Throughout the school year, we've been following two bright, young, future doctors. Now, we're wrapping up the journey with a one-hour documentary about the crucible of medical school, set against the backdrop of some of the most dramatic changes in health care in a generation. Listen to the full hour or individual segments online, below, or download and listen on the go.
Future Docs: A Lens for Looking at What's Happening in Health Care
Over the past school year, I’ve been following two future doctors, Sarah Rapoport and Peter Kaminski, through their second year at Brown University’s Warren Alpert Medical School.
Why? Because health care as we know it is transforming. We’re moving from a doctor-centered, fee-for-service system to a more patient-centered, pay-for-quality way of doing things. Plus, we as a nation are transforming, too. We’re growing older and sicker, and scientific advances are emerging all the time to help prolong our lives. The bottom line: tomorrow’s doctors will need to know how to navigate a brand new world.
So I set out to learn how medical education is adapting through the eyes of these two future docs, Sarah and Peter.
We meet Peter and Sarah in segment one. Although lots has changed for med students these days, some traditions and experiences endure, as they show us. Then, we take a look at the ways in which medical school actually has changed, as schools like Brown University and others revamp their curricula to adapt to the changing world of health care. In segment two, we hear again from Sarah and Peter as they begin to explore specialties. And we pose the question, "Are we training enough new doctors?" In segment three, we examine how medical schools are adapting to our nation's new reality: a population that's older and sicker than ever. And we find out what new ethical challenges tomorrow's doctors will face. We wrap up with a final visit with Sarah and Peter, just as they're getting ready to head into their third year of medical school and the new and unfamiliar world of the hospital wards.
Segment 1: Meet Sarah and Peter
Meet Peter and Sarah, two second year students at Brown University's Warren Alpert Medical School. Although lots has changed for med students these days, some traditions and experiences endure: learning about anatomy from a cadaver, the intense workload, and so on.
But thanks to some pretty recent – and pretty profound – changes in health care and medical science, Sarah and Peter will have some experiences and gain knowledge their predecessors probably didn’t. So in this segment, we also explore the how and why behind those changes.
Most medical schools have been operating with the same basic approach since 1910, when a reformer named Abraham Flexner introduced a new model of medical education. But advances in medical science and changes in the way we practice and deliver medicine have caused a lot of med schools to rethink and revamp. Brown University redesigned its curriculum just a few years ago, and in this segment we also meet the man who helped with that redesign and is now in charge of making sure it meets future doctors' needs.
Segment 2: Specialties and Residencies
We’re halfway through Peter Kaminski and Sarah Rapoport’s second year of medical school. The second year is often a transformative one – it’s when students like Sarah and Peter start to get a handle on the intense workload, when they get a taste of life beyond the classroom, and when they take the first of several major licensing exams. In this segment, these two Future Docs begin to grapple with a critical decision: what to specialize in.
Then, right after graduation, medical students like Sarah and Peter will start the next phase of their training: residency. Residents typically spend anywhere from four to seven years learning a particular specialty from more senior residents and practicing physicians in a hospital. It costs a lot of money: the nation spends billions of dollars every year on residency programs at hospitals around the country. That should mean we’ve got a great pipeline of future doctors, right?
But many health care experts say it’s still not enough to head off a serious shortage. That’s because there’s a bottleneck: there might not be enough residency slots available for future residents like Sarah and Peter. To find out what lies ahead for them, in this segment I catch up with a current resident at one of the area’s largest teaching hospitals.
Segment 3: Facing an Older, Sicker Nation and a New Frontier in Ethics
We’re talking about preparing the next generation of doctors at a time when medicine – and health care – are changing dramatically.Those dramatic changes include us. As a nation, we’re getting older and sicker. More of us than ever are over the age of 65. And many more of us suffer from at least one chronic disease. That makes caring for us more complicated, and more expensive.
But what does it mean for doctors in training? Well, in part it means they have to learn how to ask for help - a far cry from what doctors a generation or two ago ever dreamed of. We take a look in this segment at how med schools are facing this new reality.
Plus: some of the toughest decisions any of us will ever make will take place in a doctor’s office – especially as we get older. But before those decisions ever come up, doctors must often wrestle with the options themselves. And those options are growing more complicated every year. Advances in medicine have given us a dazzling spectrum of options to prolong or alter life. The rising cost of health care and the growing number of uninsured are forcing us to make increasingly difficult decisions about who gets care and what kind. The speed of change and discovery is quickening. And in many ways we’re still pressing the creases out of the map, trying to figure out where we are. Luckily, medical students have a few guides to help them navigate this new terrain. We meet a man who’s teaching our Future Docs Sarah and Peter and their classmates how.
And finally, we check in one last time with Sarah and Peter as they prepare to enter their third year of medical school. It's a major milestone: they're leaving the classroom behind, and heading for the hospital wards.
A huge thank you to Future Docs Sarah Rapoport and Peter Kaminski. I hope to check in with them every once in a while to see how their training and careers unfold.
If you'd like to listen to any one of 10 previous stories from our series, Future Docs, just visit the Future Docs page on our web site, or click on one of the related stories, below.