This is a time of major innovation in medical school curricula, with many schools endeavoring to introduce clinical exposures early in medical training and to integrate clinical and basic science topics. The basic science topics include disciplines such as neuroscience, pharmacology, physiology, cellular biology and genetics, all of which provide a firm foundation necessary for building solid clinical reasoning.
By phasing out basic science and phasing in clinical rotation early in undergraduate medical education, medical schools are devoting less time to teaching basic pharmacologic principles relevant to rational prescribing. Furthermore, the number of faculty with appropriate training in pharmacology has decreased substantially. These changes have led to reduced awareness of critical principles of clinical pharmacology in the medical community and a concomitant risk of suboptimal and even hazardous prescribing practices.
The Association of American Medical Colleges (AAMC) has identified critical knowledge and skills that medical students must acquire before graduating in order to be prepared to function independently at the beginning of their residency training. These are called the Core Entrustable Professional Activities (EPA) and include the ability to appropriately prescribe medications. The American College of Clinical Pharmacology® (ACCP) is developing a set of standards representing the Core EPA in clinical pharmacology that are published as a series of papers known as the Clinical Pharmacology Education: Pearls for Practice® in The Journal of Clinical Pharmacology. An ACCP Committee dedicated to this task has identified eight core topics within the Clinical Pharmacology Education: Pearls for Practice®, including pharmacokinetics & pharmacodynamics, dosage adjustment in young or old age or organ impairment, medication adherence, biologics, drug-drug interactions, working in a healthcare team, utilizing online information sources and common problem drugs. The papers that have been published to date may be accessed through the links below.
This is a time in which professional societies with technical expertise and an educational mission – like ACCP – have an exciting opportunity to play a key role in shaping the future of medical education in America. This series of papers is intended to serve as a resource not only for ACCP Members, but also for other societies in the discipline, for medical schools, for medical professionals that would like to refresh their prescribing competencies and for the AAMC Core EPA Curriculum Developers’ Guide.