On August 2, forty-two young women and men will set about of the next leg of that journey. It’s the inaugural day of The Virginia Tech Carilion School of Medicine.
Years ago, the late and beloved Roanoke dermatologist, Dr. James Lampros, commented to me that one day Roanoke would have a medical school. I made no reply, but thought to myself, not in my lifetime. Jim turned out, not surprisingly, to be prescient. If you have not driven on Riverside Circle lately, you will be close to speechless when you see the scope of what has taken place there in the last three years. The medical school is the latest addition.
The new students have already accomplished much. They have completed the undergraduate requirements for medical school at a college or university of good standing and with a GPA that puts them in the group of the highly talented. They have taken the Medical College Admission Test (MCAT) and achieved good scores. The test, given online, consists of four areas: Physical science, biological science, verbal reasoning, and writing. In 2009 more than 362,000 students applied for the test. There is no pass/fail and the 133 medical colleges in this country use their own criteria to winnow down the number applicants for the approximately 14,000 positions available nationwide. If you think those numbers daunting, figure out the odds of getting into Veterinary School—much harder!
Things have changed in medical education. When I entered medical school a long time ago the curriculum was uniform throughout the country. In the first year the student had more than 900 hours of gross anatomy, 600 hours of biochemistry, 500 hours of physiology, 350 hours of histology and embryology and several hundred additional hours of lesser subjects. There were 72 of us in the class (two women) and 72 of us graduated four years later, although it was not the same group that entered. It was the beginning of the third year when we finally emerged from the labs and began to see patients.
What the VTC students will encounter that first day will be vastly different and I think a huge improvement. Only a handful of medical schools are conducting this new type of curriculum but preliminary data indicate that it is a much better system than what we endured.
The 42 students will be divided into groups of six and will be overseen by a variety of tutors and mentors. From the outset, they will have clinical exposure. For example, a patient with congestive heart failure might be the focus. Each of the students in the group will be assigned a particular aspect of that disease to research and prepare a presentation for his colleagues, under the watchful eye of a cardiologist and others. The group depends on the expertise of the presenter. The topics might be the causes of the heart failure, the altered physiology of the symptom complex, the pathology, the treatment, research into better therapy, and the prognosis. Many other aspects could be considered.
Throughout their four years, oversight will be administered to make sure that all pertinent material is covered by each group. As they mature, more responsibility will be given them, still with careful monitoring. This is called problem-based learning and it has special requirements.
The students must be highly motivated, self starters, share the responsibility to cooperate in learning as well as teaching, take charge of their own skill set, be willing to admit weakness and accept help from their peers, use their own strengths to aid group members who need help, and foster a sense of commonality of purpose in their learning. Excellent patient care will be the goal for each day.
Research in how medical students learn has shown the problem-based approach is effective and certainly less stressful than the type of training through which my peers and I traveled. In one study the incidence of depression in the students was less in this new technique. You don’t have to be a medical student to understand how the older system could foster exhaustion, both mental and physical.
This is an exciting time, not only for these new students, but for our community and our medical system. We should all be enthusiastic about the realization of this vision that has been a long time in coming to life.
By Hayden Hollingsworth [email protected]
