While creating benefits for both the hospital and medical staff, the development of medical education programs has implications that also affect clinical service design, care delivery models, relationships with medical staff, patient perceptions, cost and revenue cycles, and institutional resource use. Therefore, before implementing OGME programs, administrative and clinical leaders should carefully consider whether medical education is in their collective best interests. In times of limited resources, it is crucial to understand these implications and to use a vigilant and informed process to make decisions. Moreover, it is important to have the board members, administrative personnel, and medical staff committed to the development and implementation of the medical education programs.
A comprehensive planning effort that defines specific programs, resident complements, faculty arrangements, academic affiliations, financial implications, and curricular needs is required. This planning is best completed through broad participation of the hospital's relevant constituencies, as well as an academic partner. Formation of an OGME Planning Committee is an important initial part of this process. Such a planning effort clarifies understanding of specific challenges for new programs and helps to identify solutions. Other important steps in the process include the following:
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Strategic plan development. Creation of a medical education strategic plan that is integrated with the hospital's strategic plan, mission, and values.
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Setting objectives. Clarification of desired outcomes to be achieved, which will direct subsequent planning and implementation and provide a reference for measuring progress.
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Assessing readiness for medical education. An assessment of the educational resources that are available and required for the OGME programs.
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Assessing the environment. A determination of the feasibility of implementing OGME programs, including consideration of the political structure and conditions in the medical community. It is naïve to assume that new educational programs can be implemented if the medical staff is unsupportive.
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Creating structure for program design. Selection of the DME, who will be responsible for managing the educational programs. At the outset, the OGME Planning Committee should assist the DME in establishing policies and procedures for program operations, including providing recommendations regarding recruitment and hiring of residency program directors.
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Gathering external data. The use of site visits, consultations, physician focus groups, and other external information. Much can be learned from established programs, and the AOA OGME Development Initiative can assist hospitals in starting new osteopathic residency programs.