New curriculum gives Jacobs School students opportunities to experience the world of medicine ‘well beyond’ the classroom
‘Well Beyond’ took shape over five years of intense research, benchmarking and dialogue with faculty, students, providers, health care partners and the public
In 1980, it took about seven years for medical knowledge to double; these days it’s estimated to take just a few months.
Experienced physicians find keeping up with this cascade of new medical knowledge an ongoing challenge. Figuring out how to introduce medical students to this reality while ensuring they are learning key principles of medicine is even more daunting.
Today, medical students are expected not just to master an ever-expanding mountain of scientific and clinical knowledge, but to do that while developing a deeper understanding of the social issues patients face, as well as the complexities of a rapidly evolving health care system.
Unlike those who attended medical school decades ago, current medical students are also expected to have a fuller understanding of humanism in medicine, population health, the structure and function of the health care system, and scientific literacy and inquiry. They are expected to be involved in their communities and to learn about how new technologies, such as artificial intelligence, can be harnessed to improve outcomes.
This month, the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo is introducing its new Well Beyond curriculum (see video) designed to help students be successful in all these areas. The new curriculum emphasizes the “triple aim” of educating physicians who provide value-based, high-quality care that takes costs into consideration while also focusing on patient safety.
“The Well Beyond curriculum empowers our students to not just master scientific knowledge but to go beyond it, to learn early on how to take what they’re learning in their classes and to put it to use right away in real-world settings with patients and out in the community,” says Allison Brashear, MD, vice president for health sciences and dean of the Jacobs School. “Well Beyond is designed to allow our students to evolve a broader understanding of the clinical and social relevance of the scientific knowledge they are learning and how that’s relevant to every patient they see, starting with their first day in class.”
Lifelong learning
“Everyone is aware of the explosion of medical knowledge that has occurred in recent years,” says Lisa Jane Jacobsen, MD, associate dean for curricular innovation who led development of the curriculum with Jennifer Meka, PhD, associate dean for medical education and director of the Medical Education and Educational Research Institute at UB.
“For students entering medical school today, it’s going to be a process of lifelong learning,” she continues. “With that in mind, many schools are reducing their classroom time in the early years, streamlining some of the basic sciences and encouraging continued learning throughout the clerkships and beyond.”
The effort to rebuild the curriculum began back in 2019, with examining the literature to identify and incorporate evidence-informed approaches. It also included a retreat at the Jacobs School that included 150 attendees — faculty, students, residents, clinicians, basic scientists, community leaders, local health administrators and administrators from throughout UB.
“We invited these stakeholders to focus groups and workshops at the Jacobs School and asked them, what do you want to see in tomorrow’s physicians?” says Meka.
The conversations took into account all the cutting-edge science students need to learn, as well as the kinds of experiences students should be exposed to in the clinic, the classroom and in the community.
Because all these perspectives need to be added to the curriculum, many medical schools, including the Jacobs School, are now reducing classroom time and streamlining how they teach some of the basic sciences to provide the right balance.
The Well Beyond curriculum allows for more experiential learning, where students will have the opportunity to learn subjects that are essential for being a good doctor in authentic clinical situations, explains Jacobsen. Students will receive focused instruction about health systems science, humanities and humanism, including anti-racism and cultural humility, and scientific literacy and inquiry.
The new curriculum is divided into three phases:
Phase 1 begins in mid-July for first-year students and lasts until December of the student’s second year. It focuses primarily on foundational skills and includes clinical immersion experiences.
Phase 2 starts in the second semester of the second year through the end of the third year and provides clinical experience through clerkship rotations.
Phase 3 begins in April of the third year and continues throughout the fourth year, where students engage in specialty-specific electives and prepare for residency.
“Phase 1, where students learn the foundational skills they need has been shortened to 18 months, which reduces it approximately four months from what it used to be while Phase 3 has been lengthened,” explains Jacobsen.
Clinical immersion
An important new feature is that first-year students will participate in an intense clinical immersion in a clinical patient care site for two weeks each semester. Students will have the opportunity to take what they’re learning in the classroom and apply it in a variety of clinical settings.
“The students will have no responsibilities other than to participate in those immersions at that time,” Jacobsen says. “It will actually be a good break for them from the classroom instruction.”
Under the new curriculum, UB medical students are now required to participate in CommunityConnect, a service-learning experience in which they work throughout their first three semesters with a community organization that serves those challenged by significant social and health inequities. The goal is to have students supporting the needs of the local community while enriching their understanding of the community they are serving.
“Well Beyond provides for meaningful and authentic experiences where students will get to know the organization they’re working with and vice versa, and they will be matched with organizations that are in line with their interests,” she says. “There’s a firm belief that our students need to participate with the community and learn from these organizations to better understand the members of our community. It will help our students with their career development, will demonstrate their well-rounded education and make them even better applicants for residencies.”
Wellness and support
A new layer for student wellness and support is the Learning Communities, where small groups of six students, plus a faculty coach, will engage during all four years. It is designed to provide students with structured, ongoing support from their faculty coach and peers while exploring humanism in medicine and professional identity formation, and engaging with the local community.
As part of the scientific literacy and inquiry curriculum, students will participate in all phases of the research process and be responsible for a scholarly project.
“Our goal is to prepare and empower all of our students to be effective creators and consumers of scientific literature,” says Meka. “This includes developing the skills necessary to effectively communicate, educate and disseminate medical knowledge with patients, other health professionals, policymakers and the community.”
Jacobsen adds that faculty response to the new curriculum has been fantastic. “We have an outstanding team of faculty who have been contributing their expertise to develop and lead these new programs. We are so fortunate to have experienced faculty who have eagerly stepped forward to become even more engaged in the educational mission,” she says. “It has been enormously rewarding to get their positive feedback.”