Contact: Mary Beth Reilly, [email protected] or Kara Gavin, [email protected], 734-764-2220
For immediate release
U-M Medical School preparing tomorrow's doctors now Launches new program for integrated medical education and patient health
ANN ARBOR, Mich. - Several years ago, a Chinese patient in the United States awoke from major stomach surgery to find that a feeding tube had been inserted into his small intestine. He insisted that the tube be removed, and then checked himself out of the hospital and flew home to China weeks before his doctors felt he was strong enough. Had the patient been asked in advance, he would have informed his surgeon that a foreign object connected to his body was culturally unacceptable; he and the surgeon could then have discussed options.
What the patient's surgeon learned from this particular incident is something now shared with second-year medical students at the U-M Medical School. He had neglected to explore his patient's culture and the ways in which major surgery and post-operative procedures might conflict with cultural beliefs and practices. The outcomes could have been deadly.
"This story, and follow-up discussions in small groups of medical students facilitated by clinical faculty, is one introductory component of the U-M Medical School's new Program for Integrated Medical Education and Patient Health, designed to help students learn how to approach, communicate with, and treat each of their patients as unique individuals," says Joseph Fantone, M.D., Associate Dean, Medical School Administration and professor of pathology.
Traditionally, early in their education students spend significant time in classrooms and laboratories learning enormous amounts of scientific information they must later synthesize into a human context in order to care for patients. As a result, students' initial tendency has been to approach patients with a focus more on scientific facts and evidence than on people.
"The characteristics that make individuals unique and contribute to disease and to wellness can be too easily lost or overlooked. This new program creates a human context for the medical sciences that students are already learning," says Fantone.
Over the last year, faculty and staff in the U-M Medical School have received support from a number of sources to integrate patient-focused topics including multiculturalism, spirituality, complementary and alternative medicine, geriatrics, and end-of-life care into the more conventional, science-based and disease-focused curriculum for medical students. The new program, made possible through funds from the Arthur Vining Davis Foundations, the Donald W. Reynolds Foundation, and the National Institutes of Health, consolidates these efforts in a Medical School-wide curriculum that will focus learning on patients.
Faculty involved in the program are collaborating with other physician-faculty members who guide medical education at the U-M to review and refresh the curriculum. Learning about scientific principles will continue in the classrooms and laboratories, but there will also be corresponding, fully-developed patient cases designed as learning tools that will challenge students on both scientific and humanistic levels. Cases will present patients of specific ages and genders, with and without symptoms or existing/changing conditions, along with information about socioeconomic status, families, ethnic backgrounds, cultural practices, health beliefs, and sexual orientation.
As they learn in classrooms and complement their learning with these cases, students will also be assigned to clinics in order to participate in patient care and learn how science and the human side of medical practice come together. The cases and clinic assignments will give students an appropriate context through which they can organize what they are learning so the knowledge is at their disposal as they progress through medical school.
As they begin to spend more time with patients - in clinics and hospitals - students will continue to be challenged to synthesize their growing scientific expertise into patient-focused care. A number of newly-developed learning aids will help with this challenge. One is a web-based "educational consultant," currently in pilot phase for third-year students. As they rotate through Internal Medicine clinics, there are many topics students need to learn and think about that affect how they care for their patients.
Geriatrics is one of these topics. As they see older patients, each student must formulate one or two questions or concerns that arise regarding patient care. Using the Internet, students send their questions to an educational consultant - a faculty member specializing in geriatrics - who answers students' questions within 24 hours. This exchange initiates a computer-based discussion between the student and the faculty-physician regarding treating older patients, and the unique issues related to such care. Faculty working in the program will expand their educational consultant efforts over the next few years. They will provide students with access to physician-specialists who can discuss with students the many complex, personal factors that influence patients' health status, the care they seek and receive, and their compliance with treatment recommendations.
"This new program is in part a response to society's needs. Today's patients expect more enlightened health care providers, particularly in terms of awareness of the immense diversity in cultures currently represented -- and growing -- in the American population. The U-M Medical School has created the Program for Integrated Medical Education and Patient Health to add yet another dimension to a curriculum that continues to provide a strong foundation in biomedical sciences, and emphasizes professionalism and communication skills," Fantone says.
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