A Prescription for Improving Med School Culture
By Glen Jacobs
Medical school has never been a walk in the park. But today's doctors-in-training have it particularly hard.
By the end of this decade, the total store of medical knowledge will double every 73 days. Those who graduate medical school in 2020 will have seen humanity's collective knowledge of medicine double four times over the course of their education.
One would expect med schools to do everything in their power to help students master this ever-expanding store of information and apply it effectively and compassionately.
Yet the hyper-competitive culture at most med schools works against this goal. This "sink-or-swim" mentality must go.
Med school leaders need to implement an approach that encourages students to collaborate with and seek assistance from teachers, administrators in student-support roles, and fellow students. Doing so will equip them to cope with the challenges they'll face in their careers.
The demands of medical school can be overwhelming. While keeping up with classes, med students must apply for residency programs and research opportunities -- and prepare for their licensing exams.
This workload is made more burdensome by a cutthroat culture. At many institutions, students who fall behind are vulnerable to shaming from fellow students and instructors.
More than 40 percent of med students who graduated in 2016 reported being publicly embarrassed at least once during their training. More than one in five said they'd been publicly humiliated.
A culture characterized by intimidation can lead to callous behavior towards patients. In one survey of third- and fourth-year students at six medical schools, 98 percent reported hearing physicians refer to patients in a derogatory manner.
Fortunately, institutions are creating programs that replace destructive cultures with those that promote compassion and collaboration.
At the medical school where I work, St. George's University, our Department of Educational Services provides students with extra academic support. All are encouraged to join collaborative learning groups. The Department's Academic Enhancement Program, for instance, organizes students in small groups, each with a faculty advisor.
Our students also work with learning strategists to address issues like time management and test anxiety. These programs aren't solely for those who are struggling; students at all achievement levels participate. Academic student support and collaboration have become key components of the culture at St. George's.
We're not alone. This approach is gaining steam at universities worldwide.
At Nelson Mandela University in South Africa, students engage in small-group learning programs run by upper-classmen. These sessions improve students' academic performance by giving them the space to discuss study strategies.
A similar program has been established at the University of Guelph in Ontario, Canada. Trained student leaders serve as role models for younger students by helping them prepare for exams and develop efficient learning strategies.
Programs like these offer numerous benefits. They provide students with ample opportunity to address academic weaknesses and anxieties. This makes it more likely that students will master the material -- which should be the goal of every medical school.
Moreover, group learning teaches students how to collaborate. Over-emphasizing individual achievement leads to a professional egocentrism that "inhibits team-building across disciplines and fails to acknowledge that most care is provided by teams of individuals," according to a recent report by the National Patient Safety Foundation.
It's time for a different approach to medical education that values collaboration among students and faculty -- and provides future doctors with the support they need to become skilled, humane medical professionals.
Glen Jacobs, D.Ed., is Vice Provost, Educational Services and Professor & Chair, Department of Educational Services, at St. George's University. (www.sgu.edu)
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