WE ARE CHARGED WITH PREPARING OUR MEDICAL STUDENTS TO BE LEADERS IN THEIR FIELDS. ARE WE LIVING UP TO OUR RESPONSIBILITY?

The following is a guest post by an academic colleague and social media buddy of mine, Kaylan A. Baban, MD MPH, who is a new Course Director at Icahn School of Medicine at Mt. Sinai, as well as a developer of eye health smartphone applications.  Dr. Baban is launching a new medical student elective at Mt. Sinai called Healthcare 2.0 that promises to bring budding docs up to speed in the new world of digital medicine.  The post below is part of the Course Description from this new elective.  Find out more about Dr. Baban at LinkedIn.  Her Twitter handle is @KaylanBaban. 

Healthcare 2.0: Preparing medical students for the dawn of digital medicine

Technology is progressing at lightning speed, revolutionizing every aspect of healthcare and life.  As medical educators, we are charged with not only providing a strong foundation in basic science and clinical knowledge, but also preparing our students to be leaders in the avant garde of healthcare as it is will be practiced tomorrow.

As a robust virtual professional presence becomes more vital to the modern physician, so too does the need to responsibly manage that presence.  It is critical to guide students not only regarding actions to avoid in order to protect themselves and their patients, but also regarding affirmative steps that can maximize educational, professional, and health benefits to themselves and the patients in their care.

Social media, mobile technologies, electronic health records, and health information technologies are quickly becoming the present of modern healthcare, and will certainly be its future.  One implication of this shift is that modern healthcare is quickly becoming a highly interdisciplinary field; one that requires an unprecedented level of technological savvy for full participation.  Physicians who are not comfortably conversant in the use of these technologies will be unable to fully participate in, much less lead, the conversation.  It is our responsibility to step out of the silo in which healthcare has traditionally been housed, and guide our students’ exposure to this reality of modern healthcare.

Physicians and patients alike are poised to benefit enormously from these new technologies.  As such, standards of care will shift.  Savvy patients will, and to some extent already do, expect their physicians to avail themselves – in a critical and responsible manner – of technologies that streamline care and communication.  This will be true not only in “boutique” practices, but also among the underserved populations our students may seek to serve domestically or abroad, since those populations stand to benefit perhaps more than any other.  As standards of care shift, today’s medical students must be prepared to lead the way.  We have a responsibility – to them and their future patients – to give them the foundation to do so.

PM: Advancing from Elective to Core Curriculum

Upstate Medical University is currently revising its undergraduate medical curriculum to keep pace with the rapid changes that have occurred in healthcare over the past couple decades.  Like many U.S. medical schools, our present curriculum is a modest variation of that proposed by Abraham Flexner two years before the sinking of the Titanic in 1912.  Needless to say, the way doctors practice medicine 100 years later is beginning to emphasize a substantially unique set of tools (e.g. EHRs), principles (e.g. genomics), and behaviors (e.g. e-Patients and social media).  

The new medical curriculum will undoubtedly implement more clinical exposure in the first two years, with better integration of basic science and clinical topics throughout the entire, standard 4 year program. Delivery is expected to incorporate increased active learning (e.g. live patients) and critical thinking, and decreased passive learning (e.g. lectures).  These are not novel concepts; many if not most medical schools across the country have made or intend to make similar changes.

The relevance of this change to me is that all material presently taught in my elective "Personalized Medicine 101: Digitizing Diagnosis for Doctors" would be absorbed into the core curriculum where all students become equally immersed in the topic areas.  PM101 topics include, but are not limited to: Genomics in Health & Disease, Molecular Diagnostics/Prognostics, Prenatal Diagnosis/Carrier Detection/Newborn Screening, Direct to Consumer Genetic Testing, Genetic Counseling, GINA/ELSI, Pharmacogenomics in Drug Metabolism, Epigenetics & GxE, Proteomics, EHRs/PHRs, Clinical Decision Support systems (e.g. IBM Watson), e-Patients & Participatory Medicine, Healthcare Social Media, mHealth, and Telemedicine. 

Should all of these topics represent core material for all budding docs setting up a clinical practice in the 21st century?  That is certainly my belief, assuming we stick with tradition and continue to train all budding docs for a once-size-fits-all M.D. degree.  Bear in mind that students entering medical school in 2012 will begin independent practice, on average, around 2020.  

This does not mean we stop teaching empathy, professionalism, differential diagnosis, systems medicine, gross anatomy, etc.  Indeed, all of those topics will be part of the new curriculum.  So, how does one teach exponentially increased clinical knowledge and skills without simultaneously increasing the curricular timeline?  Therein lies the $64M question for the task force assigned to sinking the Flexner model in 2012.