Download - Academic Medicine in the 21 st Century
Academic
Medicine in the 21st
CenturyRichard I. Levin, MD
April 16, 2008
• Maclean’s #1
• Times of London
21
12
• Science Essentials #1
HippocratesHippocrates460 BC460 BC
Hoffman Hoffman AspirinAspirin18931893
ListerLister AntisepsisAntisepsis18651865
Long Long EtherEther18421842
Osler Graduates Osler Graduates 18721872 RoddickRoddick AsepsisAsepsis
18771877
2008 AD2008 AD460 BC460 BC
HippocratesHippocrates460 BC460 BC
HarveyHarveyCirculationCirculation
16281628
Hoffman Hoffman AspirinAspirin18931893
ListerLister AntisepsisAntisepsis18651865
Long Long EtherEther18421842
Osler Graduates Osler Graduates 18721872 RoddickRoddick AsepsisAsepsis
18771877
Fleming Fleming PenicillinPenicillin19281928
Sabiston Sabiston CABGCABG19621962
WHO WHO SmallpoxSmallpox19771977
Avery Avery DNADNA19441944
Watson & CrickWatson & CrickDouble HelixDouble Helix
19531953
Oldendorf & Oldendorf & HounsfieldHounsfield CAT ScanCAT Scan
19721972
MRI MRI 19801980
Penfield Penfield Montreal Procedure Montreal Procedure 1930s1930s
HarveyHarveyCirculationCirculation
16281628
Flexner Report 1910
Marco Marra John Marco Marra John McPhersonMcPhersonKen DewarKen Dewar
Venter & Collins Venter & Collins Human GenomeHuman Genome
20012001
Challenges to Academic Medicine•Education•Research •Care
““The way we … provide instruction The way we … provide instruction is essentially the same as it was when is essentially the same as it was when our Founding Fathers went to our Founding Fathers went to school...we still educate our students school...we still educate our students based on an agricultural timetable, based on an agricultural timetable, in an industrial setting, yet tell in an industrial setting, yet tell students they live in a digital age.”students they live in a digital age.”
Paige, 2002Paige, 2002
Expansion of Medical Knowledge• 80% of scientists
who ever lived, live now
• 2000 pages of textadded every minute
• 1 days output =5 yrs reading
• Knowledge doublesevery 7 years
Challenges to Medical Education at the
Dawn of the 21st Century
•Inadequate Resources•Expansion of Medical
Knowledge•Time in the human classroom of the hospital has vanished
FACULTYSTUDENTSRESIDENTS
PATIENTS
TEACHINGHOSPITAL
DIAGNOSTICS, TREATMENTS, RECOVERY
1900 - 1990
STUDENTSRESIDENTS
PATIENTS
TEACHINGHOSPITAL
OFFICES
DIAGNOSTICCENTERS
FACULTY
AMBULATORYSURGERY
CONSULTATIONS
2008
Simulation
Challenges to Academic Medicine•Education•Research •Care
Uncovering theBiological Basis of
Disease
Translating Research into
Better Health and Care
Era of Great Risk
New Epidemic of Obesity and Diabetes
Costs per Capita in OECD Countries
National Health Expenditure Trends, 1975–2007 CIHI
Canadian health care costs have TRIPLED since
1975
Graph 6
Public Health Spending Projections, 2007-08 to 2017-18
(in millions of dollars)
2008 Task Force Report on the Financing of the Health System
Castonguay, Venne & Marcotte
Growth of health spending based on current trends (5.8%)Increase in health spending based on current rate of economic growth (3.9%)
42,0
Current System
Teaching Affiliates
MUHC JGH St. Mary’s Douglas
RUIS
McGill Academic Health Network
• Coordinate education, research and care• Recognize special areas of excellence• Capture, elevate and publicize its power
RUIS
JGHJGH St. St.
Mary’sMary’s
Dou
gl
Dou
glasas
MUH
MUHCC
McGill Academic Health Network