Cleveland Clinic's three-year medical school is making waves by graduating medical students in less time but without sacrificing quality of education.
The Transformative Care Continuum is a joint program between Cleveland Clinic and Athens-based Ohio University's Heritage College of Osteopathic Medicine that launched in July 2018. The program allows eight students interested in primary care to join the six-year undergraduate and graduate program each year. Four students study in Lakewood, Ohio, and four study in Akron, Ohio. Upon graduation, students can join Cleveland Clinic or another system. The first cohort of seven students graduated at the end of June.
"What makes this medical school so unique is that most medical school curriculums are written by people within the medical school itself," Sandra Snyder, DO, program director for the Cleveland Clinic family medicine residency and site director for the transformative care continuum at Lakewood Family Health Center, told Becker's. "It's a model that's been very successful. Some other three-year accelerated programs have fizzled out, but we've created a sustainable model with great results."
Three family medicine program directors from Cleveland Clinic worked with college professors to create the curriculum with the goal of training value-based, primary care physicians.
Cleveland Clinic made a few changes to the traditional medical school model in order to cut one year out. First, it matched residencies early, which eliminated the need for students to search, interview and match for a residency. Second, it streamlined rotations by removing those that were not directly related to becoming a primary-care physician. Then, they put a large emphasis on leadership and teamwork learning, which includes teaching students how to create community partnerships and engage with stakeholders.
Throughout the program, students spend one day per week in clinics and four days in medical school classes. On clinic days, students work with an interprofessional team to care for patients.
"The curriculum difference is that our program emphasizes experiential learning, with a strong focus on QI, leadership and teamwork," Dr. Snyder said.
Among the biggest pros for the program are moving students into the workforce faster, reducing onboard needs since students work closely with staff already, and building strong community connections.
"Seventy-five percent of our graduates from the first class have stayed in northeast Ohio," Dr. Snyder said. "They are continuing to work within the community, like one graduate who's overseeing an unhoused clinic in Cleveland called 'Doctors on the Streets,' or another who is starting a school-based mental health program in Garfield Heights."
But there are a few cons. Primarily, students have to know early on that they want to go into family medicine and the quick pace of the program can be difficult. The required one day in a clinic can also be hard for students because it takes away from study time. Since the program's launch, a few students have offboarded into a four-year program.
"Overall, I think the challenges of organizational skills and early commitment are worth it for the long-term benefit of more hands-on, value-based education," Dr. Snyder said.
Dr. Snyder said more schools should consider streamlining medical school education.
"With the physician shortage, it's important to rethink how long it takes to train a doctor," she said. "Some specialties take a long time to complete, but we could potentially shorten the timeline in a way that still maintains quality education. In fact, the fourth year of medical school has become more about securing a residency spot than truly expanding one's medical education. If we could streamline that process and allow students to specialize sooner, we could get physicians into the workforce faster. This is especially crucial in primary care, but it's not limited to that. Rural America struggles with physician shortages, and creating programs that recruit people from those communities, put them on a specific trajectory, and then return them to serve in those communities, could make a huge impact."
Cleveland Clinic does not have plans to increase the number of students in each cohort, but is working to further integrate public health and primary care into the curriculum.
"A successful family physician or primary care provider needs to understand the broader community health context," Dr. Snyder said. "Your patients are only as healthy as the community they live in, and that's what we're teaching the next generation. We'll keep refining our approach and evaluating whether we're teaching it effectively."