Our Family Ties
I returned recently from a large family gathering at our favorite lake in New Hampshire. Seventeen members of our extended clan, including a scattering of grandchildren and children from as far away as England and China, talked, laughed and played together at the scenic spot we all love. That got me thinking about the common thread that links us, despite our differences and the miles between us. There’s just something about family that transcends those kinds of details.
I think of our medical school and its affiliated hospitals in the same way. We rely on a network of 21 clinical associates across Massachusetts and in Maine to share in the teaching of our students during their third-year clerkships. Although the affiliates come in different shapes and sizes, we think of ourselves as one family in spirit, and we share a standard of excellence that extends from one end of the network to the other.
One valuable consequence of this dispersed educational model is that our students receive excellent academic training in a variety of settings, from big urban hospitals to small, more-intimate-feeling community hospitals. The demographics, economic profiles and medical practice models differ markedly from place to place. Our students have the chance to interact with all kinds of patients in all kinds of places, and I think this prepares them well for the kind of medicine they will be practicing once they begin their careers.
Different students want different things in their clerkships. We find that some like the idea of moving from site to site during the third year—to study surgery at Lahey and then rotate to St. Elizabeth’s for their ob/gyn coursework, for example—while others prefer staying put for the entire year and gaining a more intimate sense of the culture of one place, as we offer students who do clerkships at Baystate Medical Center in Springfield, Mass., and Maine Medical Center in Portland.
When students consider their choices at the end of their second year, we provide them with a wealth of information and personal guidance. They can scan our detailed reviews of each site: Every year we rate each site in 26 categories (such as quality of teaching, mix of patient interactions, exposure to specialty, general atmosphere) based on student appraisals of their experiences.
In addition, we ask some third-year students who have just completed their clerkships to participate in a panel discussion for second-years that lends a human voice to the written evaluations. This gives the curious applicants some personal detail that’s pitched, in effect, to their own sensibilities. Our second-years are thus able to absorb information from a number of sources, and once they’ve made their picks, conclude, “This fits me best.”
The system seems to be working well. Most students tell us they were really happy with their clerkship experiences, and this is borne out in the ratings that we collect. We ask each student to rate his or her clerkship site on a scale from one (low) to five (high). We have found that 90 percent of our major sites are rated better than four, an outstanding level of performance and one that we’re proud to maintain.
Dr. Amy Kuhlik, our dean of students, tells me she’s always struck by the consistently positive tone expressed by third-year students at the panel presentations to the second-years. “They’ll stand up and say, ‘I loved every site I went to,’ ” she reports.
In their site evaluations, we give students the opportunity to offer personal remarks on the year gone by. What stood out for them amid the hustle, the pressure and the learning? Dr. Kuhlik has shared with me comments from the most recent evaluations. One student wrote, “I was grateful for the hands-on experience I got in the OR.” Citing an impressive teacher, another said, “He teaches us in a way that makes things simple. He was enthusiastic and compassionate about what he taught.” Another student singled out a notable professor who had made a deep impression on her: “He genuinely listened to my concerns.”
Not to stretch things too much, but isn’t this the essence of family? I think there may be a parallel worth considering.
Harris A. Berman, M.D., is the dean of Tufts University School of Medicine.