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August 26, 2010

Medical students take unique approach to training

— Columbia-Bassett medical students were in Cooperstown last week to experience learning in a whole new way.

Some mucked cow stalls, others learned about plumbing and construction while some visited a local restaurant. The students also spent a day at Springbrook, Pathfinder Village, a physical therapy center and a local nursing home.

All of this was a part of a new curriculum created for medical training. Columbia University College of Physicians and Surgeons (P & S) and Bassett Medical Center joined forces last year to launch a new model of medical training to address the severe shortage of rural physicians and train a new generation of doctors capable of leading health systems that promote both quality of practice and cost-effective delivery of care.

According to a Bassett media release, the 10 students are poised to be among the first physicians to graduate medical school uniquely trained to lead the health systems of the future. Bassett spokeswoman Karen Huxtable said Bassett, in particular, has an interest in helping the young physicians see their patients as people first in the environment where they live and work.

Medical student Mark J. Harris, who graduated from Dartmouth College, said he believes meeting potential patients in their own setting is what sets the program apart from others.

``It is very much about relationships and people and looking at health and community on a broader level,’’ he said. ``It was cool to get insight into the community we will be training in.’’

The students are now in Manhattan where they will spend 18 months. Then they will be back in Cooperstown for two and a half years to get their clinical training. Students will experience an urban health care setting and a rural health care environment, while being exposed to features not typically part of the medical school curriculum such as finance, risk management, patient safety, quality improvement and medical informatics.

According to Columbia’s Senior Associate Dean at Bassett Dr. Walter Franck, the program is designed to address the shortage of rural physicians in addition to training students the financial and systems side of their profession.

``With this infusion of individuals who were selected not just for their professional excellence but for their personal excellence it is our hope that in the years to come, some of the students will remain in health care systems like ours, including ours,’’ said Franck.

Medical student Haley Masterson, who attended the University of Kansas, said she thought it was logical to meet the people and get a sense of what the community is all about before narrowing down the focus and learning about health care practices and Bassett itself.

Freda Ready, a Cornell University graduate, said the program’s educational model revolves around the idea that patients are whole people.

``In today’s changing health care system, it’s important that physicians not only be healers in a traditional sense, but also be advocates for their patients,’’ she said. ``I believe the Columbia-Bassett track is geared towards teaching students to do just that.’’

Ready said when students interview at most medical schools they are encouraged to chose something they are interested in and continue with it because medical students need to be complete people. However, she said she feels the Columbia- Bassett program is truly the only program that actually encourages that in practice.

``As medical students we all come to medical school with all sorts of different histories and backgrounds and at a lot of schools you are expected to leave all of that at the door as you walk in to become a doctor. I believe good doctors are people who can connect with their patients on a level other than simply providing a medical diagnosis.’’

According to Huxtable, the program was established because health care reform is on its way. ``We know health care five to 10 years from now is going to be very different,’’ she said.

``We also know medical students coming out of medical schools now are not prepared for that and we are asking how to address that so the AAMC (The Association of American Medical College) said we need medical schools to change their curriculum to meet the needs of our future physicians.’’

The AAMC has called for a 30 percent increase in U.S. medical enrollment by 2015 to address the nation’s physician shortage, which is especially severe in rural America.

When announcing the Columbia- Bassett venture, Lee Goldman, M.D., executive vice president for health and biomedical sciences and dean of the faculties of health sciences and medicine at Columbia University Medical Center, said, ``Our goal is to encourage outstanding medical students to practice in rural areas and help them develop the skills necessary to shape the health care systems of the future. This innovative new campus may be the demonstration model for a much-needed new paradigm, which will catalyze care that is at once safer and less costly and inspire other medical schools to emulate and improve upon our example.’’

Dr. Henry Weil, Columbia's assistant dean for education at Bassett, said one of the building blocks of health care reform is training that nurtures the compassionate physician while simultaneously immersing that doctor in leadership development and the systems underpinning effective health care delivery. ``In this new era of medical education, physician training is not just about medicine and science,’’ he said.

The goal of the Columbia-Bassett curriculum, said Weil, is to turn out skilled clinicians who are passionate about patient care, good communicators, adept at evidence-based medicine, and accountable to society as responsible managers of the health care system.

A total of 758 men and women applied for the program’s 10 slots - a ratio of applicants to positions that is more than double the ratio recorded last year at Columbia P & S. According to Huxtable, applicants came from more than 200 colleges and the 10 students accepted have MCAT scores and grade point averages comparable to those of students at top medical schools in the country.

In fact, she said, their GPAs and MCAT scores are higher than the mean of last year’s enrolled class at Columbia P & S.

Weil said the motives of the applicants interviewed for the Columbia- Bassett Program were inspiring.

``In essence, students were attracted to the programÆs emphasis on caring patient relationships and on learning skills to improve health care systems for populations of patients,’’ he said. ``Clearly, a new generation of physicians with such attitudes would help the United States move toward better and more affordable health care.’’

Blake Alberts, who was in the accelerated program at the University of South Dakota, said, ``Bassett has the same mission but is 180 degrees opposite in how it approaches health care.’’

Alberts said interviews for the Columbia- Bassett were held during the winter months so he was shocked to see a whole new village when coming back in the summertime.

``For a town this size, there is definitely a lot going on,’’ he said.

The group of students said they were excited to have the chance to learning a small rural community setting.

Medical student Andrew Gomez, a graduate of the University of Arizona, said visiting the Smithy Gallery was one of his favorite things he did while in Cooperstown. He said because it is the first year of the program he really appreciates all the questions form the organizers. Gomez said they are always asking how things went and how the program can be improved.

The four-year program will graduate its first class in 2014. Huxtable said there is talk about offering the program to 14 students next time around. She said there was no way of knowing how many students would take an interest in the program and was amazed by all of the interest.

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