HOW MEDICAL-SCHOOLS CAN MAINTAIN QUALITY WHILE ADAPTING TO RESOURCE CONSTRAINTS

To gain a better understanding of the effects on medical schools of on going transformations in medical practice, science, and public expecta tions, the Association of American Medical Colleges (AAMC) formed the Advisory Panel on the Mission and Organization of Medical Schools (APM OMS) in 1994. Six working groups were appointed to address different i ssues of importance. This article is a report of the findings and reco mmendations of the Working Group on Adapting to Resource Constraints. That group was charged to consider how leaders in academic medicine ca n respond to the challenges of external forces and the anticipated dim inishing of resources, and to focus on medical schools and how they ca n maintain quality while reengineering to effect needed changes. The g roup members developed their thinking within four categories: size of the academic enterprise; organizational models and their relationships to the clinical enterprise; faculty tenure and compensation; and part nerships with capital-intensive entities. Three recommendations for ac tion, to which the APMOMS unanimously agreed, were made to the AAMC, w hich has already acted upon them in ways described in the article. The group also developed a series of ''ideas for consideration'', which r epresent a range of the members' perspectives. The working group did n ot seek (and probably could not have obtained) unanimous agreement on many of the issues that these ideas focus upon. The ideas are presente d as a series of resolutions designed to stimulate discussion and fost er better-informed planning.