What is the School of the Medical Arts?
The School of the Medical Arts (SoMA) project was started as a formal effort of the Duval County School System and the University of Florida, College of Medicine in Jacksonville in April, 2007. The goal of the effort was to obtain funding from the U.S. Department of Education to create the FIRST grade 6-12 high school in the U.S. with a MEDICALLY INTEGRATED curriculum. Once successful, the model could be used to establish similar schools across the country. The importance of this effort for healthcare is the ability to expand medical training an additional 7 years, to deal with the ever more complex medical environment, but without extending graduate medical education. As of this update, 2012, the School of the Medical Arts will graduate its first 12th grade class with a full 7 years of medical training.
From the beginning, we knew the challenges would be significant. We also knew, to be successful, this effort needed much more than local resources. Its goal was to represent U.S. medical education broadly. The project has always reached out to organizations across the country and around the world to find champions interested in helping.
Darnell-Cookman (D-C) middle school was a Duval County Medical Magnet school located across the street from Shands Hospital in Jacksonville. The University of Florida, College of Medicine in Jacksonville (UF-Jax) conducts residency training at Shands Hospital. UF-Jax operates the Center for Simulation Education and Safety Research (CSESaR), one of the largest medical simulation training centers in the U.S. In 2006, CSESaR started bringing students from (D-C) to the center to support their medical training. In April, 2007,a proposal was written for the federal Magnet Schools Assistance Program to create a new school called the “School of the Medical Arts”. This was proposed as the FIRST high school in the country with a FULLY INTEGRATED medical curriculum. The proposal was accepted and included $2.8M funding from the U.S. Department of Education and $21M from the Duval County School System. The project was launched in November of 2008 with the goal of adding one new grade level per year, increasing enrollment from 600 to 1400, and graduating the first 12th grade class in 2012. The construction phase was interrupted by the 2008 recession, putting students in temporary trailers. Construction was finally completed in the fall of 2011.
Current high school medical programs teach medical skills through medical electives taken in addition to standard subject matter. The SoMA program pioneered the concept of an INTEGRATED medical curriculum. That is, all standard subject matter was modified to include medical components. Medieval history, for example, included more focus on the plague, its effects and medical treatments. Gym class included sports medicine related to the class sport. The new curriculum was developed by the school's teachers during the summer of 2007 using the DOE grant. Conventional classroom lectures were also expanded with simulation training at CSESaR which included hands-on simulation with manikins as well as Virtual Reality and hybrid scenarios.
The Educational Challenge
The amount of knowledge needed to broadly understand medicine in today’s society has grown substantially throughout the past 50 years. Extending formal medical education beyond the current 7 year typical grad school - residency program has been discussed but not found to be practical. There is another alternative, however! Go the other direction. This has already been put into practice in the form of pre-med programs in undergraduate training as well as in high schools. But the growth of medical complexity has continued relentlessly. The SoMA model shows an approach to extend this “pre-med” concept back through middle school, to grade 6, with a FULLY integrated model. This still creates 2 very difficult challenges.
First, students, now starting in grade 6, even following a planned path to a professional medical career, will not practice medicine for at least 15 years. At the same time, the practice of medicine, and methods of medical training, are evolving at a high rate. The transition to electronic medical records and simulation based training are primary examples. The rate of change will create a significant challenge for curriculum planners. It is one thing to predict where medicine will be in 4 years, to plan a graduate school medical program. It is much more difficult to plan 8 years ahead for an under-grad pre-med program. With middle school training, a curriculum plan is needed that is looking at medicine 15 years ahead, plus trying to understand how to present the appropriate medical concepts to much younger students who, additionally, have very different 21st. century learning skills and tools.
Second, college pre-med programs are weak on medicine. A SoMA effort will graduate high school students with a strong 7 year medical background. To effectively use this, college pre-med programs will need to radically change. When that is done, the same need for a radically new program will be thrust on medical schools because they will be faced with entering students that have 11 years of medical training.
In effect, the School of the Medical Arts project has the ability to launch a restructuring of the entire medical education program in the U.S.