What You Should Know About the ACME Initiative

In 2013, the American Medical Association, in response to demands from the medical community, developed their Accelerated Change in Medical Education (ACME) Initiative – and while some medical students may not have heard of this program, others at participating medical schools have already felt its impact or will in the future. Here is what every medical student should know about the ACME initiative.

ACME Founded to Foment Change in Medical Education
Dr. Susan Skochelak, in her presentation at the Council on Graduate Medical Education Meeting in 2017, noted that in the last 10 years, 15 separate national reports came to the conclusion that there was a need to modernize and update medical education in the United States. Of particular concern to the medical community was a lack of new physician readiness and perceived “gaps” in medical education, especially in important areas such as chronic disease management, communication skills, the ability to adapt to systems-based practice, and coordination of care among different medical disciplines.

The American Medical Association acknowledged this need in their detailed report on the ACME program, which notes that “As medicine and healthcare delivery in our nation continue to evolve in new and exciting ways, the US medication education system, which is based largely on an educational model more than a century old, has not kept pace. There’s been much discussion and the consensus is clear: it’s time for a change.”

In order to facilitate this change, the American Medical Association developed the ACME initiative, which began in 2013 and at the time, gave $1 million dollars each to 11 different medical schools over the course of 5 years in order to develop innovative medical education projects and programs. However, the initiative does not end there: apart from funding these project, ACME has developed a consortium of participating universities. This consortium meets regularly and was founded with the purpose of giving these medical schools the chance to share their ideas and innovations with other members in order to find what methods work and to spread knowledge of these methods among the schools. This consortium is bound by a formalized agreement to disseminate their collective knowledge, complete with intellectual property protections that are in place to foster a high level of inter-school cooperation.

While there are many variations on a theme, the core of the ACME initiative focusses in on 4 key areas:
1. Creating competency-based curricula to improve the flexibility of medical school education.
2. Incorporating new areas of knowledge into the existing curriculum.
3. Creating innovative methods for improved healthcare delivery.
4. Finding new ways to incorporate technology into healthcare.

ACME has Expanded to Meet Educational Needs
Another important thing to know about this program is that it has greatly expanded. When ACME first began, the AMA chose 11 medical schools across the country to be part of their original consortium. Just looking at the numbers, this program has a large potential impact. Becker’s Hospital Review notes that the original 11 schools covered around 7,000 medical students with the potential to impact 12.2 million patients. However, in 2016 – through a highly competitive selection process – the AMA chose 20 more schools to become members of the original consortium. According to Becker’s, the addition of these 20 extra schools will reach 18,000 medical students with the potential to care for 31 million patients. By numbers alone, then, the potential impact of programs funded by this initiative could be enormous.

ACME-Funded Initiatives are Diverse
Across the country, medical schools funded by ACME grants are developing a wide variety of programs to help meet the educational needs of 21st-century medical students. The official AMA report on ACME details some of the innovative ways that medical schools are preparing their students for 21st-century practice.

The Bridge Program: University of California at San Francisco School of Medicine
UCSF is one of the original consortium members and with ACME funding has developed their Bridges Program, one which emphasizes the importance of achieving health-promoting competencies and learning to operate in a healthcare system which is increasingly interdependent. The program helps to prepare medical students for this new reality in a number of ways, including healthcare coaching and cardiology research clinics in which medical students participate, along with students of pharmacology and physical therapy. There are plans within the college to expand this program to include other healthcare professionals in the future.

The Care by the Numbers Curriculum, New York University School of Medicine
The Care by the Numbers program at the NYU School of Medicine is another ACME-funded project whose flexible, three-year program relies on the use of technology to increase interdisciplinary cooperation and improve the quality of patient care.

This program allows students to gain experience with large data sets very early in their medical education, using de-identified patient data from a variety of real-life sources. This data is used to give students first-hand experience in a simulated group practice setting to help increase their understanding of healthcare practice for both individual patients as well as specific patient populations.

Students also use e-portfolios throughout their medical education in order to track their own personal progress – especially in regards to the achievement of competencies – and to continue to improve the quality of the care that they give their patients.

Curriculum 2.0: Vanderbilt School of Medicine
Vanderbilt’s 2.0 program is another example of ACME-funded innovation in medical school: the program’s goal is to create medical students who are adaptive learners, who will eventually become life-long learners as physicians, who will have strong self-assessment skills, and who will evolve to meet the changing needs and demands of a constantly changing healthcare system.

One important feature of Vanderbilt’s program is that students get hands-on experience as soon as possible in their medical careers. These early clinical rotations provide the students with opportunities to learn about the practice of medicine in a variety of settings and their responsibility increases as they progress in the program.

The 2.0 program uses a variety of methods in order to enhance the clinical and learning skills of their students. These include the establishment of learning communities, the use of portfolios to track educational progress, personal coaching, and integrated science courses for 3rd and 4th year students. The clerkships and clinical rotations also have a milestone-based student assessments to assist in skill and competency development.

The Accelerated Competency-Based Education in Primary Care (ACE-PC) Program, University of California (Davis) School of Medicine
University of California (Davis) School of Medicine’s ACE-PC program lasts six years and is a competency-based combination of undergraduate and graduate medical education. This program is linked to Kaiser Permanente and the UC Davis residency program and begins 6-weeks early in a course which prepares students for the skills they will need in primary care, including history-taking, physical exams, and clinical reasoning.

ACE-PC students begin clinical rotations as early as the second week in their program, and these rotations will continue throughout the 3-year primary care program in conjunction with Kaiser Permanente. Students work under the direct supervision of primary care preceptors and coaches throughout the whole of their program, which allows for a smooth integration into medical education and clinical practice. Clerkships are done simultaneously instead of in a series of 2-month blocks and content includes subjects like population medicine, the management of chronic diseases, quality improvement, and preventative health in relation to diverse or underserved populations.

In short, the AMA’s ACME program has expanded in the five years of its existence and now embraces over 30 medical schools across the country. Member schools are working in a variety of ways to transform medical education so that it can adequately meet the needs of 21st-century doctors and their patients. With the expansion of this program, ACME’s impact is likely to increase as more and more medical students are educated in ACME-funded programs.