An Association of American Medical Colleges position paper calls for a 30% increase in medical school enrollment by 2015. New faculty effort certification reporting requirements for NIH-supported investigators and increasing clinical productivity expectations at academic medical centers challenge the tradition of faculty volunteerism for medical student teaching. To better define the structure, content, and financial support of second year medical school hematology courses nationwide, in 2001/2002 we mailed a survey to the hematology course directors at 85 of the 125 accredited US medical schools. The 58 course directors who returned the survey represent all regions of the US, and both public and private medical schools. Ten of the hematology course directors subspecialized in areas other than adult or pediatric hematology or hematology/oncology. Median class size was 150 students (range 40–200), and some courses included a substantial proportion (up to 33%) of students other than medical students (dental students, graduate students, PA students). Median course hours was 33 hours (range 8 to 74, an almost 10-fold difference). Approximately 50% of the total teaching time was devoted to lecture (range 5% to 100%), but a wide variety of additional teaching approaches were also employed, including small group discussions, problem-based learning, and web-based teaching (used by 62% of course directors). The median number of faculty responsible for teaching the second year hematology course was 12 (range 1–36). The hematology course directors identified a number of obstacles, including difficulty recruiting teachers (experienced by 45% of course directors), the lack of well-defined content, and the very modest budget (less than $1500 for most courses). Only 3 of the course directors indicated that they received salary support for this role. The findings of this survey suggest that a national effort to define learning objectives for the hematology courses and to share teaching materials among medical schools is warranted. Of note, it was estimated in 1997 that the total educational costs for one medical student are $72,000–92,000 per year, and that the majority of these costs are instructional. In 2003 median medical school tuition nationally was $16,322 (for a state resident attending a public school) and $34,550 (private school tuition). The present results show that few of these funds are directed to support of faculty time to teach the hematology course, and compel the identification of a funding stream to pay faculty for teaching medical student required courses.
Decline of medical student idealism in the first and second year of medical school: a survey of pre-clinical medical students at one institution
