Opinion Pieces

Time to rethink the mission of European medical schools?

In her blog article “Rethinking the mission of medical schools”, Jemma Weymouth summarizes a recent debate which asks whether US medical schools are producing the health workforce that America needs. The recent study that sparked this debate did so by ranking US medical schools in an innovative and highly provocative way: on the extent to which they accomplish a “social mission”: producing doctors who practice primary care, work in underserved areas and are minorities underrepresented among health professionals. This debate is made all the more pressing as the US prepares for an influx of newly-insured patients under health reform. Europe is also at a point where the health needs of its citizens are changing in ways that surpass the missions’ of medical schools created to cope with 20th century challenges. Are European medical schools producing a health workforce capable to tackle Europe’s future health needs?

By measuring schools against these “social mission” criteria, Dr. Fitzhugh Mullan of George Washington University and his colleagues have created a new “best medical schools” list that ranks prestigious US medical schools such as Vanderbilt, Duke, Stanford and Johns Hopkins in the bottom 20. Ranking is always a controversial process and this one did not fail to stir up a commotion. The study came under fire from the Association of American Medical Colleges (AAMC) and by some of the low-ranking schools for what they claim is a too-narrow definition of social mission. The authors reply that the intention of the study is not to point fingers but to help schools examine how they are meeting the nation’s health care needs, which are changing in important ways.

Today global processes like climate change, health worker migration and antibiotic resistance are beginning to have impacts on European health systems. Nation states are now interdependent in more than economic terms. Health is increasingly a cross-border challenge that demands collective action and the provision of global public goods. In the last 10 years research has shed new light on the complex network of social, economic and political factors that determine the health of populations. Are European medical school curriculums up-to-date with these developments? Will Europe’s medical professionals of tomorrow be able to cope with new interdisciplinary challenges, recognise the underlying social causes of poor health and ultimately turn the health sector around from the bearer of the consequences of irresponsible governance to an activist for social justice?

To answer these questions perhaps a similar study of the “social mission” of European medical schools is needed. Over the last few years the EU has established a set of core health values that guide European health policy. These are universality, solidarity, and equitable access to quality care. My question to you is by what social criteria should we judge European medical schools? How can Europe’s health values be operationalized?