The Current State of Medical School Education in Bioethics, Health Law, and Health Economics

Abstract

Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search. In sum, teaching in all three subjects combined comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics.

Health economics education in undergraduate medical degrees: an assessment of curricula content and student knowledge

“…In a survey of AAMC medical schools in the US, hours of teaching devoted to health economics varied from nothing to over 30 hours per year (Persad et al 2008). This study also found that the majority of teachers were nonspecialists (measured by having at least one publication in the field).…”

“…In response to rapidly rising health care expenditure and an increased understanding of the social and behavioural determinants of health, researchers in both the UK and US have highlighted a pressing need for health economics in medical training (Conill & Hillman 2000;MacLeod & McCullough 1994;Persad et al 2008;Russell et al 2004).…”

Ethics Curriculum for Emergency Medicine Graduate Medical Education

“…The importance of ethics education as an integral part of medical education has been acknowledged by the Liaison Committee on Medical Education (LCME), which has an accreditation standard that states, ''A medical school must teach medical ethics and human values, and require its students to exhibit scrupulous ethical principles in caring for patients, and in relating to patients' families and to others involved in patient care'' (LCME Standard ED-23) (14). These principles also apply to graduate medical education in emergency medicine.…”

Tendencias de la formación bioética en los currículos universitarios

“…En este estudio se analizaron las instituciones con rendimiento desde aceptable hasta excelente, en los grados tres a siete y se excluyeron las de grados uno y dos, que no se recomiendan. Los investigadores encontraron que 45% de los programas de postgrado en Odontología no ofrecían ninguna clase de enseñanza de la Bioética 36 . No encontraron diferencias entre instituciones públicas y privadas, según tuvieran o no cursos y contenidos de Bioética.…”

“…Otros eran filósofos, eticistas, bioéticistas o formados en estudios religiosos, en leyes, psicología, antropolo- Ibídem., p. 303. 36 Ibídem., p. 287. gía cultural y literatura. Entre estos últimos, más que en los primeros, se encontró la tendencia a mantener una teoría ética específica, lo que podría responder a su formación en campos teóricos y más abstractos.…”