UW puts focus on new physician training model
Revised curriculum unfolds here in partnership with GUMarch 2nd, 2017
Two issues that dominate today’s health care landscape across the country also affect Eastern Washington: a rapidly changing health care environment, and an increasing demand for more primary-care physicians, especially in rural and underserved communities.
The University of Washington School of Medicine (UWSOM) is addressing those challenges by teaching students using a new curriculum model, one that is collaborative and community based. The school’s clinical faculty, who are all practicing physicians, provide clinical experiences and mentoring in Spokane and many rural areas of Eastern Washington.
As a physician, medical school faculty member, and resident of our community, I believe we have a moral imperative to prepare tomorrow’s physicians for lifelong learning: to become the best doctors possible today and to keep evolving in the delivery of care for years to come.
The challenge across the U.S. lies in a gap between traditional models of medical education and the health care system’s changing needs. In the past, medical schools have been relatively static, preparing students for the present without much thought to the future.
UWSOM’s new curriculum embraces change and looks toward the future, introducing students to emerging technologies but also building in a continuous improvement model so they are prepared for today and adaptable for tomorrow.
Looking ahead, what will medical education look like in the future? To evolve, six key factors are necessary.
Identify and emphasize the qualities of a well-rounded physician. The medical school of the future will identify and select students who have excelled outside, as well as inside, the classroom. Once those students enter medical school, there will be a focus on the entire student experience, including building character and professionalism. Clinical courses and extracurricular activities will include leadership opportunities, community service, and engaging in the humanities as they relate to medicine.
Focus on people vs. patients. One of the big challenges facing medicine is shifting the traditional approach of focusing on individual patients to managing and improving health of populations. While we need to improve the health of individuals in order to improve the community’s health, we need to broaden our view. To date, we have emphasized disease management for the individual, and we need to transition to emphasizing the health of the population.
Physicians will always care for the ill, but as a profession, we need to be proactive and emphasize keeping people healthy rather than simply reacting once they become sick. How can we improve the health and quality of life for the greatest number of people in the community and do this in a cost-effective and efficient manner? That’s the essence of population health.
Balance the tension between technology and humanism. Increasingly, technology will be used to deliver health care. We are already seeing applications of that with teleradiology, telestroke, teledermatology consultation, and ICU consultation. While urban and rural physicians and hospitals are increasingly able to offer higher levels of care through these methods, they don’t replace or substitute for the doctor-patient relationship. We need to ensure that our students and physicians focus on treating the patient with the disease, rather than just the patient’s disease. Most schools, including UWSOM, are starting to do that in a variety of ways, beginning early in medical school.
In addition, medical schools of the future will integrate the humanities into medical education. UWSOM has collaborated in early work demonstrating that humanities coursework in medical school preserves empathy amongst medical students. In Spokane, we are taking that one step further by integrating discussions of the humanities and professionalism into our daily rounds with students and residents through a program called “A Daily Dose of Humanities.”
Forge new types of partnerships that leverage impact. Medical schools of the future will forge new partnerships that create synergies with a variety of partners. Medicine increasingly will become more of a “team sport” involving many different caregivers, each contributing their expertise to ensure optimal patient outcomes. In addition, health care systems, providers, higher education institutions, and research and technology innovators will pool their combined strengths to leverage resources that generate significant impact.
That’s been our experience with the UW School of Medicine-Gonzaga University Regional Health Partnership, which leverages the strengths of both universities. UWSOM is the nation’s leading medical school for primary care, family medicine, and rural medicine training, as well as the leading recipient of National Institutes of Health funding among public universities. GU has a trusted health sciences education track record. As the partnership joins with the community on collaborative initiatives, we will advance the health of our communities and foster growth to bolster Eastern Washington’s economy.
Continue evolving curriculum and teaching. The amount of knowledge that a medical student must acquire is staggering, from basic molecular and genetic information to specific diseases to epidemiology. At UWSOM, we have adopted a new curriculum model that helps our students put this information into a more meaningful context. It’s one of the reasons the American Medical Association chose us to join its “Medical School of the Future” consortium—a group of leading medical schools tasked with determining the direction medical education needs to take, to support population health.
Basic scientists deliver important information to our students, but the majority of our curriculum is taught by experienced physicians. The combination of small group learning, case-based materials, and working clinicians providing guidance and oversight has been extraordinarily effective. Students engage in projects related to rural health, service learning volunteer projects, and they participate in a variety of clinical research projects during all four years of medical school. We believe that this new, always-evolving, clinically-focused curriculum that emphasizes inquisitiveness will produce physicians who are ready to practice in any health care environment.
Expand the collaborative medicine community. Learning the practice of medicine from and with multiple health sciences disciplines will help to ensure that our medical students understand how all facets of patient care are interconnected.
The UWSOM-GU Regional Health Partnership taps a community-based network of nearly 800 health care professionals to provide training throughout Eastern Washington. That includes practicing physicians at all of the regional hospitals, in large groups, small groups, and solo practices. It also involves clinicians from nursing, pharmacy, physical therapy, and occupational therapy, as well as physician assistants and scientists/researchers.
Our future physicians, partners, and communities surely will benefit as we embrace new realities in medicine and medical care. In the end, our region will benefit as the health of our population and the health of our economy improve together.
Dr. Darryl Potyk is the chief of medical education for the University of Washington School of Medicine-Gonzaga University Regional Health Partnership and associate dean for Eastern Washington for the University of Washington School of Medicine.