Musculoskeletal Preclinical Medical School Education: Meeting an Underserved Need

Abstract

Musculoskeletal problems including both rheumatologic and orthopaedic pathologies are the primary reason for physician office visits across the United States, with approximately 92.1 million encounters reported annually, according to the 2004 National Ambulatory Medical Care Survey1. Despite the impact that musculoskeletal diseases have on society and the wide range of medical practitioners who treat these conditions, there is compelling evidence that undergraduate medical curricula do not adequately prepare physicians in musculoskeletal medicine2-5. In 2005, the Association of American Medical Colleges (AAMC) issued a Medical School Objectives Project Report on musculoskeletal medicine highlighting the need for medical schools to improve the education of future physicians in this area6. The report outlined educational guidelines to establish a more coherent undergraduate musculoskeletal curriculum. We conducted a study at our medical school during the 2005-2006 academic year that substantiated the need for improving the musculoskeletal curriculum. Students lacked cognitive mastery, demonstrated low clinical confidence, and were dissatisfied with the amount of time spent learning musculoskeletal medicine. Findings of the study suggested the need to improve the integration of musculoskeletal medicine into the curriculum3. Data from the 2005 Step-1 United States Medical Licensing Examination at our institution also revealed that performance on the musculoskeletal section was the lowest of all the subsections. Thus, both national as well as institutional concerns prompted us to lobby for, develop, and begin implementation of a four-year integrated musculoskeletal curriculum. We focused our initial reform endeavors on the preclinical (first and second-year) curriculum. The process of curriculum reform and development differs among various medical schools. As such, the purpose of this study was to provide a framework that may assist educators in achieving the adoption of an integrated musculoskeletal curriculum into the preclinical curriculum at their own school. We offer …