American Medical College Association

Embedding Racial Justice and Advancing Health Equity at the American Medical Association

A 12-Year North American Longitudinal Study of Gender Equity and Equality in Gastroenterology

Changes in Sex, Race, and Ethnic Origin of Emergency Medicine Resident Physicians From 2007 to 2017.

Integrated cardiothoracic surgery: Developing a successful residency application

WASHINGTON—Tucked away in a leafy corner of the Foggy Bottom neighborhood here, the headquarters of the Association of American Medical Colleges (AAMC) could stand as a metaphor for the organization itself. A sturdy, traditional five-story office block faced with trendy salmon-colored bricks, the building sports a thoroughly modern interior, all shiny chrome and sparkling glass. A central atrium opens the space, brightening dozens of cubicles and offices. As he talks about the fate of medical education, AAMC President Jordan J. Cohen, MD, projects a similar aura: grounded in tradition and embracing the future. It’s a critical time for him to look ahead, as myriad pressures squeeze medical education. Declining interest from young people, spiraling health care costs, highly publicized research protection failures, competition with research and clinical endeavors, and waning faculty morale situate AAMC’s members—141 US and Canadian medical schools and some 400 teaching hospitals—in an unstable nexus as the organization celebrates its 125th anniversary. Such turbulence wasn’t always the status quo. Founded in 1876 by the deans of 22 US medical schools, AAMC’s early days were characterized by malaise. Internecine squabbling over education guidelines effectively shuttered the organization from 18831890, when it was reinvigorated by the deans of Baltimore’s four medical schools ( Johns Hopkins School of Medicine, University of Maryland School of Medicine, and two now defunct schools, Baltimore Medical College and Baltimore University School of Medicine). Still, there were no rigorous standards. In 1910, the Flexner report on medical education advocated reforms called for by the AAMC and others. At the top of the list: providing more clinical learning opportunities. However, the recommendations languished and clinical teaching remained largely unheard of until after World War I, when military officers returned home and complained about the poor work of field physicians. The movement for improved medical education coalesced in the 1920s, after the AAMC and the American Medical Association set aside a turf war and formed the Liaison Committee on Medical Education, which eight decades later is still accrediting US medical schools. After World War II the AAMC came into its own. A flurry of standards, conferences, and seminars broadened the association’s impact, entrenching the organization as the primary force in medical education. An earnest 1965 ex-

What has the Association of American Medical Colleges (AAMC) accomplished in the last 25 years in its efforts to advance medical education, biomedical research, and health delivery in this country? Can the AAMC's past accomplishments help predict how it will respond to future challenges? To answer these questions, the author traces in detail the recent history of the AAMC, focusing on the expansion of the association's role and constituencies and how these and other changes were precipitated by recommendations in the AAMC's 1965 "Coggeshall Report." He also recounts how the AAMC has responded to the pressures and needs of recent years (such as fostering an increase in the number of practicing physicians) and describes in detail the organization and functions of the AAMC's staff, with emphasis on its six divisions and the fact that many of the complex issues that confront the AAMC transcend the boundaries of governance councils and staff divisions and dictate that association policy be based on broad consensus. Looking ahead, he sees at least four important activities that the AAMC will continue to be involved with: fostering the education of more minority students; promoting health services research; finding an appropriate role in the evolution of health care reform; and addressing the need for academic medicine to be more socially responsive. The author concludes that the AAMC's highly regarded record, its organization, and its financial stability all indicate that it will do well as it tackles the issues on the horizon and others not yet in view.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical physician leaders have become an increasingly important asset to hospitals and hospital systems in a changing healthcare environment. Specifically, the role of the chief medical officer (CMO) has expanded and evolved amid the shift to value-based payment models and sharpened focus on patient safety, quality, community engagement, and equity in healthcare, as well as a global pandemic. In light of these changes, this study examined the transformation of CMOs and similar roles and evaluated the current needs, challenges, and responsibilities of clinical leaders today. The primary data source used in this analysis was a survey fielded to 391 clinical leaders in 290 Association of American Medical Colleges-member hospitals and health systems in 2020. In addition, this study compared responses to the 2020 survey with findings from two prior iterations of the survey from 2005 and 2016. The surveys collected information regarding demographics, compensation, administrative titles, qualifications for the position, and the scope of the role, among other questions. All surveys consisted of multiple-choice, free response, and rating questions. The analysis was conducted using frequency counts and percentage distributions. Thirty percent of eligible clinical leaders responded to the 2020 survey. Twenty-six percent of the clinical leader respondents identified as female. Ninety-one percent of the CMOs were members of the senior management team in their hospital or health system. CMOs reported that they were responsible for five hospitals, on average, with 67% indicating they were responsible for more than 500 physicians. This analysis provides hospital and health systems with insight into the expanding scope and complexity of CMOs as they take on greater leadership responsibilities within their institutions amidst a shifting healthcare landscape. In reflecting on our results, hospital leaders can understand the current needs, barriers, and responsibilities of today's clinical leaders.

Medical Student Education

The United States has a physician specialty imbalance, primarily a shortage of generalists (defined as family physicians, general internists, and general pediatricians) relative to other specialists. In recent years, the rising costs of health care, the expansion of managed care, and problems of access to care have accentuated the critical role that generalists must play in a cost-effective, accessible health care system. Despite numerous public and private initiatives designed to address the supply of generalist physicians, the ratio of generalists to specialists has been decreasing. Although the factors contributing to the shrinking proportion of generalists are many and are often outside the control of educators, there is evidence that medical schools can play a major role in influencing specialty choice. Recognizing the need to address the specialty imbalance in this country, the Association of American Medical Colleges (AAMC) appointed the Generalist Physician Task Force to develop a statement suggesting actions that the AAMC and its constituents could take to foster a greater representation of generalist physicians in the United States. The task force produced an Executive Summary, published as an AAMC policy statement in early 1993, that contained recommended strategies for medical schools, graduate medical education, and the practice environment. The authors of the present article critique these recommendations, provide a background and rationale for each of them, and give suggestions about how some of the recommendations might be implemented. While they are in general agreement with the AAMC policy statement, they feel the recommended strategies fall short of the need. They maintain that the AAMC statement represents an admirable but cautious approach to a daunting problem, and that the time is past when cautious approaches will suffice. The authors conclude with the hope that bolder initiatives will emerge from the new AAMC Office of Generalist Physician Programs.

AAMC describes 13 activities that medical students should be able to perform, regardless of specialty, to standardize expectations for learners and teachers and better prepare students for roles as clinicians.

This essay analyzes Lowell T. Coggeshall's impact on American medical education by focusing on Coggeshall's 1965 report to the Association of American Medical Colleges (AAMC), Planning for Medical Progress through Education. Coggeshall graduated from medical school in 1928 and became an expert on tropical diseases. During his military experience in World War II, Coggeshall shifted his focus to administration. He was a skilled executive and became well acquainted with the ways of both the federal government and academic medicine. The AAMC, founded in 1876, was a kind of informal "deans' club" for many years. The many social and medical changes of the 1950s and 1960s prompted the AAMC to form a committee, headed by Coggeshall, whose chief task was to provide guidance for the AAMC. The 1965 report recommended that the AAMC move its headquarters to Washington, D.C., and take a more active role in shaping national health policy. However, many of the report's suggestions were not implemented, such as having the AAMC change its name and represent not only medical schools but all health-related academic units. While the report was widely praised, it was also strongly opposed by some powerful groups. This essay reviews the impact of Coggeshall's report and examines the nature of such reports in general. Coggeshall's greatest contribution to American medical education was his role in reshaping the AAMC into an effective voice for academic medicine.

The Impact of COVID-19 Pandemic on Medical School Admissions: Challenges and Solutions

US plans to boost number of medical schools

Back to table of contents Next article Education & TrainingFull AccessWomen Now a Majority Of Med School ApplicantsMark MoranMark MoranSearch for more papers by this authorPublished Online:16 Jan 2004https://doi.org/10.1176/pn.39.2.0001After a six-year decline, the number of applicants to U.S. medical schools is on the rise, according to data released by the Association of American Medical Colleges (AAMC).Almost 35,000 individuals applied to attend medical school in the 2003-04 school year, a 3.4 percent increase over last year’s applicant pool of 33,625.According to the AAMC, the main reason for the increase was the number of women applicants—17,672, an almost 7 percent rise over last year’s total. In fact, the 2003-04 school year marks the first that women have made up a majority of medical school applicants.In addition, black women applicants increased by almost 10 percent, to 1,904, according to the AAMC.Since 1996, when the number of individuals applying to medical school peaked at 47,000, the total number of medical school applicants has steadily dropped between 1,000 to 4,000 applicants in each subsequent year. This six-year trend reached its lowest point with last year’s total of 33,625 applicants, according to the AAMC.APA Area 4 Trustee Sidney Weissman, M.D., an educator who has long maintained a keen interest in workforce numbers and demographics, told Psychiatric News that the two trends—an increasing number of applicants and an increasing number of women applicants—are portents to which APA leaders, educators in training programs, and physicians in general should pay attention.“We are seeing some changes in the interest of undergraduate Americans in medicine,” he said. “One is the change in numbers, which fluctuates over time partly in response to the economy. When the economy lags and there are fewer jobs available, more people apply to medical school.”He said the pattern goes back more than 20 years. The steep decline in the numbers of people applying to medical school in the last six years followed on the heels of the economic boom of the 1990s, for instance. But he noted that in that case, the phenomenon was also fueled by a widening perception that because of managed care and other factors, medicine was no longer the prestigious and desirable profession it once was.The other important indicator in the AAMC numbers, Weissman said, is the increase in the number of women. “There is a significant shift in who the people are that are entering medicine,” he said. “Better than half are women. That’s important because women are more likely to enter psychiatry and child psychiatry.”Already, he said, there are more women entering psychiatry than men. And in child psychiatry the ratio of women to men entering the field is similar to that in pediatrics. In time, he said, women will represent the majority within psychiatry, with important implications for APA leadership.For educators, too, the shift in demographics has important implications. Training programs will need to become “women friendly,” he said, conforming schedules to the demands of childbirth and child care, as well as paternity leave for male residents.Other statistics from this year’s application process highlighted by AAMC are the following:• The number of black applicants overall rose almost 5 percent to 2,736—largely due to the 10 percent increase in black women applicants. But the number of blacks who were accepted and then went on to attend medical school (1,056) declined by 6 percent.• Hispanic applicants increased by less than 2 percent to 2,483, while the number who entered medical school declined by almost 4 percent to 1,089.• The sharp decline in the number of men applying to medical schools, a trend that started in 1997, leveled off this year. Men applicants totaled 17,113, about the same as last year’s figure of 17,069.Because of the recent U.S. Supreme Court decisions on affirmative action, statistics on minorities underrepresented in medicine are likely to be carefully scrutinized for the next several years, the AAMC said.“These latest figures contain both good and bad news for the medical profession,” said AAMC President Jordan J. Cohen, M.D. “The decrease in minorities entering medical school underscores the need for redoubled efforts to attract a critical mass of students from diverse backgrounds in order to enhance the education of all future physicians. At the same time, the increase in total and first-time applicants is a reaffirming sign that the current generation of young people recognizes the attractiveness of medicine as a profession.”More information is posted online at the AAMC’s Web site at www.aamc.org/newsroom/reporter/dec03/medicalapps.htm. ▪ ISSUES NewArchived

This paper highlights the role of the Association of Medical School Psychologists (AMSP) as a bridge between academic medicine and psychology. AMSP’s affiliation with Division 12 of the American Psychological Association is discussed, but the primary focus is AMSP’s affiliation with the Association of American Medical Colleges (AAMC) and the AAMC’s Council of Academic Societies (CAS). The history, structure, activities, and goals of AAMC and CAS are examined. AMSP’s affiliation with AAMC is important for psychologists in medical schools and academic medical centers, and for psychology in general, because AAMC is the major voice of academic medicine in the US. AAMC activities affect medical education at all levels, as well as research and health services at academic medical centers, and health care policy at the national level. AMSP’s dual affiliation with AAMC’s CAS and APA’s Society of Clinical Psychology will increase psychology’s visibility and influence in academic medical centers and enhance the two-way flow of ideas and information between academic medicine and psychology.