UNIVERSITY OF CALIFORNIA COMMISSION ON THE FUTURE OF MEDICAL EDUCATION

In light of the rapid changes underway in American heath care, President Atkinson appointed a commission in August 1996 to examine issues related to the education and training of the medical workforce and the delivery of health care in California. The commission has been asked to develop recommendations to guide the University in tailoring its medical programs to ensure that the state's needs for the next century are met. The charge to the commission and its membership follow:

The revolution in the American health care marketplace presents many challenges for health sciences education, particularly medical education. As the nation's largest provider of medical education and clinical care, UC and its five health sciences campuses and associated teaching hospitals have a tremendous impact on the size, preparation, and specialty mix and distribution of the medical workforce that serves California. From the perspective of the University of California, it is critical to tailor medical education programs to meet California's future requirements for physicians.

Consequently, the President of the University is establishing the University of California Commission on the Future of Medical Education to examine a wide range of issues related to education and training of the medical workforce and the delivery of health care. In undertaking this task, the Commission recognizes the breadth of the health care workforce and will take the non-physician workforce into consideration. However, the Commission will focus on medical and graduate medical education and training and will develop recommendations to guide the University in transforming those programs to ensure that the State's physician workforce needs of the next century are met.

The Commission will undertake to design a blueprint for medical education and graduate medical education as a continuum which begins with a student's entry into a medical school and culminates for the practitioner with programs for re-education and the application of new and innovative technologies. Owing to its size, changes implemented by the University will have a significant impact on the State, and the work of the Commission may be useful to future efforts across the nation to restructure the education and training of physicians.

In pursuit of this charge, the Commission will examine the following four questions:

1. What is the size, configuration, and quality of California's present health care workforce?

The Commission will examine the current number, distribution, and mix of allopathic, osteopathic, mid-level and alternative health care practitioners and project their supplies through the early twenty-first century. An analysis of quality will relate current practice patterns of physicians to the "best practices" for the prevention and treatment of disease and include documentation of any gap that may exist between current and best practices.

2. For California's health care needs, what is the appropriate size, configuration, and quality of the workforce?

The Commission will estimate the numbers of allopathic, osteopathic, mid-level and alternative health care practitioners necessary to meet California's health care needs now and early in the next century. In developing these estimates, the Commission will assume a managed health care system that is increasingly integrated in a state that may undergo significant economic and demographic change. In particular, the Commission will make recommendations as to the core competencies the physician workforce should possess to meet the present and future health care needs of Californians.

3. What changes should the University make to respond to California's present and future health care needs?

The Commission will recommend policies that the UC system should implement to ensure that its medical and graduate medical education programs produce the appropriate number, distribution, and mix of physicians and mid-level practitioners. These policies should also ensure that physicians and mid-level practitioners who graduate from UC possess the requisite core knowledge and skills. Further, the Commission shall study and recommend postgraduate education programs for continuous maintenance of the knowledge and skills of the physician workforce in keeping with current best practices.
In developing these recommendations, the Commission will take cognizance of the inter-relationship between the schools of medicine and the medical centers and the linkage between education, research, and patient care.

4. How rapidly and in what sequence should and can the Commission's recommendations be implemented?

The Commission shall recommend a process, sequence, and timeline for introduction of the proposed changes.

Although the Commission is an advisory body supported by the Office of the President, it will develop an agenda and pursue its work independently. Charles B. Wilson, M.D., Senior Associate to the President on Medical Affairs, will serve as staff to the Commission. Dr. Wilson is currently on a one year sabbatical leave from his position as Professor of Neurosurgery and Director of the Brain Tumor Research Center at UC San Francisco.

The Commission is asked to submit its report and recommendations to the President during the Spring of 1997.

Memebers of the commission are: