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Medical Schools Reboot For 21st Century [NPR.org]

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Medicine has changed a lot in the past 100 years. But medical training hasn't — until now. Spurred by the need to train a different type of doctor, some top medical schools around the U.S. are tearing up the textbooks and starting from scratch.

Most medical schools still operate under a model pioneered in the early 1900s by an educator named Abraham Flexner.

"Flexner did a lot of great things," says Dr. Raj Mangrulkar, associate dean for medical student education at the University of Michigan Medical School. "But we've learned a lot and now we're absolutely ready for a new model."

Michigan is one of many med schools in the midst of a major overhaul of their curricula.

For example, in a windowless classroom, a small group of second-year students is hard at work. The students are not studying anatomy or biochemistry or any of the traditional sciences. They're polishing their communication skills.

In the first exercise, students paired off and negotiated the price of a used BMW. Now they're trying to settle on who should get credit for an imaginary medical journal article.

 

[For more of this story, written by Julie Rovner, go to http://www.npr.org/blogs/healt...oot-for-21st-century]

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This is an amazing important article.... I am not going to edit my prior post.. Instead i will edit on a word document and put more information about my experience at Michigan Medical School complete with any edits in a new post... 

 

Thank you. Tina.

Gosh, I wonder if Michigan would like my opinion. I have lots to say. That place was bad for a trauma surviver. I am gonna have to contact them. I have LOTS to offer.  

 

My first rotation my third year was the surgery rotations. My first was surgical subspecialty. I chose ENT (otolaryngology).  I did well there. They were nice and not amazing cruel.  The next rotation I was sent to was Gastroenterology surgery... 

 

This was the first time I ended in the "glitter room" and almost lost my life.   How you may ask? Because the surgery attending would punch the wall. I was freaked out and wondered "how do you remain a surgeon when you risk your hand)... but what really scared me was here is an adult hitting something and screaming at students.  Screaming at me was not a good choice.  I got to the point that I could not look at Michigan scrubs. I would have major panic attacks. I was always prone to fear before that but I never had panic attacks.  Medical school gave me panic attacks.  It was a cruel place. It was a place I believe they thought everyone was something more than human.  I may not be able to write all I need to here at this time but I have lots to write about this... Medical school at Michigan the best treatment "if you don't die".   That is a little radical. I can certainly explain why..... 

 

I went to school there at a time there were trying to get more students into rural medicine... The school was about creating specialists.   I should have been a specialist but I didn't have the money...Who lots to say...I ain't done.. This will probably get back to Michigan and I think it should.... 

 

So the student was picked up from her house on State Street.... She was found standing on a two x two with a rope around her neck tied to a tree 20 feet above the ground......

 

That would kill someone if they fell off the two x two... I lived in a beautiful house on State street cross road Catherine (when I describe this --- I know anyone from Michigan will know -- I am telling the truth).....


I am gonna edit this later.......

 

Much more to add..

 

Oh so I went to the "glitter room".  "If you don't get me off this rotation, I am going to quite medical school today!"

 

The head of surgery was Dr. Greenfield (the maker of the Greenfield filter -- it keeps clots out of your lungs by putting a filter in the leg with blood clots).  Dr. Greenfield did not excuse me from medical school, he put me on his service... I was on the same hall right next to GI surgery.   I did great on Cardiovascular surgery (his service.) 

 

At the end, he told me he wanted to give me more than a pass (I do really well on tests and Michigan at that time was all about tests).  He asked me "why did you feel you needed to leave GI surgery?"  Well I never told him that I was having my first panic attacks of my life and close to suicide due to the GI attending punching the wall and the resident was called the "Little General" and she played the part well.... that didn't help much... I remember... in medical school you go from patient room to room and you have to as a student give the patient history and the attending or just the resident is there to judge you... I was never in this position before.... I would try to talk to the patient (my favorite thing) and get the history from the labs and chart (and I was doing this in a way no one saw me... I would go in at 4 am -- way before you needed to be there cause I didn't want to be seen-- the Little General one day ripped the chart (the clipboard with the vitals and nursing notes) out of my hand.   That is when I just became a continuous panic person.... I was still doing all my rotations in a state of continuous panic....

 

I never told Dr. Greenfield what I had experienced.. It was horrible... It was almost a death experience except I don't think anything but old age can kill me.... Will edit and put more in soon....

 

Dr. Greenfield... I think you rock!!!!!

 

 

Abraham Flexner's report, if I'm not mistaken, was based on a Male only German medical education model. At the time of Flexner's report, 95% of babies born in the United States, were born at home, delivered by Midwives. During the tenure of the National Health Planning and Resources Development Act of 1974 (Public Law 93-641), a Family Physician wrote an article for the (U. of Pennsylvania) Health Law Project Library Bulletin, about three of his patients who taught him things he wasn't taught in Medical School: (1) A couple wanted to have their baby delivered at home...taught him "how he would have liked to have been born"; (2) A terminally ill man, who wanted to die at home, with friends and family at his side, ....taught him "how he would have liked to die, with dignity"; and (3) A man he used to pass, and greet, every day en route to his office, finally returned the greeting, and for a few weeks, they exchanged greetings every morning, and they chatted briefly. The physician subsequently asked him: "What Happened To You?" [rather than "what's Wrong with you?"], and the man with the Heroin Addiction told him about being on a machine gun post at a landing zone in VietNam, one night, when the V.C. attacked, but they marched all the women and children from the village in front of them when they attacked, and come sunrise, he realized what he "had done". And the physician (Listened to him, first) and told him that that wasn't "his fault", that those things sometime happen in war. ... and a few days later the man asked the physician for help getting off the heroin. (This was before PTSD was conceptualized as a diagnostic construct.). I read [portions of] this article, aloud, at one of our Health Systems Agency board meetings, back then, when we had "Consumer Majorities" on all Health Planning, Certificate-of-Need, Project Review, etc., Boards, and you couldn't be a Consumer representative if you earned more than 10% of your income from a "health related source", or were married to a "Provider", or you were an "Indirect Provider" (like an EMT/Paramedic, Dental Hygienist, etc) .

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