Musculoskeletal Education in Medical Schools: a Survey in California and Review of Literature
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ORIGINAL RESEARCH
Musculoskeletal Education in Medical Schools: a Survey in California and Review of Literature Tim Wang 1
&
Grace Xiong 1 & Laura Lu 1 & Joseph Bernstein 2 & Amy Ladd 1
Accepted: 26 October 2020 # International Association of Medical Science Educators 2020
Abstract Introduction Though musculoskeletal complaints account for roughly one-quarter of primary care and emergency department visits, only 2% of US medical school curriculum is devoted to musculoskeletal disease. Many graduating students demonstrate poor knowledge and report low confidence in treating musculoskeletal disorders. This study defines the current state of musculoskeletal curriculum of medical schools in detail to identify variations and potential shortcomings. Methods All eleven medical schools in California were invited to participate in an in-depth survey detailing the design and content of their musculoskeletal curriculum. Results A response rate of 100% was achieved. Overall, schools devoted an average of 58.7 h to musculoskeletal medicine, of which more than half was spent covering anatomy. The primary instructor for musculoskeletal medicine was a clinician in four schools (36.4%). Six schools offered a dedicated musculoskeletal physical exam course. No schools required students to complete a clinical rotation in musculoskeletal medicine. There was high variability among institutions when evaluating core subject coverage. Discussion There is large variation in the content and structure of musculoskeletal instruction among California medical schools. Increased curricular time, integration of preclinical and clinical experiences, greater specialist participation, and standardized objectives may provide more consistent and comprehensive musculoskeletal education. Keywords Medical school . Medical education . Musculoskeletal education
Introduction A large discrepancy exists between the frequency of musculoskeletal disease seen in the clinical setting and the attention devoted to it in medical schools [1]. Musculoskeletal issues are the most common presenting complaint to a physician, accounting for 15–30% of primary care and 20% of emergency room visits in the Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s40670-02001144-3. * Tim Wang [email protected] 1
Department of Orthopaedic Surgery, Stanford University, 450 Broadway St, Pavilion C, 4th Floor, Redwood City, CA 94063, USA
2
University of Pennsylvania School of Medicine, Philadelphia, PA, USA
USA [1]. These conditions are a leading cause of longterm disability [2, 3] and are responsible for 850 billion healthcare dollars each year [4, 5]. However, many medical schools require no clinical clerkship in musculoskeletal medicine [6]. Among schools that do offer a dedicated musculoskeletal educational program, less than 5% of total academic time over the 4-year medical school curriculum is spent on the topic, a fraction disproportionate to the burden of disease [6–8]. Freedman and Bernstein revealed 78–
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