency-based assessments and interprofessional education initiatives, with a focus on addressing social determinants of health in medical education.

"How we learned yesterday is insufficient for learning today. The experience of those who learned yesterday doesn't necessarily serve us today and will hardly serve us tomorrow." (Public dominion). This underscores the importance of continually updating medical curricula to respond to societal changes, technological advances, and the evolving landscape of diseases and disorders.