Medical schools have traditionally focused on providing students an intensive basic science foundation during the preclinical years, teaching advanced physiology, anatomy, pharmacology, and more. This was classically followed by 2 years of rotations where students could exercise their newly acquired objective knowledge in a more practical setting.
With the recognition that this seemingly straightforward process resulted in significant student burnout, and with providers lacking strong patient-facing skills, medical schools have recently shifted toward a more integrative approach.
Schools now prioritize earlier clinical exposure with the understanding that the vital humanistic skills of communication and empathy must be developed early on in one's career.
At Thomas Jefferson University, in particular, our faculty place a large focus on early clinical exposure. Even in the first months of medical school, we regularly learned basic clinical skills such as physical examination, empathetic patient interviewing, and techniques specific to the body system we covered in class that week.
In addition to producing more competent clinicians, this shift also keeps preclinical medical students happier. When I see real or standardized patients after a long week of lectures, I am quickly reminded why I entered this challenging profession. Although I absolutely love the science content we learn in lecture, nothing beats interactions with patients.
Keeping this patient-focused end goal in mind helps me persevere through the science coursework, and also helps me synthesize my new knowledge and apply it to the real world.
One program I particularly enjoy is Clinical Experience, which allows students to visit various hospital locations and conduct evaluations for patients' nonmedical conditions that may be influencing their health.
Readmissions plague US healthcare, and much has been said about the outsize health impacts of patients' zip codes over their genetic codes. Experts continuously discuss how we must refocus on preventive care.
Particularly with the COVID-19 pandemic, the field has demonstrated a newfound interest in public health. Social factors outside a patient's control often dictate their ability to comply with physicians' advice or follow best practices for their health. As a medical student in Philadelphia, I have learned that these issues are particularly important as our city has one of the nation's highest poverty rates — over 25%!
Deeply rooted in our newfound understanding of the social determinants of health, the Clinical Experience program was designed to help students directly make a difference in patients' outcomes, even in our early years before we learned advanced medicine.
We interview patients regarding their access to healthy groceries, stable housing, transportation to medical care, and other social conditions. If patients are found to lack a key social need, we connect with social workers to offer the patients a solution. Although there are certainly not enough options, the city offers numerous programs to help residents in need, but awareness of these choices is limited.
Patients connected to these resources are very grateful. Moreover, students truly make a tangible difference in their patients' lives while developing their communication skills and emotional intelligence. I hope this experience will also help us better understand these social factors once we become practicing physicians. Ideally, the physicians of tomorrow will not only prescribe medications or perform surgeries, but also work with their patients on the human level to address more preventive, nonmedical factors that may influence their health.
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Cite this: Yash B. Shah. The Value of Clinical Experiences Early in Medical School - Medscape - Jan 05, 2022.