Are med schools failing future docs?
As the most-wired generation works toward their degrees – and gears up to practice in a whole new healthcare world – some are rethinking how much ITOctober 7, 2013From the October 2013 print issue
It's a safe bet that this fall's crop of new medical students is the most tech-savvy cohort yet. These are young adults, after all, who've been tapping on smartphones since they were 16, surfing the Web pretty much since they could read.
But how much information technology are they actually getting their hands on in school?
Physicians nationwide are being carroted and sticked into making meaningful use of electronic health records and other health IT, but what about the physicians of tomorrow? Many medical students have never even had the chance to make a note in an EHR, even though the technology will be inextricable from the way they'll practice from now on.
That's to say nothing of more advanced analytics training, say, or a primer in the newfangled terminology - quality measures, care teams, bundled payments - that will be the common language of the post-reform era.
A study published last year by the Alliance for Clinical Education, which comprises education leaders from an array of medical specialties united to work toward better instruction of medical students, was not encouraging.
It found that just 64 percent of med school programs allowed future docs any use of electronic records; of those that do, only two-thirds allowed students to actually write notes with in the EHR.
"Schools have a responsibility to graduate students with the expertise and sense of duty in the basics of practice," said Lynn Cleary, MD, president of the Alliance for Clinical Education, upon that study's publication. "The EHR is now part of that skill set."
Maya M. Hammoud, the study's lead author and associate professor of obstetrics and gynecology at the University of Michigan Medical School, says most schools "realize it's important," to give students a solid grounding in EHRs, but "it's difficult to implement; it's a different way of doing things."
There are hurdles both practical and philosophical when it comes to actual patient care, says Hammoud.
For one, "How do we meet billing requirements and, at the same time, be able to write notes in the charts. If a student writes a note, and the note is not accurate, and then there's an issue with the patient and there's a legal issue, what happens? That's one reason it's been difficult to integrate: People want students to write their notes, but don't want it to be part of the chart."
But more generally, EHRs in the student setting represent a fundamental change from just five or 10 years ago, she says: "How do we get the faculty to adjust to it? And then how do we integrate it with the students?"
Having published the Alliance for Clinical Education study in 2012, Hammoud says she hopes those adoption numbers "would be a lot higher now."