A structural examination of medical education reform.

Submitted December 23, 2014; accepted January 5, 2015. Osteopathic medical education is currently navigating stormy waters because of unprecedented changes from the Patient Protection and Affordable Care Act, the Institute of Medicine report Graduate Medical Education That Meets the Nation’s Health Needs,1 and a new single graduate medical education (GME) accreditation system. In response to health care reform, the osteopathic medical education system has focused on increasing the size of the physician workforce by rapidly establishing new colleges of osteopathic medicine (COMs) and increasing class sizes of existing COMs.2 However, increasing the number of physicians will not provide the solution unless those physicians are trained to meet the needs of our changing health care delivery system. Osteopathic medical education must widen its focus beyond quantitative workforce solutions and align its education with the efforts of the care-delivery redesign that is driving health care today. To address how medical education can prepare physicians for the changing health care system, the American Osteopathic Association (AOA) and the American Association of Colleges of Osteopathic Medicine (AACOM) established the Blue Ribbon Commission for the Advancement of Osteopathic Medical Education (BRC). The BRC’s report, Building the Future: Educating the 21st Century Physician,3 provides a comprehensive framework to fundamentally change osteopathic medical education and optimize the alignment between osteopathic medical education and health care delivery. Simultaneously, the Accelerating Change in Medical Education Initiative from the American Medical Association (AMA) arrived at many of the same conclusions as the BRC and created 11 pilot programs to evolve medical education to meet these needs.4 The benefit of increasing physician supply as the main response to predicted physician shortages has been debated. In the November 2013 issue of Health Affairs, Ricketts and Fraher5 promoted the increase