Dora on CNN
Just thought it was pretty damn cool that my classmate Dora made CNN and the AP about our new curriculum. I feel kinda bad, I have no big crazy research interests like her. Just hope I can make some sort of impact with my patients and my community. That’s a decent goal, right?
There’s a somewhat random quote from Citizens for the Right to Know about some fears about the new curriculum, but I know there’s probably more people in my class interested in public health, community health, and family practice because of the new scholarly concentration. I think specialization is fairly common at most hardcore research institutions, anyway, and most upperclassmen did research or community work anyway, even before this new curriculum made a track mandatory.
bq(quote). Joan Werblun, volunteer executive director for Citizens for the Right to Know, said Stanford’s experiment, if widely copied, could encourage specialization when managed health care increasingly “shuttles people to the general practitioner.”
“I don’t know if this is going to work,” said Werblun, a former nurse who heads the Sacramento-based patient advocacy group. “Managed care could turn around and bite Stanford.”
Update: Seeing as though our entire class passed both molecular biology and histology a couple weeks ago (which hasn’t happened in 5 years) and our anatomy midterm yesterday went the best it’s ever gone since the anatomy professor started teaching here, I’m giving the curriculum a thumbs up so far.
Update 2: GruntDoc couldn’t be more wrong about Stanford students.
The whole point of the new curriculum is to give us some depth of knowledge in the medical field, instead of just the fire-hose version of breadth. CNN got it wrong–they’re not like majors, they’re like minors, and all health related. The first eight: Molecular Medicine, Bioengineering, Bioinformatics, Community Health and Public Service, Humanities and Bioethics, Immunology, Women’s Health, and Health Services and Policy Research.
Sure, medical school is a graduate program, but medicine doesn’t work in a bubble; there are social issues, community issues, research to do, policy, technology–issues that, I think, physicians should have some background in if they want to make the most of their practice. (Note: the new curriculum isn’t all that entirely different from what Stanford med students have been doing for years–70% of the class takes an extra year to do research, manage one of our two student-run clinics, pursue another degree, learn a foreign language, or volunteer abroad. The fact that the university is now trying to facilitate and organize our extracurricular interests is secondary; our interests existed long before any curriculum reform began.) I don’t care if Stanford requires 200 hours or 2,000; I can’t think of any person in my class who won’t do beyond the 200, because we’re passionate. We’re sponges. We want to soak up all the knowledge and wisdom that we can. And we’re the furthest from lab-rat masochist gunner medical students as you can meet. Some of our students even take six years. Yes! Six! Generally because they’ve got families, partners, or children that they want to raise, or decide to go get the Ph.D., too.
Medicine’s changing, GruntDoc. I think there’s a fairly common sentiment in my class that we’re not happy with the direction medicine is going–the health care system is a disaster, patients have growing distrust with doctors, doctors are pressured to practice medicine in a hurried, who’s-next manner, and it concerns us. I want to be a patient advocate, not the adversary. I want to be the best clinician I can be (we’ve now already started learning how to do patient histories and physical exams in the first year, something the article never mentioned), but I want to make broader changes, too. Idealistic? Absolutely. But frankly, anything’s better than the status quo right now, and if I don’t do it, it doesn’t look like anyone else is stepping up to bat.
Down off the soapbox now.
Nice pose. You know Dora’s serious when she’s wearing a stethoscope around her neck to… look at blood cells. (?!)
But seriously, at Melbourne University where I study, we’ve just implemented a change to the curriculum such that students now take a year to do research into a field of their choosing. Not necessarily lab work or clinical either – I have friends who spent their year doing research into medical ethics, medical history, bio-informatics amongst others. This sounds similar to the program that you had with the 70% research/extracurricular year.
How well did it work in our case? Well, it’s too early to say at the moment but I think overall it’s been a positive experience. The curriculum had to cut back on a lot of the old teaching to accomodate this research year (they kept medicine as a 6 year course). The hardest hit by the changes was the teaching of anatomy, which went from about 300 hours to 60. Subsequently, many of the medical students flocked to the surgical anatomy research elective to compensate for what they felt was a deficiency in their learning. This was strongly discouraged by the faculty who wanted to promote diversity and broaden the minds of students. Eventually though, students re-equilibrated themselves without having to be forced, and it worked out alright.
I think there are differences between the American method of teaching medicine and the British methods. In Australia, most (~2/3) of medical students are accepted straight out of high school. It seems that when I ask most of my colleagues they really have no idea what they want to be when they graduate, preferring to have experience in all areas before committing to one. A program that forces students to nominate an area of interest in first year would probably be disasterous in this case. No one would know what to pick!
Even in the case of the research year, my primary reason for nominating my research project was just because I met a whole bunch of research supervisors, and ended up with the one who was most keen to have me. Luckily for me, I guess, it worked out well, and I’ve developed an interest in this area.
Without knowing the exact details of the Stanford curriculum, it’s hard for me to say for sure if the fears about hyper-specialisation and loss of primary care providers is well-founded. At this stage I’m fairly skeptical about the changes, though. One of the things is though is that it’s actually fairly hard to make catastrophic changes to any medical curriculum (short of say, sacking all the lecturers and replacing them with trained chimpanzee) as medical students in general tend to be so neurotic that despite whatever curriculum changes, students will self-regulate into something resembling useful medical people.
I could be wrong, but I side with Gruntdoc on this;
I think adding another 200 hours into med school in areas which are peripheral to medically caring for a patient is just making med school less appealing. If you have interests in these areas, you should explore them in undergrad (that’s what electives are for). Making more requirements which have nothing to do with patient care (policy studies?!?!), will be detrimental to the already shrinking applicant pool. It will also reinforce the “I’ve paid my dues, now it’s time to get paid” attitude. Hell, the new step 2b is merely an excuse for the NBME to bolster it’s budget. By making it more expensive and time consuming, you are only sucking more of the life out of the students. After med school, the bloodletting continues with what can be brutal years as an intern and resident. If you want more compassionate doctors, then show them some, yourself. Forcing them to go through an extra training regimen does not help. Many are doing it anyway, on their own, but making it a requirement will defeat the purpose, and turn a joy into a chore. Nothing is restricting students from doing these things now, so why fix it if it is not broken? Ugh, must sleep……
…….exam in 10 hours.
Read my comments at my blog (became very long)!
Stanford sets new policy for med students
Stanford Med discovers their students are occasionally sleeping, and comes up with a solution: CNN.com – Stanford sets new policy for med students – …Stanford announced last month it would become the first U.S. university to require new medical stude…
Stanford sets new policy for med students
Stanford Med discovers their students are occasionally sleeping, and comes up with a solution: CNN.com – Stanford sets new policy for med students – …Stanford announced last month it would become the first U.S. university to require new medical stude…