Photo: First-year medical students attend orientation for a longitudinal curriculum in community medicine, a pilot program launched this school year.
In an effort to woo more medical students into primary
care, the
Keck School of Medicine
of the University of Southern California (
USC)
has launched a longitudinal curriculum in community medicine that began
this school year.
The pilot study, coordinated by the Keck School’s Introduction to
Clinical Medicine (
ICM)
program, consists of 12 first-year medical students who will be able to
follow a patient’s care through their four years at USC. The students
are paired with community faculty mentors who will teach them how to
develop patient-doctor relationships and spot disease progression over
the course of time.
The approach runs contrary to the episodic nature of the clinical
rotation model historically used at U.S. medical schools.
“Most students will see patients at the hospital but likely will not
see them again,” said
Jo Marie
Reilly, M.D.,
associate professor of family medicine and co-director of the Primary
Care Community Medicine Program at USC. “In this program, students will
be in the same place, have the opportunity to see the same patients and
work with the same physicians. We’re bringing in reality to medical
education.”
Experts project a nationwide shortage of doctors to occur within the
next decade if current rates of training do not change. The
American Academy of
Family Physicians
estimates that a typical accredited family medicine residency program
would need to increase from an average of 21.7 residents to 24 to meet
population demands in 2020.
“We are entering a period of health care reform, which is going to
require a greater number of primary care doctors,” Reilly said. “Our
pilot program is trying to address this problem by educating more
students about what kind of career this is. Research shows that
students who engage in such programs in med school are more likely to
enter a primary care career.”
Photo: Jo Marie Reilly (left) and Kim Bader, instructors in the Keck School's longitudinal curriculum in community medicine, welcome students on Aug. 23, 2011
Incoming Keck School students applied for the longitudinal experience
in July, and 12 were selected by lottery. In August, they were assigned
to community health centers, where they will train during their first
two years of school. They will have the option to complete their
mandatory third-year clerkship at the same center and follow their
patients from the center the following year. Each is also part of an
interdisciplinary team (comprising medical, pharmacy, physical therapy
and occupational therapy students) that meets with a geriatric patient
at an independent living facility during the first two years of school.
The coursework takes the place of other electives within the school’s
Introduction to Clinical Medicine program, in which all Keck students
participate.
Although literature on longitudinal curriculums for family medicine
goes back some 20 years, there are barriers to changing the norm,
according to The Society of Teachers of
Family Medicine.
More recently, longitudinal curriculum tracks with multidisciplinary
emphases have been gaining traction at universities like Harvard and
Cornell, but the focus has been on the latter part of training. At USC,
students start seeing patients in their first year, which gives them
the opportunity to observe how continuity in care can develop over a
longer period of time.
“Longitudinal curriculums are a new movement in education across the
board,” said Keck School Dean Carmen
A. Puliafito, M.D., M.B.A.
“The Keck School of Medicine of USC is dedicated to educating and
preparing the next generation of academic clinicians using the most
innovative techniques available. This pilot program answers a need.”
The longitudinal curriculum is an offshoot of the Keck School’s Primary
Care Community Medicine Program, funded through a grant from the U.S. Health Resources and
Services Administration. If well received, the curriculum will
begin recruiting for its second cohort of students in the summer of
2012.