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 IT

She was exposed to EHRs in school, she says. In different care settings, she learned the ropes on three different systems: Epic, Cerner and VistA.

But none of that came until the "beginning of third year," says Runyan, "right before we were going into the hospitals full-time." At that point in their schooling, students get a "pretty basic training in EMR, and then they kind of learn it as they go."

At the time, she says, "I just thought, 'Oh, this is just how it works. I'll just shadow for the first two years and then I'll get to be more on my own.'"

But with some perspective, now that she has her sheepskin and is planning to start practicing soon, Runyan thinks differently.

"Now that I think about it, in retrospect, it would make more sense if I knew how to document (earlier), if I had those skills," she says. "The transition to third year would be much smoother. That's a big part, that learning curve of how to document. Everything is documentation. That would have been really helpful."

As a first- and second-year student, when she was "shadowing," Runyan had to sign a confidentiality agreement. "I got to look at a paper chart," she says. "I should be able to look at an electronic record. Or at least get to know the system. That way I'm learning more, I'm a more intricate part of the team."

When the American Medical Student Association gathers for its Empowering Future Physicians conferences in Philadelphia and Atlanta, Oct. 11-13 and Oct. 18-20, respectively, it's fair to wonder how many first- and second-year docs-in-training will be thinking the same thing.

Incentives improvement

"We've seen a significant increase in efforts to integrate learning using the electronic health record in the last couple years," says Carol Aschenbrener, MD, chief medical education officer at the Association of American Medical Colleges. (AAMC is the other sponsor, alongside AMA, of the Liaison Committee on Medical Education.)

There may well be good reasons for certain schools' slowness to adopt and adapt, she says. "Some students, we hear, are not using EHRs but it's not the fault necessarily of the educational program. Some systems, as they're implemented, make it very difficult for the student to interact directly."

Despite the forward strides, there's plenty of room for improvement still, she says. How to get there? There are plenty of ways to push for wider use.

"Medical educators (should) advocate with the companies that make electronic health records about the importance of accessibility to the learner," says Aschenbrener. Educational use has not been a priority, to date."