Student Perspective: What Makes a Great Medical Education

Zabinski: I don't know if you're familiar with TED talks. I have found some of those to be so enlightening and exciting and inspiring but I would love to see teachers bring more of that kind of lecture to the classroom. I'm Jeffrey Zabinski. I'm a third year medical student from Boonshoft School of Medicine at Wright State University in Dayton, Ohio.

Announcer: Asking questions, seeking perspectives, searching for answers. Algorithms for Innovation, live from Philadelphia at the AAMC 2013.

Li: I am Dean Li, Chief Scientific Officer of the University of Utah Health System as well as Vice Dean of Research for the School of Medicine. And Jeffrey, what are the things that you think could improve medical education. And what are the innovative ideas that you wish people would begin to adopt?

Zabinski: One of the things that I get really excited about is getting to see patients as soon as possible in medical education. Having something like longitudinal clinical experiences, that would just make me really excited to see that somewhere.

Li: What do you think are the barriers for making that happen?

Zabinski: I think one of the biggest barriers is just resources first of all. Just figuring out how to get us as student out to places where we can see patients in an appropriate setting, that's considered above our level of training. But still getting us really excited about those clinical years that can sometimes seem so far away when the basic sciences really have a hold on us those first two years.

Li: Within the basic science curriculum, do you think it needs to be lessened, do you think it needs to be spread out over all four years?

Zabinski: Well, one of the things I tell people sometimes is that I wish I knew before I was in medical school is that I could have taken biochemistry and anatomy courses before I got there. I know it would be difficult to make a change like this. Having some of those courses that often take such large chunks of time during the first two years and either make them part of a pre-medical curriculum or abbreviate them in such a way that we could either shorten the first two years to one year, one and a half years. Give us both more time for clinical experiences or research or service or traveling abroad and getting wonderful global experiences.

Li: What do you think of some of the rules that are in place now for how many hours you can be on call or how many hours you can be in clinic leave?

Zabinski: I can see where those caps are a convenient thing for us. But at the same time I would love to be able to spend many more hours just sitting there and hearing the stories of patients to see really their full course when I'm in the hospital as opposed to having to leave at a particular time.

Li: What makes a good intern or resident intern from a perspective of a medical student?

Zabinski: I think the thing that I really appreciate from residents is just when they're obviously being considerate of you as a student and respecting where you are in training. They're managing expectations. Sometimes you might have a resident that has expectations that feel unreasonable but they maybe push you a little more. But sometimes they just take it all a little too far. Or on the flip side maybe residents that don't have much experience with students or with teaching, sometimes it can be difficult to really feel like you're getting the highest value for your time when they have to be documenting, etcetera.

Li: What's the best experience that you had either in the classroom or on the wards where you could call your parents and say I made the right choice to be a medical doctor?

Zabinski: During my internal medicine rotation while I was an inpatient, I was with a fellow that day. After the fellow had finished speaking with the patient I could tell that something wasn't exactly right. So I asked if it would be okay if I just go back in and talk to them and see what was going on? They had a really long and detailed story about all kinds of things that were going on in their life that they hadn't shared. As a student you sometimes question how much value can I be to this team. At the end of the day I said, "I really contributed something and I feel like this is something that I can really do."

Li: When you put in your application for medical school, what type of a doctor did you think you wanted to become? And now that you're at your third year of medical school, has it changed?

Zabinski: It's still similar to what I thought when I was coming in. My background is in social work and ethics. Prior to that, that was my graduate work, prior to that I was in engineering. I feel like I have these diverse experiences. I could see myself anywhere from medicine and psychiatry to maybe some of the surgical specialties that get a little more time with patients.

Li: Most of your teachers are from the Baby Boom era and were teaching Millennials. What do you think are the cultural differences and what is it that you think is an opportunity for both sides to learn from each other?

Zabinski: Coming from the Millennial generation, I think of us as you know a YouTube, Google, kind of Wikipedia group of people who like to think both independently but also with this idea of crowd sourced information. Just that idea of just many voices coming together we really appreciate. Sometimes I think the expert opinion that can come from the professor in a lecture based format that doesn't use a lot of other resources. I think that that's sometimes where a bit of the disconnect can come. When a professor uses these tools well, I think it can make such a difference for the engagement of the class.

Li: Tell me a story of your favorite professor and the moment that you said, this was an excellent teacher.

Zabinski: Sometimes I feel like the places that I have received the best lectures and the best information have been from talks that have been recorded external to medical school. What I mean by that is I've had some incredible lecturers at the medical school, but I don't know if you're familiar with TED talks. I have found some of those to be so enlightening, exciting and inspiring that I'll move on from that and even do my own research.

I think that it's of that high level, gets you really engaged in such a short amount of time without the traditional two, three, four hours of lecture that I think really just makes me excited. I would love to see teachers bringing more of that kind of lecture to the classroom.

Announcer: Possible Problems in Academic Medicine. Hear how others are solving their impossible problems at Algorithmsforinnovation.org.