HM Test Drive
Michael was one of seven students in the inaugural UPIM session. The program is open to UCLA undergrads who volunteer at least 80 hours at the medical center and pre-med students at the California Institute of Technology, where Dr. Afsar-manesh received her undergraduate degree. Seventeen students applied for the first session; the seven who were selected were chosen based on their motivation, maturity, and enthusiasm for medicine. The plan is simple: UPIM aims to offer an early spark of excitement that will stay with students and serve as positive reinforcement as they proceed through medical school and confront the challenges of an IM career.
UPIM participants were integrated into teams of attendings, residents, and medical school students, and they spent time on hospital units and subspecialty consult services. The undergrads observed residents in their patient evaluations, daily rounds, and discussions with patient families. They witnessed a number of procedures, including central-line placement and bone-marrow biopsies. Although the attendings and residents weren’t required to teach the undergrads, many volunteered a significant amount of their time, Dr. Afsar-manesh says. Some of the students spent night shifts at the hospital.
“The students felt they had participated in something special. They felt the experience had overshadowed anything they had previously done,” says Dr. Afsar-manesh, a member of SHM’s Young Physicians Committee. “I think it’s a program that can really quickly grow.”
Every Friday, undergrads participated in a teaching session, during which they had to present a medically, socially, or ethically challenging case from the previous week. They received lectures on common HM topics, such as coronary artery disease, hypertension, and diabetes mellitus. The sessions featured guest speakers who touched on career options in IM and HM, research careers, tips for getting into medical school, and international health issues.
“I loved the patient interaction, as well as discussing a case with fellow students. I didn’t even mind the long hours,” says Stacey Yudin, 23, a senior pre-med student at UCLA. “While on rounds, medical students and doctors took the time to explain concepts while we were scurrying from patient to patient. The program gave me the opportunity to test-drive my dream. We always test-drive a car before we hand over thousands of dollars for it. Shouldn’t future medical students be able to at least safely experience the practice of medicine?”
Round Two: Upgrade
This summer, Dr. Afsar-manesh is improving the student presentation and guest speaker component of the Friday sessions. She will add QI and patient-safety sessions. But the biggest change to the program is expansion, as she and fellow UCLA hospitalist Ed Ha, MD, will offer a summer session for medical students between their first and second years.
Dr. Afsar-manesh also is busy reaching out to other academic IM and HM programs interested in establishing a preceptorship program. So far, she’s made headway with 10 institutions, including Northwestern University, Stanford University, the University of Michigan Health System, and a handful of the campuses within the University of California system. She’s invited the institutions to participate in a research collaborative to combine their data on program results. “We ultimately need to see how many participants will go into IM and compare that to the national numbers. That will take years,” she says.
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Uphill Battle
Mark Schwartz, MD, an associate professor in the division of general IM at New York University’s School of Medicine, believes UPIM and programs like it will help—even if only marginally—address the declining interest in IM careers among medical students.
“It will take more than tinkering around in the educational environment,” says Dr. Schwartz, who believes workforce planning, changes in reimbursement, and redesigning medical practices are essential to recruiting medical students to internal medicine (see “A Good Start, But Not Enough”).