On changing curricula: Lessons learned at two dissimilar medical schools

Two dissimilar U.S. medical schools-the University of Pittsburgh School of Medicine and the University of Texas Medical Branch at Galveston-changed th eir curricula for the first two years of medical education from ones that w ere lecture-dominated and departmentally run to ones that are centrally gov erned, multi-modal, goal-oriented, and fully integrated, with mechanisms to continue curricular change into the last two years of medical education. T he change at each school was in response to national education philosophy, the recommendations of the Liaison Committee for Medical Education after th e most recent site visit, and faculty's and students' concerns and interest s. The change process took place over a three- to four-year period at each sch ool, involved students, faculty, and administration, and utilized task forc es and retreats as communication vehicles. The barriers encountered (e.g., belief by some that the curriculum needed no change; concern over loss of d epartments' control) and the processes employed to overcome them and to rad ically change the curricula (e.g., commitment of the central administration and dean to the change, involvement of all segments of the school in the c hange process, appointment of department chairs on task forces, and creatio n of a strong curriculum committee that gave authority to faculty and stude nts) were essentially identical. The resulting curricula were also largely similar in their main characteristics, but there were notable differences, based on the goals and concerns of the two institutions.