Journal of Medical Education and Curricular Development (11/01/23) Squirrell, Kyler; Deivanayagam, Shanthi; Niles, Katharine; et al.

Researchers compared the content and evaluated the consistency of mission statements from affiliated medical schools and teaching hospitals to find any incongruencies that may hinder the progress of graduate medical education (GME) trainees. They identified the top 163 North American medical schools and their respective teaching hospitals from a publicly available list of Association of American Medical member institutions. The authors also accessed each school and hospital's respective mission statements from their websites. The review yielded the themes of Global Care, Community Care, Diversity, Education, Ethics, Patient Care, Professionalism, Religion and Research. The researchers discovered a 45% congruency between the medical schools and their respective hospitals' missions, indicating that less than half the themes reported in the schools' mission statements overlapped those in the affiliated hospitals' statements. Medical schools' mission statements also covered significantly more themes than those of teaching hospitals, and they also shared twice the number of themes than those between affiliated institutions. Mission statements generally included the themes of Patient Care, Research and Education, highlighted by most institutions either as a list or as guiding precepts. Community Care was included in teaching hospitals' mission statements more frequently than Research and was a consistent theme within the statements of both institutions. The most commonly shared themes among affiliated school-hospital pairs were Patient Care, Education and Research; however, there was a notable disparity in Patient Care's respective frequency between each institution. The mission statements also commonly shared Community Care, while affiliated institutions significantly under-shared the remaining themes. A relatively large percentage of hospital mission statements shared the theme of Religion compared with medical schools, while their emphasis on Diversity and Global Care was considerably lower. "These findings suggest that the affiliated medical schools and hospitals predominantly share the basic tenets of GME but differ crucially in the nuances that make them unique based on location and community," the authors note. The implication is that distinctions among these regional subtleties can potentially impede the forming of a cohesive purpose, affecting the quality of GME. The researchers urge further research to clarify the impact of mission statement incongruency on quality and whether affiliated medical schools and hospitals could support a more beneficial GME environment through unified priorities and recognition of common goals.

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