Harvard alters doctors' training

[Celebration]

http://www.boston.com/yourlife/health/diseases/articles/2006/03/20/learning_the_patients_view/

Harvard Medical School is embarking on the most dramatic changes to its curriculum in 20 years, in an effort to better train doctors to understand illness from the patient's perspective and appreciate how patients' lives and the disjointed healthcare system complicate their care.

The biggest shift will occur in the third year, which is the first time that students leave the classroom to see patients. At present, students go from hospital to hospital for one- to three-month stints, a practice that gives them few opportunities to get to know patients or senior doctors.

Under the new curriculum, students will stay in one hospital and follow some patients the entire year.

Senior doctors would be able to better spot students' strengths and weaknesses, and they will hold twice-monthly conferences in which students will discuss not only their patients' medical issues but also ethical dilemmas, family problems, and health insurance snafus.

[sir_captain]

1. It seems like HMS changes its curriculum

every 5 years or so--definitely not ideal for its students.

[Warpy]

2. As somebody who had to deal with those med students

during their three month stints at Boston teaching hospitals, I can only say WOO HOO!!! It's about bloody time.

They will have a much better grasp of what's facing their patients when they come back into those hospitals as interns the following year, and that will improve patient care at teaching hospitals dramatically while lowering the burden on nurses who often feel compelled to point out the obvious to baby docs who don't have a clue.

This new practice of having them follow patients for an entire year is a great one. I had a similar experience my last year of nursing school, following a head injured patient from trauma intensive care through the stepdown unit and on into rehab. It was a valuable experience that few of my classmates had, and that one patient taught me more than any other I cared for while I was in school. I'm sure it'll do the same to Harvard's med students.

[Mikimouse]

3. Same experiences here, and in the same venue...

I was exposed to the med students at NEMCH and Deaconess.

[Warpy]

4. For me it was mostly MGH and Brigham & Women's

but all the teaching hospitals in the area were full of Harvard med students. Are you still getting "that" lecture about how nurses are their last hope of turning back into human beings?

[Mikimouse]

6. My experience was from a little different perspective...

I was the supervisor of the nuclear cardiology lab., and later the department of nuclear medicine, so my experiences were more of trying to educate the little morons that badgering their patients into having a diagnostic test that they didn't want was inapropriate. My techs always explained the nature of our studies to the patients and my policy was, if a patient was hesitant or frightened of the procedure, we didn't proceed, simplae as that. We would notify the ordering physician (many times a third year med student, which I also thought was inapropriate) and advised them of the patient's 'refusal', but only after we sent the patient back to the floor. This gave the patient time to consider his/her options. In my final days at NEMCH, things were beginning to change for the worse. Patients were kept waiting for their students/interns/residents for hours at times, because it had been decided that they couldn't be interrupted during conference. I almost lost a patient when she went into flash PE on my table and her resident wouldn't answer his damned page (stat paged over the PA system and by pager as well). He finally sauntered up after I called a code. She survived, but not because of anything he did, useless POS. I left healthcare in 1993, and never looked back. It has deteriorated to such an extent that the term itself is an oxymoron.

[Warpy]

9. Yowza!

I too almost lost somebody because a little wart of an intern didn't want to leave his precious conference to deal with a problem. My patient lived, too, and then the little wart tried to blame ME for not notifying him.

Too bad there were multiple calls and pages on record.

Maybe of they give these little bastards a little more reality therapy during their last year in med school they'll respond a little better.

I left healthcare 3 years ago because I got sicker than my patients. If I were cured tomorrow, I wouldn't go back. It's become a nightmare, a total meat grinder for staff, appalling working conditions that no amount of money can compensate for.

[benddem]

5. This is FINALLY

a step in the right direction. Maybe now the new docs will think of more than what expensive tests to order. :bounce: :bounce: :bounce:

[Mend]

7. I liked the old way: we rotated through Cook County

Hospital which was mainly serving the poor, through Michael Reese which was serving the rich, through Mt. Sinai which was a mixed bag of people, and the VA. It really showed how poverty complicates illnesses, treatments, follow-up care, and staying well. I thought the VA was by far the worst place to be a patient. When I was a resident, we started following patients long-term.

[varkam]

8. The powers that be are getting through their head that...

you can never say too much for bedside manner and a little human compassion. I'm not a doc, nor a med student, but I have been a patient of a doctor who just about made me cry once.