Coordinating the Educational Experience

Photo by Graham Ramsay Beverly Woo

Like a person buying a new wardrobe for the changing season, Patient–Doctor I (PD-I) is tailoring itself to fit into the new curriculum. With all the modifications wrought by curriculum reform, the veteran PD-I course, with its small-group discussions (six to nine students) and training in how to interview patients, will be a vital constant. It is the only course students will take for the duration of their new first year (except during the January bloc), and it is the first course to give them any clinical exposure, said course director Beverly Woo, HMS associate professor of medicine at Brigham and Women’s Hospital. That means coordinating PD-I discussions with the in-depth work done on the same subjects in basic biological science classes and in the new required courses on medical ethics and social medicine.

“We will integrate our curriculum in terms of readings and discussions with those two courses,’’ explained Woo. “We will know what the other is doing, and whoever goes second can try and build on the learning that’s already taken place.”

In discussing alcoholism, for example, Woo and her faculty will leave study of the national ramifications of substance abuse to their social medicine colleagues. But PD-I will explore “how you as a provider will go about screening patients for a substance problem and learning what the problem is for that individual person, while examining your own attitudes as a future physician about things like alcohol and drugs. The students go to an AA meeting as part of that.”

PD-I students might also discuss different cultures’ perspectives on health and medicine, a topic the social medicine course also will probe, said Woo. PD-I students who meet patients as part of their coursework can try out concepts they are learning in both classes. Elsewhere in the curriculum, the first-year genetics course will be coordinated with PD-I’s session on how to interview a patient about her family and genetic history.

The reform effort has been advantageous to PD-I, said Woo. Requiring ethics study of all students, for example, bolsters PD-I’s exploration of that issue. “It takes a certain foundation in the subject before you can have a brief discussion and work with a patient. In Patient–Doctor I, we will be able to do some kinds of discussion and patient-oriented activities that we weren’t able to do before because students will have a better understanding of medical ethics. I think we’ll actually be much more effective as a result of these new courses.”

In addition, PD-I faculty have been asked to work with basic science courses in their patient interviews and clinical sessions. “One of the great benefits of the curriculum reform,” Woo said, “has been the opportunity for faculty from different courses, particularly the course directors, to learn more about the other courses and how we can complement each other and make a better and better learning experience for the students.”

—Rich Barlow

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