RENEE MONTAGNE, host:
Medical education in the United States is going through a growth spurt. After decades without a single new medical school and the closing of several old ones, five new schools have opened since last year. Ten more are being accredited and several more are planned. It's a response to the growing doctor shortage, especially primary care physicians.
Along with producing more doctors, many of the new schools will try to do something else, and that's reshape medical education. NPR's Greg Allen reports on one of the new schools at Florida International University in Miami.
GREG ALLEN: Miguel Flores and Eric Liss are part of a class of second-year med students who are learning how to conduct a physical exam. And how better to learn than on each other?
Unidentified Man #1: Like try to supinate(ph).
Unidentified Man #2: And what is it? Bicipital tendonitis. Do you feel pain?
Unidentified Man #1: Yeah, exactly. (Unintelligible)...
ALLEN: This kind of practical instruction has long been an important part of medical education. Teaching future doctors how to interview and examine patients is the first step toward treating them. At Florida International University's new medical school, students start working on those skills in their first year. Many medical schools also have students work with a practicing physician who acts as a mentor and a teacher in a clinic or ER.
Mr. MICHAEL HANN (Medical Student): But for us, they're much more developed.
ALLEN: Michael Han is a second-year medical student.
Mr. HAN: It's integrated into our curriculum. We go there and we don't just do history taking. We help the physicians taking physical exams. You know, we get input in things. We interact with the community. It's a much more developed program.
ALLEN: The dean here, Dr. John Rock, has long worked in medical education, at Johns Hopkins and as chancellor of Louisiana State University's Health Sciences Center. Starting a new medical school, he says, gave him and other educators a chance to try something innovative: a community-based medical curriculum.
At FIU, every medical student is assigned a neighborhood in the Miami area and a family who lives there. Rock says their mission is to improve the health of the family and the quality of life in the neighborhood.
Dr. JOHN ROCK (Dean, Florida International University Medical School): We've adopted those neighborhoods, and we never leave. Clearly, we have a commitment to those neighborhoods, to be there and to work with households and with the community to address the socio-determinants of health care.
ALLEN: Rock says he wants his medical school to produce more primary care physicians. But he also believes the school's commitment to community care will also make better doctors of the students who pursue specialties.
Doctors like Joe Greer. Greer helped plan and shape FIU's community care-based curriculum. He's a gastroenterologist who founded and directs Camillus Health Concern, a free clinic in Miami that cares for the poor and the homeless. He's served as an adviser to two presidents and received a MacArthur Award. He believes medicine and medical education have to be better.
Dr. JOE GREER (Director, Camillus Health Concern): What we've become is a nation of interventionalists. If you're dying, I'll save you. But it's sort of like in America we won't let you die, but we'll let you suffer. So how do we get beyond that?
ALLEN: By putting students in the neighborhoods, Greer says they can begin to learn that treating a disease oftentimes means more than just treating a single patient.
Dr. GREER: Somebody comes in because they're diabetic. Why are they diabetic? Well, maybe it's because they're obese. Well, why are they obese? Well, maybe it's the type of food they have access to and they're in a poor neighborhood and they have no access to fresh fruits or vegetables. Well, people should take personal responsibility. Why aren't they exercising? Well, the gang sort of prevents you from doing that. OK? Plus, it's South Florida. It's 100 degrees in the summer, 70 percent humidity, and there's no shade or pools in these poor neighborhoods.
ALLEN: Through the community care program, which they call Neighborhood Help, the doctors at FIU say they're determined to make actual, measurable improvements in the health and quality of life in the neighborhoods they've adopted.
For some students, who've come from other parts of the country or from affluent families, plunging into some of Miami's poorer communities is an eye-opening experience. But there are others, like Patricio Lau, who moved to Miami from Nicaragua when he was 14, for whom it's a homecoming.
Mr. PATRICIO LAU (Medical Student): One of the neighborhoods we're working with is trailer parks. So I'm used to - I have lived there. That's why it's one of the good things about Neighborhood Help, because I feel that I can actually give back to the neighborhoods that I am from.
ALLEN: Other new and established medical schools are also making commitments to community-based medicine. Dr. Joe Greer says it's clear medicine and medical education have to change. And in that way, a brand new medical school like FIU, he says, has an advantage.
Dr. GREER: Changing a curriculum in a medical school is like turning a battleship in a pool. Luckily, all we had was a raft. Now, our job is to make sure that raft is pointed in the right direction, so when it becomes a battleship, it has the ability to turn when the turns are needed, to adjust to society.
ALLEN: Greer says he feels as a medical educator he has another charge as well: to help give students the inner strength and inspiration they need to carry them through their careers. You have these great young minds and incredible hearts, he says. It's our job to make sure they stay that way.
Greg Allen, NPR News, Miami.
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