Health systems science education for undergraduate medical students: a 3-year longitudinal curriculum preparing students to drive real-world health system improvement

BACKGROUND: Medical education has traditionally relied on basic and clinical sciences as the two foundational pillars for preparing physicians to enter practice. Recently, health systems science (HSS) has emerged as a third pillar, aiming to address the complexities of rapidly evolving healthcare systems. However, it remains limited or absent from most medical education programs worldwide, often lacking structured formal integration within broader medical education curriculum. METHODS: In August 2019, a new 3-year longitudinal Health Systems Science (HSS) course was introduced into the fourth year of a 6-year undergraduate medical curriculum at the Mohammed Bin Rashid University of Medicine and Health Sciences in Dubai, United Arab Emirates. The course addresses competencies such as value-based care, population health, interprofessional collaboration, health system improvement, and systems thinking. It combines structured classroom instruction, online modules via the Institute for Healthcare Improvement (IHI), and the completion of an experiential Quality Improvement (QI) project in the final year. RESULTS: All students participated in workplace-based quality improvement project and presented their findings as posters at a year-end HSS school symposium. When surveyed at the end of the course, all 47 students who completed the survey indicated they would recommend the course to future students, with 93.62% of respondents rating the course as ‘Excellent’ or ‘Good’ (M = 4.34, SD = 0.60). Students also appreciated the new QI skills they acquired and their deeper understanding of health systems. NEXT STEPS: The course faculty plan to continue instilling and nurturing HSS competencies during the early stages of medical education and envision expanding such courses to more health professionals in the future, including those from nursing, pharmacy, and other health programs. Student feedback and lessons learned will be used to inform course improvements, implement robust assessments, and influence a cultural shift towards greater engagement in QI work alongside clinical care.