In 2015, Harvard Medical School scrapped the curriculum they’ve taught with regular updates since 1987 for an entirely new approach to teaching medicine.
Seismic changes are afoot in medical schools across the country. NPR reports that “top medical schools around the U.S. are tearing up the textbooks and starting from scratch.”
The Wall Street Journal says “a wave of innovation is sweeping through medical schools.”
This wave of change acknowledges that there is simply too much to know to teach in four years. School can’t impart all the medical knowledge that will come in handy during your career in that time frame. It’s too voluminous.
“Facts are necessary, but they are not sufficient,” Gordon professor of medical education Richard Schwartzstein explained. “And there are too many facts for everybody to learn anyhow, so let’s get away from this notion that you could possibly learn them all, even if you wanted to.”
Additionally, medicine advances too quickly for medical education to be a one-and-done endeavor. “Half of what we teach you during four years of medical school is going to turn out to be wrong or irrelevant by the time you graduate,” Harvard medical education dean Edward Hundert tells arriving students.
So what can a doctor do to ensure that their education continues beyond the medical school years? Here are five surprising fields of study that doctors say make them better at medicine.
1. Neuroscience and learning techniques
How do you learn how to learn better? Figuring out how you learn best is a key way to make sure you’re always learning as a doctor. New apps and techniques are making that easier.
For example, Shiv Gaglani, a medical student at the Johns Hopkins School of Medicine, used his background in neuroscience to co-found Osmosis, a medical education technology company.
Studying cognition reveals that people learn most efficiently by hooking new information onto information they have already learned. Osmosis recommends new content to learn based on what you already know.
Neuroscience also shows people remember stories better than facts, so Osmosis teaches doctors the side effects and interactions of drugs through narratives.
Another example is Atul Gawande. He’d been a surgeon for eight years, but he felt like at some point, he stopped getting better results. He recalls watching Rafael Nadal play a tournament match on the Tennis Channel.
The camera flashed to his coach, and the obvious struck me as interesting: even Rafael Nadal has a coach. Nearly every élite tennis player in the world does. Professional athletes use coaches to make sure they are as good as they can be. But doctors don’t. I’d paid to have a kid just out of college look at my serve. So why did I find it inconceivable to pay someone to come into my operating room and coach me on my surgical technique?
Gawande writes that the “traditional conception of pedagogy” presumes that, “after a certain point, the student no longer needs instruction. You graduate. You’re done. You can go the rest of the way yourself.”
Coaching, he writes, is different. So he engaged a coach. And it made a huge difference.
Elaine Schattner, M.D., writes:
“There are new facts constantly coming to light, and changing conventions, about which doctors in all fields should be aware. So I think it’s wise for all physicians to be actively learning—or perfecting their knowledge base.”
According to the World Health Organization, “Effective teamwork in health-care delivery can have an immediate and positive impact on patient safety.”
The University of California, San Francisco, has medical students practice teamwork by working together to solve a genetics problem. And at the University of Michigan Medical School, second-year medical students build their communication skills by negotiating the sale price of a used BMW.
UCLA’s David Geffen School of Medicine aims to help students make friends through social events and trips. It certainly worked for Jiwoon Chang, M.D., and Abinav Baweja, M.D., who met at orientation in 2011 and are close friends to this day.
The two became friends while bonding over eclectic musical taste and UCLA basketball during one such trip to a music festival. They say having close friends helped them get through med school and has prepared them well for careers in medicine. Chang adds:
“I think the most important set of skills to learn from medical school is forming strong connections, working together and sharing knowledge to work toward the same goal.”
“Medical school admission committees are thinking more ‘outside the box’ in terms of identifying and selecting specific skills that may define an ‘ideal’ candidate for medical school,” according to Robert Glatter, M.D., emergency physician.
An aptitude for so-called left-brain thinking (biochemistry, pharmacology, anatomy) is obviously necessary for gaining the skills you’ll need to practice medicine. But Glatter writes that the right-brain skills (art, music, writing, sociology) you’ll develop by studying the humanities “may actually hold greater value in the eyes of some experts.”
Studying art, in particular, can enhance doctors’ ability to excel in medical school and become effective physicians. Dr. Salvatore Mangione, artist and Associate Professor of Medicine at Thomas Jefferson University, recommends doctors and future doctors develop artistic and visual skills. He adds:
“More and more, the data are quite convincing that people that think in pictures may actually have greater innovation and greater creativity than people who think in words.”
Mangione has studied Leonardo da Vinci extensively. In an episode of The Drexel Interview, Mangione says of da Vinci, “For him, there was no separation between science and art.”[youtube https://www.youtube.com/watch?v=2nSij6UvjjM]
Watch Dr. Mangione discuss creativity in medicine and the need to develop a tolerance for ambiguity
Since opening its doors in 2009, Texas Tech University’s Paul L. Foster School of Medicine has required all students to learn medical Spanish language skills.
Dr. Cynthia Jones-Nosacek, a family practice doctor at the Milwaukee Guild Catholic Medical Association, studies Spanish on her own to better relate to her growing Hispanic patient population.
“I am not fluent, but know enough to understand the conversation,” Jones-Nosacek tells me.
She learns for “the look of relief on [patients’] faces when I ask them a question in Spanish or reply to a question they have asked someone to translate for me,” Jones-Nosacek says. “It must be scary to have to hope that someone else, a relative or translator, will say exactly what you mean to say. I have also caught family members or translators ‘coloring’ the translation and have corrected them.”
Orthopedic Surgeon Dr. Barbara Bergin tells me she took Spanish in high school and college and then spent a summer in Mexico City, where she says, “I didn’t allow anyone to speak English to me.“
“I speak Spanish fluently and I use it in my office every single day! I can connect to, and understand my patients’ needs much better when I speak their language.”
Research shows that Mindfulness Based Stress Reduction (MBSR) can help prevent physician burnout.
More than 40 years ago Jon Kabat-Zinn and U Mass colleagues showed that physicians gained superior resilience after an eight-week meditation and yoga training compared to their colleagues who didn’t take the course. Subsequent studies have repeatedly confirmed these initial observations, according to Dike Drummond, M.D.
Bianca Belcher, MPH, PA-C, blogged about having “a small meltdown” after a fax machine at her practice destroyed her only copy of a patient’s medical record from Japan.
“I can’t lie,” Belcher writes. “I came close to pushing the entire machine down the stairs. We’ve all been there, but quickly regaining personal perspective is invaluable. Did the fax machine burn down my house, transmit a life threatening disease, or cause me permanent disability? No? Great, then five to six deep breaths should do the trick. This approach has been an enormous stress reliever in my day-to-day life.”
Medical Marijuana Physician Matt Roman, M.D., says that:
“Studying bonsai trees has improved my medical care of patients by teaching me that ‘less is more.’”
“It was a hobby I picked up to balance my work life as a hospitalist physician,” Roman says.
Caring for a Bonsai tree is almost a prototypical mindfulness meditation exercise.
“Versed in intensive care management, I was surprised at how poor my survival rate was for these seemingly simple plants,” Roman says. “Over time I grew to love the trees and, the less I cared for them, the more they thrived. The same is frequently true of patients.”
Roman offered his attending physicians as an example. “Each had their style to managing patients. Some would optimize every treatment, diet type, activity permissions, and IV fluids to ensure the fastest recoveries. Ironically, the attendings with the least micromanaging had the smoothest patient flows. Minute changes can overshadow the big picture: patients need time to heal their own bodies and our role was merely supportive!”
To learn more about how mindfulness can help your practice, check out this post.
Other fields of study for doctors
Of course there are far more than five surprising fields of study that doctors say make them better at medicine.
Other examples include split-second lifesaving skills on 911 calls. Students at the Hofstra Northwell School of Medicine spend their first eight weeks becoming certified emergency medical technicians. Or helping sick patients and their families navigate the medical system at the Penn State College of Medicine.
Students at New York University School of Medicine learn data analysis by trying to determine why, for instance, it costs $3,000 on average in a rural area to deliver a baby but $22,000 in New York City.