The Medical School Objectives Project is an initiative of the Association
of American Medical Colleges (AAMC) that is designed to reach a general
consensus within the American medical education community on the
"skills, attitudes, and knowledge" that students graduating from
accredited American medical schools should possess before beginning
postgraduate training. Since its inception in 1997, the Medical School
Objectives Project has published special reports addressing specific topics in
medical education. The goal of these reports is to outline these learning
objectives and the educational and assessment strategies that might be put to
use in their implementation. Titles of previous reports issued by the Medical
School Objectives Project include "Medical Informatics and Population
Health," "Communication in Medicine," "Basic Science
and Clinical Research," "Quality of Care," and
"Genetics Education." These reports are available online at
.
The underlying philosophical thrust of the reports, and of the Medical
School Objectives Project, is the belief that mastery of their content might
result in physicians who are altruistic, knowledgeable, skillful, and dutiful.
In order that the critical importance of the mastery of musculoskeletal
medicine and surgery would be appreciated by medical educators, the Committee
on Medical Student, Resident and Fellow Education of the Council on Academic
Affairs convened a meeting entitled "Musculoskeletal Medical Student
Educators' Workshop" in October 2003 (see Appendix). Representatives of
the AAMC, United States Bone and Joint Decade, American Academy of Orthopaedic
Surgeons (AAOS), American Society for Bone and Mineral Research, American
College of Rheumatology, and American Academy of Physical Medicine and
Rehabilitation gathered in Rosemont, Illinois, with the goal of producing a
preliminary list of learning objectives that the participants believed that
medical students across the country should demonstrate mastery of prior to
graduation. The result of this meeting was a list of eighteen objectives that
serves as an initial document from which the "objectives" defined
by the Medical School Objectives Project of the AAMC might be distilled
(Table I and Appendix).
The list is intended to be inclusive rather than exclusive. Orthopaedic
surgeons participated in the workshop, as did representatives of the
organizations listed above, because of a longstanding interest in
musculoskeletal education and curriculum development. The participants
compiled this list of objectives during a series of workshops. It was debated
and refined and then collated and distributed.
The list serves as a necessary first step in a process that will heighten
awareness of the need for increased undergraduate musculoskeletal medical and
surgical education. It will be of substantial importance in leading to the
issuance of an AAMC report that outlines the objectives, potential methods for
evaluation, and opportunities for teaching and inclusion of these objectives
within the undergraduate curriculum. This list will be sent both to the Deans
of AAMC-accredited medical schools as well as to the Associate Deans in charge
of medical education at those same accredited medical schools. The list does
not serve as an outline for a course in musculoskeletal medicine and surgery.
The demands and the heterogeneity of medical school education in 2005 are such
that a prescribed course as recommended by any subspecialty society or the
AAMC might prove overly restrictive and could not be implemented. This would
immediately render the committee's work useless. These topical objectives
should more appropriately be considered in the sense that their inclusion at
any time within the undergraduate medical curriculum can and should occur,
without any notions of preconception as to timing.
Presently, Dennis Boulware, MD, a practicing rheumatologist and the Senior
Associate Dean of Education at the University of Alabama, Birmingham, is
chairing the AAMC Expert Panel on Musculoskeletal Education. He has been
charged by Michael Whitcomb, MD, Senior Vice President, Division of Medical
Education of the AAMC, to produce this report. The expert panel includes
thirteen additional participants (including two orthopaedic surgeons, Joseph
Bernstein, MD, of the University of Pennsylvania and myself) and several AAMC
staff persons (see Appendix). The work of the Committee is presently ongoing,
and opportunities for further development and refinement of the list are in
progress.
The American Academy of Orthopaedic Surgeons, through the Council on
Academic Affairs Committee on Medical Student, Resident and Fellow Education
and its chair, Peter Stern, MD, continues to support actively the premise that
musculoskeletal medical and surgical education in the medical school
curriculum is of critical importance because of the disease burden of
musculoskeletal illness in a rapidly aging population. Textbooks published by
the AAOS, including Musculoskeletal Medicine, edited by J. Bernstein,
MD, and Essentials of Musculoskeletal Imaging, edited by T.R.
Johnson, MD, and L.S. Steinbach, MD, can aid substantially in this effort. The
Committee on Medical Student, Resident and Fellow Education and the AAMC
Expert Panel on Musculoskeletal Education actively encourage and solicit
commentary on, and critique of, this report and on the List of Objectives
itself. The participation of all orthopaedic surgeons in this process is
encouraged and welcomed. Suggestions for alterations and improvements in the
List of Objectives can be e-mailed to me directly at
boyerm@msnotes.wustl.edu.
Tables presenting the names of those attending the Musculoskeletal Medical
Student Educators' Workshop in 2003, the complete List of Objectives, and the
members of the current AAMC Expert Panel are available with the electronic
versions of this article, on our web site at
(go to
the article citation and click on "Supplementary Material") and on
our quarterly CD-ROM (call our subscription department, at 781-449-9780, to
order the CD-ROM).