Incoming Medical Students Clear Empathy Hurdle

Caroline Helwick

July 27, 2011

July 27, 2011 — An innovative medical school program is basing admissions as much on the individual’s emotional intelligence as his or her ability to memorize organic chemistry formulas and score high on the MCAT.

"We intend to change the DNA of healthcare, one future physician leader at a time," said Stephen Klasko, MD, MBA, dean of the University of South Florida (USF) College of Medicine in Tampa, where the SELECT (Scholarly Excellence. Leadership Experiences. Collaborative Training) program is based.

Dr. Klasko, a passionate advocate of patient-centered doctoring, observed that medical care has shifted from the model of the kindly Dr. Welby to the narcissistic, brusk, but brilliant Dr. House. "How did we physicians go from saints to sinners so quickly in the public’s eye?" he asked. "Solving that question has driven my research for the last 10 years."

The SELECT program is meant to produce physicians who will be as bright as Dr. House but as compassionate as Dr. Welby. "We want to make sure that we have a futuristic curriculum that emphasizes leadership education, values and ethics, and health systems and policy, so our students can become leaders as opposed to followers of health care reform," Dr. Klasko said.

The idea attracted medical student Yasir Abunamous, who was impressed with the program’s "emphasis on leadership in concert with emotional intelligence," a concept he has found lacking at other medical schools.

"Also, there is a very intense focus on values-based, patient-centered care," he added. "This is something the program is all about, and it’s on the cutting edge of medical care."

Alicia Monroe, MD, vice dean for educational affairs at USF, said Mr. Yasir and his classmates seem to be a perfect match for the program’s intent. "I just spent the first day with the students, and while it’s too soon to tell much, I heard a level of self-awareness, self-reflection, and candor that far exceeded what I expect of first-year medical students."

"They were able to go deeper faster, and to broader content areas than we typically ask medical students to even think about," she observed. "Early indicators are that they are a subset of our universe of students who want to go to medical school because they are going to do more than be an excellent physician. They want to make the world better in ways that transcend their own personal benefit."

A Joint Venture 1000 Miles Apart

SELECT was jointly created by USF College of Medicine, where students will spend their first 2 years, and Lehigh Valley Health Network (LVHN) in Allentown, Pennsylvania, where they will complete their clinical training within a healthcare network that shares this philosophy.

"USF and Lehigh Valley Health Network share the same mission, which is consistency around excellence, education, research, and patient care. In Lehigh we found a clinical partner who is as passionate about change and redesigning medical education as we are, so we created a formal campus there as well," said Dr. Monroe.

She added that LVHN has a long history of collaboration with the medical schools in the area, but "they wanted a bigger take in the game. They wanted consistent contact with a cohort of students. We both wanted more, and we just worked around the geographic boundaries," she said.

The program intends to grow annually and ultimately will enroll 56 students per class.

SELECT Students Will "Dive Deeper"

The program seeks applicants with "the intellectual perspective, empathy, creativity, and passion to change patient care, the health of communities and the medical profession," according to its Web site.

The founding principle of SELECT is the concept that students with high emotional intelligence are more likely to develop the skills needed to transform healthcare and improve the health of communities. In essence, students with high emotional IQs will become more engaged and compassionate physicians who will work effectively with teams and can lead change in healthcare organizations.

The 4-year curricula will incorporate "new ways to teach the science and technical competence that are essential for the practice of medicine while putting patients and their needs and expectations at the center," Dr. Monroe said.

Because the SELECT program exists within the larger medical school, students will spend at least 80% of their time satisfying the traditional curricula, along with other classmates, and the remainder of their time immersed in SELECT activities.

"In essence, the SELECT students will take a deeper dive," she explained.

This will include readings and exercises related to leadership skills and emotional intelligence. Students will be required to set goals. They will be part of peer and faculty "coaching" groups intended "to help them cultivate this skill set of emotional competence," according to the vice dean. "And this will be manifested in benchmark activities."

A summer internship between years 1 and 2 will allow students to interact with a leader of their choosing, possibly a physician entrepreneur, the state’s surgeon general, or a health network medical officer. Students can also "minor" in business and entrepreneurship, health disparities, engineering, international medicine, law, medical humanities, public health, or even medical writing or music, Dr. Klasko added.

Unorthodox Selection Process

The students had all been accepted to USF College of Medicine and had expressed an interest in being part of the new program. That’s when the unorthodox 90-minute "behavioral event interview" took place, one that is often applied in the business world but rarely in academic medicine. Specifically, students were asked to recall milestone events in their lives to reveal how they responded to and what they learned from each situation.

"This is a way to get underneath people’s plug-and-play responses," said Suzanne Rotondo, executive director of the Teleos Leadership Institute, who trained faculty to conduct the screening. "You get to such depth, such detail, that people can’t fake it. For emerging leaders, this is a way to get under the surface and see how someone’s mind and heart work."

The Teleos Leadership Institute’s mission is "to prepare people to lead, follow and join together with others to achieve collective goals that allow each of us to leave the world a better place because of our unique contributions," according to its Web site.

Teleos staff trained the SELECT faculty to look for "a grounded explanation in students’ lived experiences," Dr. Monroe said. "To see, through this, how the students articulated the way in which they reason, problem-solve and use self-awareness to interact effectively with others, to communicate empathy and to manage relationships. The interviewer looked for evidence that the student had the capacity to be the kind of physician who would be a good fit for this program."

Yasir Abunamous, a psychology major at USF, was a good match, it seems. Yasir has worked in Washington, DC, for the group Muslims Without Borders, supervising volunteer operations in Haiti and making several relief trips himself — most recently as part of a team distributing hygiene kits to earthquake survivors in Port-au-Prince.

Asked why he might have been selected, he told Medscape Medical News, "I have asked myself the same question. I think it’s because of the extent of my involvement on campus, my leadership experience. I think I communicated fairly well in the interview. I reflected on my experiences and the internalizing lessons I gained."

He predicted that the exposure to essential concepts of SELECT will enable students to "focus on giving quality patient care," but the value of the program will not stop there.

"Once we become more aware of how we interact on an individual level, we will be prepared to collectively lead efforts for systemic changes in healthcare delivery. This is the big picture and it is still abstract, but I hope this program sets us up to do just that," Mr. Abunamous stated.

Dr. Klasko, Dr. Monroe, Ms. Rotondo, and Mr. Abunamous have disclosed no relevant financial relationships.


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