Medical schools across the country are implementing exciting and innovative curricular reforms to promote and encourage students to pursue primary care medicine, but the University of Utah School of Medicine is in a crowd of their own. Utah has created a primary care track for medical students interested in family medicine, pediatrics, or internal medicine. They start developing leaders in primary care as early as the first few weeks of medical school.
During the first two years of medical school, which are focused on basic science, Utah has found a way to better incorporate primary care values into their students' experience. First year students work as a medical assistant in a local clinic during their orientation month generating a better appreciation for the work that others on the medical team perform. Additionally, first year students work in a longitudinal clinic that they go to for a half day every other week. Continuity of care is a core value of all primary care, so Utah is exposing students to this important aspect of the field early. Also, during the first couple years, strong focus is put on clinical and communication skills.
Utah is alone in how they utilize the fourth year of medical school to better prepare students for their first day as a primary care intern. The curricular reform was derived from a need to make fourth year more productive and useful for students. The fourth year is broken into four components: longitudinal course, 4 week module, continuity care clinics, and teaching.
In the longitudinal component, all students in the primary care track spend a half day together, two times per month. Each longitudinal session is focused on an important issue or skill needed by primary care doctors. Some topic examples include communication, team building, ethics, public health, health reform, and health systems. The students have specific assignments during each of these sessions to tie it back into the rotation that they are currently on. For example, if a student is doing a cardiology rotation, they will have an assignment to bring in the primary care issue being discussed to that rotation. It is a way to make each fourth year rotation pertinent to primary care.
The four week module is a more intensive time to hone skills that are specifically needed by interns. They review note writing and see a lot of standardized patients to develop important technical and interpersonal skills.
The continuity care patient experience is the most exciting aspect of the primary care track. Towards the end of their third year, students recruit a panel of patients who they will track the entire year. Every time a patient on their panel has an appointment -- whether the appointment is for surgery, delivery, primary care, oncology, etc. -- the student accompanies them and serves as their health advocate. This experience shows students the inner workings of the U.S. health system firsthand, but also provides a valuable asset to patients. Having a medical professional present who knows your medical history inside and out improves care and outcomes. Kinks are still being worked out with this aspect of the track, but the idea is innovative and a very important component of their curriculum.
Lastly, the students in the primary care track have obligations to teach second year medical students. Primary care doctors need teaching skills for their patients and future medical trainees, so this is a time to develop those while reviewing important science knowledge and technical skills.
Utah is ahead of the crowd in terms of creating an innovative, primary care centered medical curriculum. It will be worth keeping tabs on how this program continues to develop.
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