Published March 30, 2018
The Jacobs School of Medicine and Biomedical Sciences received national attention last week from the American Medical Association (AMA) when Andrew Gurman, MD, immediate past president of the organization, visited with faculty and students on March 23rd.
Gurman, an orthopaedic hand surgeon, whom in 2016 Modern Healthcare magazine named one of health care’s 100 most influential people, was in town for the meeting of the Medical Society of the State of New York. While here, he wanted to find out more about the Jacobs Schools’ move downtown and its innovations in medical education.
After a tour of the building with Michael Cain, vice president for health sciences and dean of the Jacobs School, and other faculty, Gurman met with local media to discuss how medical education is changing, both in Buffalo and across the nation.
He described the first-ever assessment of medical education back in the early 1900s, when the profession invited an educator named Abraham Flexner to tour the nation’s medical schools.
“That report was highly critical of medical education,” said Gurman. “As a result, many medical schools closed.”
The schools that remained open adopted a model of medical education patterned after the European model, in which medical schools organized their departments around the departments found in hospitals.
That model persisted for about the next century. But that’s not how medical care is delivered now, he said.
“Most medical care now is delivered outside of hospitals,” he said. In his career, many procedures that used to require a hospital stay now are performed in outpatient clinics and the patient returns home the same day.
These and many other changes in health care have precipitated a new education initiative at the AMA called Accelerating Change in Medical Education. Under that program, the AMA provides grants to medical schools to develop curricular innovations. Some of them have now been gathered into a textbook, called Health Systems Science, focused on the science of how health care is delivered and how health professionals work together to deliver that care.
Medical schools around the U.S., including the Jacobs School, are already implementing a range of curricular innovations to better prepare medical students. Gurman noted, for example, the capstone course for fourth year students developed by Daniel Sheehan, PhD, MD, associate dean for medical curriculum, which is designed to ease the transition from undergraduate medical education to residency.
And Nancy Nielsen, MD, PhD, senior associate dean for health policy and a past president of the AMA, described Jacobs School students as both “high-tech and high touch,” possessing academic skill and a strong grasp of technological advances in medicine as well as demonstrating strong commitment to the underserved. She pointed out that Jacobs School students have developed a number of award-winning programs for Buffalo’s homeless population, ranging from the street medicine program, UB HEALS, aimed at helping increase access to health care, to Prescription4Warmth, which provides socks, hats and gloves through local hospitals and clinics to those being treated for frostbite.
Gurman also learned about the Jacobs School’s new Health in the Neighborhood course from Linda Pessar, MD, professor emeritus of psychiatry and one of the course’s founders. In the course, first year medical students learn about medical disparities directly from those who experience them in an underserved Buffalo neighborhood.
Students Connor Orrico and Jenna Herskind discussed how the course has already changed their perspective on what health disparities are and how deeply they affect individuals.
“Health disparities are just an abstraction,” said Herskind, “until you hear from a mother how her son was denied access to care.”
After hearing from students who were taking the course, Gurman said: “Would I like to see this at other schools? Absolutely. It’s so critical for doctors to understand the notion of cultural competence.”
Gurman later met informally with a group of medical students to further discuss innovations in medical education.
Other UB faculty members who participated were Karen Zinnerstrom, PhD, administrative director of the Clinical Competency Center and Behling Simulation Center; Linda Jane Jacobsen, MD, associate dean for medical curriculum; and John Marzo, MD, professor of orthopaedics.