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USF joins national effort to reform doctor training

TAMPA — Sitting in a circle, the aspiring physicians each shared one word to summarize what they would take away from their first week of medical studies. Connection. Perspective. Balance. Awareness of others.

No one mentioned science, hospitals or any other traditional linchpin of medical school education. They were focused on emotional intelligence, the catchphrase for this new program at the University of South Florida College of Medicine known as SELECT — Scholarly Excellence, Leadership Experiences, Collaborative Training.

With it, USF joins the growing ranks of medical schools rethinking how they train doctors. All Children's Hospital in St. Petersburg is developing a new model for pediatric residencies, complementing curriculum changes at the medical school of Johns Hopkins, the hospital's new partner.

Medical schools across the United States want to build better physicians. Some are infusing economics and finance into their curriculum. Others are screening candidates not just for grades and test scores, but also bedside manner.

While these steps may seem like common sense to patients, medicine long has been practiced in rigid hierarchies. Many doctors already strive to communicate more clearly with patients, and better collaborate with colleagues, but only recently have medical schools begun to formally teach these values.

"We haven't traditionally invested in developing physicians as people," said Dr. Alicia Monroe, vice dean for educational affairs at USF College of Medicine.

"We were trained to be really good, smart, well-prepared individuals. But guess what? The practice of medicine really now requires teams."

The 19 students enrolled in the first class of SELECT had the test scores and grades to get into USF's incoming class of 142 medical students. But these candidates also were vetted to assess their self-awareness and how they approach and manage relationships — what the university calls emotional intelligence.

Students in the new program, expected ultimately to grow to 50-plus students, will spend the first two years at USF studying basic medicine and leadership. For the second two years, students will move to the campus of USF's partner, the Lehigh Valley Health Network in Allentown, Pa. There, in addition to clinical training, they will participate in projects on issues such as safety and quality improvement.

SELECT marks USF's take on a movement already under way at medical schools, including national leader Johns Hopkins. Two years ago, Hopkins introduced a new curriculum to reflect the evolution away from disease-specific medicine.

"You had a diagnosis — breast cancer, diabetes, sepsis or asthma — whatever it was, it was focused on understanding the underlying science of the disease, not of the person with the disease," said Dr. David Nichols, vice dean for education at Hopkins. "That's where we are taking this now."

When it comes to a condition like asthma, for example, Hopkins has shifted its focus from the difference between normal and abnormal to teaching students to understand illness over a lifetime. Some patients may rarely experience severe episodes, while others fight for their lives in intensive care.

Considering all the factors, from genetics to environment, that influence health risks captures the complexity of treating chronic diseases such as heart disease and diabetes, increasingly among the nation's top killers.

Hopkins also is emphasizing teamwork, collaboration and communication. Students are videotaped talking with patients, then software is used to analyze their interaction.

"You can actually see when the patients aren't getting a word in edgewise," Nichols said.

Over the next two years, Hopkins and All Children's will translate such themes into a new training program based in St. Petersburg, expected to start in the summer of 2013 with 10 to 12 pediatric residents.

How it's designed will be decided locally, Nichols said. But one potential model can be seen in a Hopkins residency in internal medicine, where residents now have fewer patients, so they can get to know each one better.

These residents pay a house call to patients after they leave the hospital and often are surprised to see them struggling to manage medicines, or skipping drugs to pay bills.

"The doctor of the future is part of a team," said Nichols, who has advised the Hopkins-All Children's team developing the new pediatric residencies.

The end goal: Helping people to manage their health so they avoid the hospital.

Teamwork is also the vision USF is imparting to its SELECT class.

"I would like to be a leader of a team setting," said 22-year-old Aresh Ramin of Pennsylvania, one of the inaugural students. "I would like to be a part of a department, leading other doctors and teaching them everything I have learned."

Times staff writer Richard Martin contributed to this report. Letitia Stein can be reached at lstein@sptimes.com or (813) 226-3322. For more health news, visit www.tampabay.com/health.

USF joins national effort to reform doctor training 08/04/11 [Last modified: Friday, August 5, 2011 10:28pm]
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