Dr. Julie Loeb of Royal Oak checks Braxton Purtrus, 5 weeks old, with his mother, Anna Bailey of Rochester Hills, and medical student Ade Nuga of Ypsilanti, center. Oakland University William Beaumont School of Medicine stresses kindness in its training for doctors. (Todd McInturf / The Detroit News)
Fifteen seconds can separate a good doctor from an excellent one.
That’s one of the lessons students glean at the 3-year-old Oakland University William Beaumont School of Medicine in their first week.
“As part of our communication skills training, we demonstrate how if a doctor remains quiet for at least 15 seconds to hear a patient’s full story, the doctor will have a much better idea of what’s going on with the patient,” Dr. Lynda Misra said.
Listening isn’t easy, doctors in training learn.
“Even when they think it’s been 15 seconds, we show the students a video of their exchange that proves they interrupted in 3.4 seconds,” said Misra, associate dean for undergraduate clinical education at the school and director of students at Beaumont Health System in Royal Oak.
The campus welcomed its first class in fall 2011, one of 17 new medical schools in the United States since 2005 and the first of three new sites in Michigan. Central Michigan University introduced its first class in August 2013; Western Michigan University’s Homer Stryker M.D. School of Medicine opens this fall.
The surge of new schools follows a projection by the Association of American Medical Colleges of a doctor shortage by the end of the decade that threatens to limit access to health care for Michigan residents.
The nation faces a shortage of 90,000 doctors by 2020, according to the AAMC; Michigan’s shortage is projected to reach a 2,000 to 8,000 shortfall for all specialties by 2020 and 4,000 primary-care physicians by 2025, according to the Annals of Family Medicine.
But despite a record number of students applying to med schools — applications grew 6.1 percent to 48,014 on 2013, according to the AAMC — the number of residencies, where doctors continue their on-the-job training at least three more years after medical school, has remained capped by Congress at 26,000 nationwide.
Medical school officials say that beginning in 2016, there will be too few residencies to accommodate the surge in students. Many are urging the government to add 15,000 spots.
Oakland, meanwhile, has found a way to attract notice. Its “kindness curriculum” is helping Michigan stand out for medical school innovation, observers say.
The exercise in listening, for example, stresses kindness, compassion and sensitivity, the core qualities with which the school wants to send students into their medical careers. This focus, which extends beyond patients’ bedsides, has helped shape a distinct identity for the school, some experts say, and allowed the school the freedom to approach teaching medicine differently.
Students sing their praises
Dr. Carol Aschenbrener, chief medical education officer at the Washington, D.C.-based AAMC, said the school’s approach to training doctors goes beyond developing a personal approach.
“A lot of schools have something similar in their curriculum to help develop physicians as people, but nothing to this degree that OUWB has,” Aschenbrener said.
The approach is more holistic, focusing on treatment of the whole person, rather than just the physical symptoms of a disease, she said. While it remains to be seen what impact it will have on legacy medical schools, she suspects every school is watching the new kid on the block.
Andrew Koo of Grand Rapids, who expects to graduate in 2016, was accepted into four medical schools but chose Oakland because students and administrators were unified with their praise about the training.
“What the students I got to talk to were saying mirrored what the administration was saying, so I knew that the administration wasn’t just putting its best foot forward to impress me but presenting the true version of itself,” Koo said.
Classmate Rachel Hunt of Albuquerque, N.M., is struck by how focused the administration is on her well-being.
“Not only are they showing me how to be a kind and compassionate doctor, but they show me all the time how much they care about me as a person,” she said, citing a free meditation class during exam time.
“They model the behavior they want from us.”
Koo said after talking to friends who enrolled elsewhere, he chose well.
“The contact I’ve had with real patients and ... (actors) pretending they have certain symptoms, in my first year of school is so much more than my friends in other medical schools have had,” Koo said. “The more exposure you have, the more comfortable and confident you are.”
Ready to innovate
Patient exposure is one of the hallmarks of the school’s Art and Practice of Medicine course beginning in the first term, with students visiting new patients’ bedsides to collect medical history.
The students also receive sensitivity training on everything from how to recognize elderly abuse to how to consider the cultural needs of patients.
Instructors invite guests to teach “cultural competency.” In one visit, an imam explained differences within the Muslim religion, helping to guide students in treating Muslim patients and their families.
“Any school that is new has the greatest opportunity to innovate,” Aschenbrener said. “When new medical schools were announced, our hope was that they would depart from the traditional ways and give us something different, and OUWB is doing that.”
Longtime Beaumont doctors and patients have seen the results of this patient-centered approach on hospital rounds, Misra said.
“I was with an endocrinologist this morning who kept saying, ‘What wonderful students. I can really see a difference in them,’ ” she said. “Even the patients were telling him, ‘Wow, I’ve never had a physical like that before and I can’t believe it was a student.’ He told me in his 30 years of teaching, he’d never had so much positive feedback. It used to be once in a blue moon.”
Founding Dean Dr. Robert Folberg is proud of the capstone scholarly project each student must complete during the four years of undergraduate medical education. The project must impact the health care of the community.
Student Hunt’s project is analyzing the impact of radiation therapy on Alzheimer’s patients, while Koo is looking at curbing readmission rates of cardiovascular surgery patients.
The projects are designed to encourage them to think deeper, collect data, analyze a situation and use research to improve a community’s health.
“The capstone is a way to build up these skills that they will be able to use throughout their career, no matter what concentration they choose,” Folberg said. “It also provides an opportunity for students to get outside the classroom to promote health in a wide range of health-related settings.”
Folberg said the capstone project was so popular that other medical schools have added the requirement to their curriculum.
A balanced approach
The admissions process looks for balance in a student’s life. It uses traditional test scores, but also explores a candidate’s commitment to community service, teamwork and leadership to see if they match the school’s culture and mission.
“We’ve customized our admission criteria to what type of physician we want to produce,” said Christina Grabowski, assistant dean of medical school admissions and financial services. “We are very interested in educating compassionate physicians who want to give back to their communities.”
Grabowski knows how important kindness is to patients.
“I’ve done admissions at Oakland University for more than 20 years and when I mentioned five years ago I was going to be working at the medical school, people said to me, ‘Only pick people who are going to be good doctors who have good communication skills and bedside manners,’ ” she said.
“It was clear to me the general public wants to go see a physician who is going to care about them as an individual and who can communicate well,” Grabowski said. “That’s the candidate OUWB wants to recruit.”
Rene Wisely is a Metro Detroit freelance writer.