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Healthcare Professional Education - Project 100 - Musculoskeletal Education / 
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Project 100

AAMC Recommended Learning Objectives for Musculoskeletal Medicine Education Released

The Association of American Medical Colleges (AAMC) issued a Medical School Objectives Project report on Musculoskeletal Medicine Education, October 2005.  This report describes the basic learning objectives and educational strategies related to musculoskeletal medicine education for all American medical schools. 

The expert panel convened by the AAMC to author this report strongly recommended the integration of musculoskeletal medicine throughout the curriculum in medical schools so that all graduating medical students will be able to aptly treat the many millions of patients with conditions effecting musculoskeletal systems.

This report will support the efforts of Project 100, a Decade sponsored venture to ensure that 100% of American medical schools offer dedicated instruction in musculoskeletal medicine.

"The U.S. Bone and Joint Decade created Project 100, to improve medical school education in musculoskeletal medicine, and ultimately to better the care of patients. The objectives and education strategies articulated by the AAMC report will help make certain that students will be prepared for that important work," says Joe Bernstein, MD, chair of Project 100.

"We are delighted with these new recommendations," says Nancy E. Lane, MD, president of the U.S. Bone and Joint Decade. "With the growing responsibility of musculoskeletal diseases in our aging population, it is mandatory that we incorporate these criteria in the medical school setting."

Click here to view the report, Contemporary Issues in Medicine: Musculoskeletal Medicine Education.

"This report is only the beginning", stated Martin I. Boyer, MD a member of the Objectives Panel and a Loeb Fellow in medical school education at Washington University, St Louis. "Although more than 100 schools have endorsed the Decade, we still have more work do to—at the local and at the national level. But this report will certainly help further our efforts."

AAMC and the medical school objectives project (msop)
- Musculoskeletal Medicine Education

In light of the increasing age of the US population and an expected corresponding increase in the prevalence of musculoskeletal disorders, there is a growing concern that practicing US physicians are ill equipped to recognize and treat these conditions.  To properly prepare the physician population, it is imperative that medical schools provide learning experiences that will allow students to gain an appreciation of the importance of these conditions and the challenges inherent in caring for patients who are so afflicted.  Leading recommendations for learning objectives to instill the appropriate attitudes, knowledge and skills related to musculoskeletal medicine include:

  • First and foremost, medical schools most foster an appreciation for the complex effects musculoskeletal conditions have on afflicted patients. 
  • Students should be knowledgeable about the clinical manifestations, pathology, and pathophysiology of the common musculoskeletal conditions.
  • Medical students must be able to conduct a musculoskeletal physical exam and be capable of identifying common musculoskeletal diseases and conditions, and initiating appropriate treatment for these patients.

Hyperlink to www.aamc.org/meded/msop

Background on MSOP:  The MSOP initiative is designed to develop within the medical education community a consensus on the appropriate learning objectives and educational strategies to use in educating undergraduate medical students in selected subject areas.  Prior topics include population health, genetics, communication, and informatics.  MSOP reports are organized around the categories of Attitudes, Knowledge, and Skills. 

Report recommendations:  The recommendations listed below are the lead-ins for each of the common MSOP report categories of Attitudes, Knowledge and Skills.  Within the report proper there are specific bulleted learning objectives related to each category.

            Attitudes:  First and foremost, medical schools most foster an appreciation for the complex effects musculoskeletal conditions have on afflicted patients.  Students must come to understand that these conditions can severely affect a patient's mobility, produce chronic pain, limit their independence, and result in serious psychological and financial consequences adversely impacting quality of life.

Knowledge:  Students should be knowledgeable about the clinical manifestations, pathology, and pathophysiology of the common musculoskeletal conditions.  And they should possess an understanding of the diagnostic tests that should be employed to confirm a diagnosis and current approaches to the treatment of those conditions. 

Skills: Medical students must be able to conduct a musculoskeletal physical exam and be capable of identifying common musculoskeletal diseases and conditions, and initiating appropriate treatment for these patients

Project 100

The U.S. Bone and Joint Decade's Project 100 aims to improve medical school education in musculoskeletal medicine. This initiative is being directed by Dr. Joseph Bernstein of the University of Pennsylvania. The goal of Project 100 is to have 100% of American Medical Schools offer a required course in musculoskeletal medicine by the end of the Decade.

According to Dr Bernstein, currently fewer than half of the country's medical schools require such a course. Not surprisingly, research has shown that recent medical school graduates lack cognitive mastery of musculoskeletal medicine and lack the necessary confidence in the subject as well. "If the care of musculoskeletal disease is to improve, as we hope, improving medical school education will be a necessary milestone," said Dr Bernstein. "With the growing burden of musculoskeletal disease in an aging population, it is essential that we raise the profile of medical school education in this discipline."

As a Bone and Joint Decade program, Project 100 is a collaborative project among organizations participating in the Decade. The American Academy of Orthopaedic Surgeons (AAOS), led by Dr. Martin Boyer of the Committee on Medical Student, Resident and Fellow Education of the Council on Academic Affairs, has been an early supporter. Dr Boyer (boyerm@msnotes.wustl.edu) hosted a breakfast meeting at the 2003 AAOS annual scientific meeting in New Orleans, addressing medical school education. At this meeting, 86 orthopaedic educators offered their commitment to the project in person, and 62 others sent their support.

AAMC Objectives Project

On October 10, 2003, a meeting of musculoskeletal educators was held. Representatives from, the American College of Rheumatology, the American Society for Bone and Mineral Research, the American Academy of Physical Medicine and Rehabilitation, the American Academy of Orthopaedic Surgeons and the American Association of Clinical Anatomists were present to hear a presentation by Dr. Michael Whitcomb, senior vice president of the Association of American Medical Colleges.

Dr. Whitcomb invited the group to apply to the AAMC's Objectives Project, and the AAMC then convened an expert panel to determine the learning objectives for medical students in musculoskeletal medicine.

Musculoskeletal Medicine Textbook

October 2003 the textbook Musculoskeletal Medicine was published. It is published by the American Academy of Orthopaedic Surgeons (AAOS) and has been reviewed and approved by the American Academy of Family Physicians and American Academy of Pediatrics. In a world where over 30% of office doctor's visits relate to musculoskeletal injuries or conditions, Musculoskeletal Medicine improves a physician-in-training's knowledge of the numerous challenges they encounter in daily practice. It covers the structures and functions of the musculoskeletal system, normal and abnormal conditions, how to properly identify maladies and injuries and why problems arise. It contains useful discussions of biology, disorders and clinical topics, but is particularly noteworthy for its presentation of anatomy and physical examinations. The section on anatomy teaches a method of drawing basic diagrams that stresses functionality and ease of recall. The highly-illustrated book also contains an integrated CD-ROM with physical exam videos, a structured legend, and detailed, printable anatomy plates. Its clear, concise structure and content makes Musculoskeletal Medicine ideal for classroom use or self-directed learning. More information on the book can be found by clicking here. The AAOS is offering volume discounts for classroom adoption. For this program, contact AAOS Customer Service at 800-626-6726.

Deans' Declarations of Support

To serve as the foundation of Project 100, the U.S. Bone and Joint Decade asked that the deans (or vice deans for education) sign a declaration of support, stating, "This Medical School recognizes the importance of musculoskeletal diseases and the disability caused by these conditions in our society. We support the goals and objectives of the United States Bone and Joint Decade, and declare our commitment to advance education, research and patient care for bone and joint diseases." 

All schools have now signed the declaration of support. A list of participating schools can be viewed at Friends of the Decade- Medical Schools.

The Project 100 team welcomes participants from all interested member organizations.

Please contact Dr Bernstein at orthodoc@post.harvard.edu for more information.

Files & Links:

  USBJD Salutes American Medical Schools (file)

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