Return on investment: a qualitative approach to understanding the value of undergraduate medical education from the perspective of health system and academic leaders

Purpose – Teaser: This study examines perceptions of systems leaders about the value of stude nt education illuminating non-financial motivators for investing in UME.Medical schools prioritize education as central to their mission; however, most exist within complex academic medical centers and health care systems where prioritization of education, clinical, and research missions varies. Support for medical student education has diminished in many settings. This study aimed to understand how leaders broadly consider the value of medical student education programs and consequently make choices to invest resources in undergraduate medical education (UME).Method – Value measurement methodology (VMM) was used to develop a semistructured interview guide to assess value across 5 domains: individual, operational, financial, social and societal, and strategic and political. Hospital executives, department chairs, and deans from 4 health care systems affiliated with the University of Colorado School of Medicine participated in interviews from November 2023 to March 2024. A hybrid thematic analysis was performed using the VMM framework.Results – Twenty-nine leaders across systems and departments were interviewed. Leaders consider the value of UME aligned with their strategic priorities. Leaders ascribed both tactical and symbolic value to investments in student education and considered student impact on their current and future workforce as well as their mission. Student education is perceived as a connecting force between academic missions, attracting talented faculty, and encouraging reciprocity of learning in clinical settings. Leaders voiced responsibility to train the next generation and influence how the future workforce is trained.Conclusions – The strongest reason leaders invest in student education is return on investment: education is an upfront cost, but value manifests in anticipated mission and workforce outcomes. Understanding how leaders consider the value of UME is paramount as medical educators propose collaborative efforts to enhance investment in clinician educators and curricular efforts.