52. Medical education will be made continuous, engaging, and scalable in the age of increasing clinical demands and limited work hours.

Bryan Vartabedian, MD, Director of Community Medicine | Gastroenterology, Hepatology & Nutrition Texas Children’s Hospital; Assistant Professor of Pediatrics Baylor College of Medicine

This is part of a series of essays on the Health Rosetta’s Principles.

Medicine is changing fast. Yet, the way we train doctors is not changing nearly as fast. It’s reflected in an education system built for medicine’s 20th century industrial age. This generation of physicians will witness a profound change in the practice of medicine. The digital world is upon us and this, more than any other change, will fundamentally alter the way medicine is practiced and taught.


New literacies

So how should we best train today's physicians to meet 21st century demands? We can start by considering what doctors will need to be able to do in order to function in a digital environment. Shaping medical education today requires some understanding of the needs and skillsets of the next generation.

New literacies for the digital age should be considered foundational elements in medical education. American medical education is graduating doctors thoroughly unprepared to deal with the challenges of a connected age.

While there may be many, we may consider 3 key literacies that will define the doctor of 2033. Network awareness, information control, and digital content creation.


Networked intelligence

Physicians in 2033 will practice as part of a broad network of collective knowledge. The ability to communicate, collaborate, share, care for patients and learn as part of this global network will become a critical skill.

For the first time since the inception of the Internet, medical educators are witnessing the matriculation of digital natives on the clinical wards. Our young trainees have grown accustomed to the concept of real-time communication and transparency in dialog. But fluency in social dialog and health privacy are often at odds. Young physicians have little understanding of health privacy, professionalism and how it relates to our public conversations. Consequently, educators are facing the issue of privacy transgressions and professional boundaries among students and graduate trainees.

Networked intelligence involves a basic working knowledge of the power and limitations of new, public forms of media communication. Specifically, we need learners to understand the changing boundaries of the doctor-patient relationship, the limitations of public, short-form dialog, and the professional implications of permanent, scalable publishing.


Impeccable information management

By 2033 medical educators will move even more from teaching students and residents what they need to know to teaching them how to access what they need to know. Consequently, one of medicine’s greatest challenges will be managing the inevitable information overload. The body of medical knowledge available to physicians will be beyond the point of what any individual can know. Doctors will need the tools and skills to manage information, inputs and exploding networked knowledge.


Capacity for digital communication

A networked environment calls for a physician who can communicate and create using digital tools. The ability to use basic communication platforms to translate, transfer and share information and knowledge will be a necessary skill for the physician, especially the academic leader.


Unique human skill sets

We must also remember that the ultimate interface is human to human. As machines progressively replace what physicians have traditionally done with their eyes, ears and hands, physicians will ultimately be left with a unique new role as human intermediary. So the more advanced medicine will become, the raw human capacity for connection, translation and communication will become critical.

There will be many new skill sets and technological competencies necessary for the doctor of 2033. Educators have no option but to build medical education around the realities of changing workflows and a digital environment. Our system of education will need the capacity to adjust in a dynamic way. Advancement of medical education will not meet advances in technology if changes happen around dated administrative models.

Richard Horton of the Lancet has suggested medical education is fundamentally conservative, indoctrinating new generations into the failed ways of the old. For too long we have hugged the shore of safe and acceptable tradition.

Disruption in medical education is undermined by a system designed to suppress change. As noted by Clay Shirky, institutions and regulatory bodies will work to preserve the problem to which they are the solution. Real change in medical education will not come from current institutional structures but grassroots efforts.

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