Monday, July 11, 2011

SELECTING MEDICAL STUDENTS FOR COMMUNICATION SKILLS

Excuse me, please. I haven't blogged as often as usual the past couple of weeks because it's finally summer here. Need I explain further?

I'm moved to write today, though, because of a fascinating development in medical school admissions strategy, outlined in an article in today's NY Times Well Blog, http://www.nytimes.com/2011/07/11/health/policy/11docs.html?pagewanted=1.

Of course, medical schools continually tweak their admissions procedures. When I applied, which was shortly after Lincoln's assassination, there had been a push for more "rounded" students. My science grades were mediocre but I shined in languages. The standard interview question was, "Why do you want to be a doctor?" I was able to respond correctly ("To help people") trilingually, so I was in. My class consisted mainly of science nerds, but a few poets and artists, too--all of whom became psychiatrists, by the way--and a couple of really entertaining weirdos. The class following ours featured a concentration of political activists; when they organized the hospital staff and led them out on strike, the admissions committee scrapped its progressive policy and returned to admitting science nerds, period.

Now some leading schools, including Stanford and UCLA, are beginning to screen for communication skills. Applicants are given multiple interviews which include discussion of ethical problems involving payment, alternative remedies, circumcision, and so on. The schools wish to address two increasingly visible problems in medical practice: doctors' generally suboptimal communication skills and the growing need for partnership between physicians and other practitioners.

This new admissions strategy looks progressive but one wonders how it will survive in generally unfriendly soil. It will need to compete within the extant atmosphere of medical training and practice, where human contact is still considered an endeavor somehow less useful than hard-nosed science. It'd be nice if this strategy were the beginning of intense communication training all through the medical curriculum.

At any rate, this admissions strategy won't reveal its usefulness until the students move into practice. Considering the length of professional training, we might not see an effect for a decade. But I'm hopeful. 

3 comments:

  1. Hi Dr. Kane - I work for a magazine and blog aimed at patients with chronic illness and their caregivers. We would like permission to repost some of your blogs - they are so well written! Can you contact me? tmitschang@fffenterprises.com. The magazine website is www.igliving.com

    Thanks, Trudie

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  2. I teach bioethics at a state University and find your article perfectly insightful and a great prescription to create some change in the next decade. Many of the students are health care professionals and share some of your very ideas and similar observations each semester. Thank you!

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  3. Dear Dr. Kane,

    Thanks for your empathy, perspective and insight. There's much room for change in the standard allopathic model, especially with regard to understandings of chronic pain, the burden on caregivers, issues related to opiods and not-so-alternative therapies.

    I've been recovering from an accident and dealing with pain for the past 2.5 years. I finally opted to seek out options such as Ayurveda and Chinese medicine in the East - arriving recently in Ubud, Bali. I am now healing in nature, with traditional Balinese healers, bona fide (restorative) yoga practitioners and more. There is much value in the healing practices on this island; the West could learn a thing or two.

    In gratitude and peace,
    Amit

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