Every year, millions of Americans opt for surgeries, tests and other procedures that might not improve their health — and could even undermine it. To help reverse this wasteful, often harmful trend, the ABIM (American Board of Internal Medicine) Foundation and the Josiah Macy Jr. Foundation are supporting a new initiative by the Dell Medical School at The University of Texas at Austin to select and coach 50 medical student leaders from across the country with the goal of changing the way medical schools address this issue.

The STARS (Students and Trainees Advocating for Resource Stewardship) program is working to teach students core tenets of value-based care — efforts to create better health outcomes for patients at lower costs by focusing on people’s health and lives. Through the program, a pair of students from 25 medical schools will:

  • Learn about the concept of value in medicine
  • Review the Choosing Wisely value-based care campaign, along with medical society recommendations;
  • Train to create local and regional change in the areas of overuse or waste; and,
  • Use concrete tools to drive change at their medical schools to improve the value of patient care they provide as they progress through their training
A faculty champion and a dean-level leader at each of the 25 medical schools also have committed to support these innovations within their institutions, which include:
  • The University of Texas at Austin - Dell Medical School,
  • University of Chicago - Pritzker School of Medicine,
  • Johns Hopkins University - School of Medicine,
  • University of Colorado - School of Medicine,
  • University of Arizona - College of Medicine Tucson,
  • University of Minnesota - Medical School,
  • Eastern Virginia Medical School,
  • Ohio State University - College of Medicine,
  • University of California San Francisco - School of Medicine,
  • University of California San Diego - School of Medicine,
  • University of Michigan - Medical School,
  • Mayo Clinic - School of Medicine,
  • UT Health San Antonio - Long School of Medicine,
  • Oregon Health & Science University - School of Medicine,
  • Vanderbilt University - School of Medicine,
  • New York University - School of Medicine,
  • University of North Carolina - School of Medicine,
  • Icahn School of Medicine at Mount Sinai,
  • Northwestern University - Feinberg School of Medicine,
  • Boston University - School of Medicine,
  • University of Utah - School of Medicine,
  • Texas A&M - College of Medicine,
  • University of Washington - School of Medicine,
  • University of South Carolina - School of Medicine Greenville and
  • U of Texas Southwestern - Medical School
The U.S. STARS program kicked-off with a one-day summit for first-year medical students at the Dell Medical School in December that included large-group sessions, workshops and informal networking.

The overall program will mirror the successful STARS program started in 2015 by Choosing Wisely Canada with support from the ABIM (American Board of Internal Medicine) Foundation. Over the first year of that program, Canadian medical students led several projects to advance Choosing Wisely, a campaign launched in 2012 by the ABIM Foundation to encourage clinicians and patients to discuss medical tests and procedures that may not be necessary. STARS is becoming an international movement, with the Netherlands recently launching its own program.

The next phase will invite the U.S. medical students to participate in a community where they can share stories of success and challenges. They will also be invited to join the ABIM Foundation’s existing Teaching Value in Health Care learning network. The goal is for these students to launch their own local programs and Choosing Wisely initiatives, supported by the community, which will reach across the country. Chris Moriates, MD, assistant dean for healthcare value at the Dell Medical School, is working to create an innovative curriculum for value-based healthcare for undergraduate, graduate, and continuing medical education. “By engaging medical students in introducing the concepts of Choosing Wisely into their own training, we expect to have ripple effects that will eventually reach all corners of our health care system.”