VA HealthCare: A High-Qualtiy, Cost-Effective, Resource for 21st Century Medical Education for All

The US is facing an imminent shortage of physicians and nurses. New training schools are welcome. No organization could do it better than the VA.

I Part I we traced the history of affiliations between Medical schools and VA Hospitals. Five aspects of current affiliations deserve your attention. First: the numbers of young medical students sent by medical schools to VA hospitals for training speaks to the recognized teaching quality of such VA experiences. Second: mostly the students are sent to VA specialtists in General Surgery, Orthopedics, Dermatology,etc). Rarely are students assigned in Primary Care despite Primary Care being a premier VA medical service. Since students are rarely mentored in Primary Care they seldom choose it for a career. Future VA medical students will be mentored in Primary Care Third: VA medical schooling should be less costly. Current graduates face a $140,000 indebtedness on graduation, an indebtedness, that distorts their career choices. Fourth: although private practitioners recognize the merit of electronic medical recording they find it difficult to learn and costly to acquire. The future VA medical graduate will be electronic medical record-wise and will be averse to practicing without it. That would be another big plus for the country. Fifth: As we have noted the VA has mentored a significant portion of medical students in their final two school years. But only the Medical school receives tuition payment for those two years. No monies are shared with the VA.

Looking ahead, can the government run a medical school? It currently graduates 170 physicians every year from its tuition-free Uniformed Services University of Health Sciences in Bethesda. Each graduate is committed to 7 years government service. Have any hospitals ever become medical schools? Yes, outstanding examples are Mayo Clinic Minnesota) and Mt Sinai (New York). What changes are needed? For the last two school years the VA is currently well well prepared. For the first two years Pathology labs already do autopsy dissections and might easily teach anatomy and clinical labs might easily teach biochemistry, but, we must accept that some additional space and staff will be necessary. Some reverse affiliations may take place wherein VA medical students go across the street to the university medical school for selected early science courses. The benefits of this VA initiative will be huge and well worth the efforts.