The University of California, San Francisco (UCSF) School of Medicine launched its new Bridges curriculum that immerses students in clinical teams right from the start – and trains them to continuously improve care. Their understanding of the foundational sciences will be in sync with what they are learning in active clinical settings – and they will be challenged to ask questions that advance their understanding of human health and disease and the frontiers of science.
“What is new in medical education is that we have a better understanding that solving these problems requires a new way of working as a health care professional, much different than what was imagined 100 years ago,” said Catherine Lucey, MD, the School of Medicine's vice dean for education.
That new way of working in health care, Lucey said, includes continuously asking questions and finding ways to answer them through collaboration with different types of health care professionals and scientists. Additionally, all the health care professions must be able to integrate as a functional unit in the clinical setting so the elements introduced in Bridges to develop interpersonal as well as systems improvement skills, among others, include early clinical immersion and a pursuit of a research project that will span their years of medical school.
The unique UCSF training program, built from the ground up, is the medical school’s first new curriculum in 15 years. More than 300 faculty, staff and students have been working more than four years to plan and implement elements that will revamp medical education to reflect society’s current needs.
“There was a time when we thought that physicians needed only medical knowledge to provide the best care for patients,” said Anna Chang, MD, a professor of geriatric medicine who has been involved in planning Bridges since its inception. “But now we know that there are safety and quality gaps in patient care that are less about a physician’s ability to recall scientific facts, and more about a person’s ability to communicate and work well with everyone on the health care team.”
Bridges students will learn a new set of cutting-edge teamwork and system skills, said Chang, that will allow them to identify what is working well and what can be improved in health care systems, and to participate in developing new ways to improve patient care.
Emphasis in Bridges will be on developing clinical skills to continuously improve care, built upon the underlying concept that medical knowledge is constantly changing, and that UCSF graduates should be ready to become tomorrow’s leaders in answering the unknown answers and unsolved problems. “Medical education has a responsibility to help health care improve today, not just to wait for the next generation of students to graduate to help,” Lucey said.
“We set out with this new curriculum to ensure that every medical student develops an understanding not only of the solid building blocks of biomedical science as they are known today, but also the cutting-edge science occurring today that will lead to advances in the way they care for patients tomorrow,” said Lucey. Basic scientists have complained for years that medical school focuses almost exclusively on concepts in the biomedical sciences that are “tried and true,” she said, and that students may be exposed to scientific discovery if they work in a research laboratory, but medical school in general does not cover ongoing research.
The Bridges curriculum provides dedicated time for all of students to engage in a scholarly project during medical school. In their first year, as part of the Inquiry element, medical students will spend two weeks addressing a chosen topic related to the most pressing challenges in biomedicine and health care.
During their last two years, they will work with a faculty mentor to complete a scholarly project in one of six domains of science – not just the biomedical and clinical science, but also social and behavioral, population and data, systems and education science.
“This is the only way we are going to improve our healthcare system, which is struggling to meet our promise to society and in need of skillful leadership,” said Chang. “The more we teach medical students about our healthcare system and the colleagues they are working with, the more effective they will be at leading this much-needed change.”