Case's New Direction

[SoulRFlare]

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Has anyone read the statement from Dr. Horwitz regarding his vision for Case? I think they just put it up on the website the other day. here's the link for ppl who are interested
I'm curious to see what ppl think. as for my own reaction--it sounds very exciting, though I must admit that I'm not too knowledgeable about public health...which I guess is the point of the changes.

 

[exmike]

Originally posted by SoulRFlare
Has anyone read the statement from Dr. Horwitz regarding his vision for Case? I think they just put it up on the website the other day. here's the link for ppl who are interested
I'm curious to see what ppl think. as for my own reaction--it sounds very exciting, though I must admit that I'm not too knowledgeable about public health...which I guess is the point of the changes.

Wow, thanks for posting that!

Since I have a PH background I have always been convinced that the quality of medical care in the US can be greatly enhanced by better integrating concepts of public health with medicine. I'm excited that Case has pointed to this as a area of need and will in the future encourage the development of its curriculum into a more interdisciplinary model of medicine and public health. Case is definitely moving in the right direction and it gets me excited just thinking about going there next year! It appears their new curriculum wont be ready for a while though, at least not soon enough for C/O 2008 to experience.

 

[savvyr]

Wow, that is really cool! It sounds like they're really doing innovative things.

 

[niveknat]

Wow, this is awesome. Thx for the link, soulrflare. I can't picture a more complete and rigorous approach to medicine, especially in our day in age. The realisation of modelling a medical education in an attempt to bridge public health with academic and clinical medicine will--I think--really make Case a leader in many ways for years to come.

-KT
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Future CCLCMer 2009

 

[W222]

What up Danny? You comin over tonight? I am going to hit the gym with the lady and we will be home around 7ish.

 

[Kashue]

Originally posted by W222
You may be surprised to hear this but this "new direction" is really going to change things and its angering alot of people, students and faculty.

Mind explaining?

 

[juddson]

What do you mean by this "you can't fund student research without paying for it"?

I need some elaboration. Are you saying that the typical med student at Case won't be able to do paid research or research for credit at Case? They just built a new research building (making it like 6 total now, not including CCLCM). Surely the school is focused in research more than anything, no?

Please spell this out a bit for some of us prospectives.

Judd

 

[Danielle]

Since the "new cirriculum" will focus more on research some of the old cirriculum must be removed. As a result, anatomy, histology, etc. will be taught at a lighter load. My question is how can one be a doctor if one does not understand the anatomy or histology of the body?

 

[idq1i]

Sounds like ramming primary care down everyone's throat

 

[juddson]

I think this is the general trend, no. No one can deny that many schools (maybe most) have drastically cut the number of "in-class" hours down in favor of more independant study. No one denys that med students are a smart bunch and can learn the stuff anyway. But that is merely a side note the greater trend - which is that medical schools are shifting away from basic pedigogy (in the form of fact lectures) to "fuzzy" types of instruction.

Take CCLCM as an example. The anatomy is prosectional. I;m not even sure thay have histology slides. It's probably all computer now. And exactly HOW MUCH flaling to and fro is expected of a student in a PBL style session? A lot.

I think much of this is the result of the following: there are simply too many facts for a single person to know. Hence, there's an increased emphasis on process and system and less on function and part. This is true everywhere - not just at Case.

It seems to me that Case has made explicit the next step (an integral part of all progressive curriculums, I'm sure, even if not spelled out like Case has done) which is that they want to incorporate the "public health" aspect into the curriculum.

personally, I've given this PH aspect of medicine thing a lot of thought lately. For instance, at the internal medicine clinic I shadowed at for four months, 90% of the patients we saw had public health issues, NOT health issues. These patients were sick, no doubt, but they would NOT have been sick if they had been (1) properly fed, (2) properly clothed, (3) properly maintained, (4) properly sheltered ,(5) properly educated and/or (6) properly motivated. Many of the medical problems we saw were the result of the breakdown of the public health system (which includes the breaksdown of the social "net" system we all find important). Honestly, would we need 80% of the Plavix and Lipitor we currently consume if we knew how to eat right and take care of our bodies. These are public health issues, NOT just medical issues.

I think Case (not JUST Case - I'm sure dozens of schools have similar outlooks) recognizes the way forward for the American healthcare system is NOT discovering an artery cleaning pharmceutical, but a system designed to keep the arteries clean in the first place.

Judd

 

[juddson]

Originally posted by Danielle
I would not care if they lighten the load because I will reseive my master's of anatomy before med school begins. However, I have seen what the how much of the core subjects such as anatomy or physiology are taught to the med students and do not believe it needs to be any less. If they decide to decrease the amount that is taught, they probably will still be able to pass the boards. However, they will probably realize that they needed that extra education once they reach their residency and are being crammed with questions that they cannot answer.

I wondered about this. I took an embryology class in the med school last semester and there were a few med students in there. Was that class more "in-depth" than the embryology taught as part of the medical school curriculum. I thought there was quite a bit of info to take in (certainly more than any other class I have every taken).

Judd

 

[exmike]

For current Case'rs, are there parts of the new vision that people are happy with?

I'm sure there was just as much if not more consternation when Case moved towards its integrated cucrriculum in the 50's, and it worked out well then. I wonder how this will pan o ut.

 

[DannGee]

i can see why some people might be afraid of these changes- they seem to be very major and very ambitious. i'm sure Dr. Horwitz got input from many people, both inside and outside Case, before he decided to announce this initiative. it seems clear to me that Dr. Horwitz is trying to position Case to be mentioned alongside Harvard and Yale in both prestige and innovation, and I think the timing of these changes is also great, as they will coincide with the jump in the rankings Case will make as a result of their partnership with CCF. with the school sure to gain increased visibility, why not take the opportunity to propose a medical school curricula that integrates matters of public health?

 

[exmike]

Perhaps its worth mentioning that the Top two medical schools in the country also happen to have the top two public health schools in the country.

 

[fuzzylogic]

ph is important. research is important. the trick is to find a balance so both areas will be taken care of. it's great for the dean to take an initiative. it will be even greater if dean horwitz can keep the research tradition while improvising the ph curriculum.

 

[Danielle]

Originally posted by juddson
I wondered about this. I took an embryology class in the med school last semester and there were a few med students in there. Was that class more "in-depth" than the embryology taught as part of the medical school curriculum. I thought there was quite a bit of info to take in (certainly more than any other class I have every taken).

Judd

Are you talking about the class taught by Dr.Friedeu? If you are then yes that class is way more in depth than the embryology taught in the med school. In reality, I wish I would have taken it sooner before anatomy etc. because everything seemed to make more sense (i.e. structure and function) once I realized how it developed. However, that class certainly is not as bad as histo!

 

[juddson]

yes, I took the one with Dr Fridoue (sp?) just this past semester. Were you in there with me?

Judd

 

[exmike]

did we just lose a bunch of posts?

 

[Danielle]

Originally posted by juddson
yes, I took the one with Dr Fridoue (sp?) just this past semester. Were you in there with me?

Judd

Yeah
I was the blonde girl that always sat in the front row

 

[fuzzylogic]

btw, if you are familiar with the hms's system, case seems to be moving towards that direction:

case - university program (will focus on ph)
harvard - new pathway program (focus on patient care and ph)

case - college program (focus on science, research and thesis)
harvard - hst (focus on science, research and thesis)

coincidence, you be the judge!

 

[juddson]

Reddy,

You got the sense that some people were leaving Case because of the CCLCM program?

Please elaborate.

Judd

 

[oldtimer]

I wonder how much of these curriculum changes that the class entering in 2004 will really see. The implementation date for Dean Hortwitz's vision is for the class entering in 2006.

 

[fuzzylogic]

people who want to leave the school because of these new changes are shortsighted. these people are afraid of change because of its uncertainty. if these new programs are well managed and well organized, people in the medical field should be extremely excited about these changes at case.

it is difficult for an individual medical program to focus on multiple areas (i.e., ph or biomedical research). it makes sense to have two programs at case and dedicate each program to a particular focus. these programs will allow future applicants to apply for a program according to their interests. also, case can develop a more effective curriculum based on students' interests in each program.

overall, i think this is a more effective way to train future physicians. plus, case can utilize harvard's model as an example to improve both the ph and biomedical research programs. i am not saying that following someone's footstep is a good thing. but, harvard has certainly done very well with this particular model. why don't other schools utilize it, funding or pride? Once again, you be the judge.

 

[SoulRFlare]

bump

 

[hobs]

as a social science-lovin person, i'm really happy to see that case is wanting to integrate ph ideas into the current medical system, and into medical education. it makes sense, doesn't it? especially based on what judd was saying before.
Although the development of new medicines and procedures is very important, so is the identification of risk factors and preventive measures for certain diseases.

i think it's great that case recognizes this potential for public health intervention----and trying to solve public health ills is, i think, more challenging, in certain ways, than searching for a new gene or something. ((yes, i'm speaking from gross inexperience on the side of benchtop research)... we already know how difficult it is to convince a nation of McPeople to 'eat fresh fruits and vegetables' and cut down on the cardboard/lard mix that is most processed food. and nutrition is just one problem out of many. so, in terms of how to talk to people, as a physician, about things like eating or smoking, and really translate that into effective negotiation with a patient to modify those behaviors----that's really important! and part of most every physician's job, not just the primary care doc.

 

[mosoriire]

Unless med school is lengthened by a year, I'm not sure Case wil be able to actualize it's vision...Not sure yet, still researching it. Ive not been impressed with any med schools that try to intwegrate PH. Funny thing is they usually are the research-oriented med schools

 

[exmike]

Originally posted by mosoriire
Unless med school is lengthened by a year, I'm not sure Case wil be able to actualize it's vision...Not sure yet, still researching it. Ive not been impressed with any med schools that try to intwegrate PH. Funny thing is they usually are the research-oriented med schools

i dont think they're trying to integrate an entire MPH level of competency into the curriculum. I think they're just trying to integrate public health more than they have in the past. From my experience thus far from first year medical school coursework, even a bit of public health integration would be a huge step forward at some schools.