Whether they are part of undergraduate (UME) or graduate medical education (GME), educators training future physicians have the same goals for the next generation of doctors. They want, among other things, physicians to work in teams, see their patients in a social context, advocate for their patients and challenge authority so improvements can be made to the system.

So why then is there often such a disconnect between UME and GME, and how can educators better align the two phases of physician education? That is the key question George Thibault, MD, president of the Josiah Macy Jr. Foundation, focused on in a recent talk titled “The UME and GME Continuum: Aligning Education with the Needs of the Public.” The lifelong medical educator of both medical students and residents spoke at the AMA Accelerating Change in Medical Education Spring Consortium Meeting in Scottsdale, Arizona.

“We set up false dichotomies and barriers,” he said. “We should think of this as a common mission that we share, a noble mission, to create the doctors of the future. UME is no more noble than GME. Neither one can exist without the other.”

He said medical education needs greater flexibility and must move away from a fragmented model. “It does not serve us well,” he said.

Dr. Thibault noted this is the right moment to better align the two steps to become a physician, and he said looking at the changes coming in medicine can help transform the education system. For example, he said, doctors know the delivery system is dramatically changing. Although not all the features are known, he said physicians know that care will be more team-based, that there will be more patient and community partnerships, and that everything will be part of a system. Physicians, he said, also know the patient population is older and more diverse and that patients want to be more involved in their care.

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