Articles, Blog

Zucker School of Medicine at Hofstra/Northwell—Knowledge in Action

February 16, 2020

When we started the school, we said something very simple: “What is medical practice going to look like in the 2020s?” With technology and science moving at warp speed, we knew that there were going to be radical changes in the way medicine was practiced. Hofstra University and Northwell realized that combined, they could easily support a medical school. The partnership is really the key to the success of the school. Hofstra brought the infrastructure of the university that a medical school needs, and Northwell, with now 21 hospitals and hundreds of ambulatory facilities, supply almost an unlimited number of clinical sites to train the students. In the process of developing an innovative curriculum, we made a decision that we would teach medicine through a problem-solving, case-based methodology. We’re attracting people who believe they can resonate with a problem-based curriculum, as opposed to lectures, in a very traditional way of delivering fact-based curriculum, but also clinical faculty. We are committed that everyone graduate an outstanding physician. The trend in medical education today is to start clinical work earlier than students used to do historically. So rather than wait until the latter part of the first year or the second or third year, we actually start clinical practice in the first day of medical school. Doing an ambulance run, it’s a different perspective altogether, and it has its own rules and how to manage the patient. I think that our EMT curriculum during the first year helped us; seeing patients, and seeing what it’s really like out there on the front lines in our community. Moving into the medical school curriculum, I’m able to more aptly apply the lessons that were being told and not worry so much about the anxiety of meeting a new patient, but rather trying to work and direct the best care for them. In that, observers are actually participating in the care of patients in the field, and it also allows them to practice their physical diagnostic skills, which they also learn during this curriculum. And it does help because we have smaller groups, and that brings out the best of everyone, as well as higher-order thinking. Here, it’s very integrated with the structure lab, as well as our other courses that we’re currently taking. PEARLS is an acronym for Patient-centered Explorations in Active Reasoning Learning and Synthesis. The students see a new case fresh, every Monday. Students go through that case and they develop their own learning objectives. On Wednesdays, they’re expected to have researched those learning objectives and have a group discussion about those learning objectives. Every case is written so that the students will be able to elicit the learning objectives that the faculty feel that they should be able to elicit. Because we’re a self-directed learning environment in the school, these students are expected to modulate and plan their own learning, and learn how to be lifelong learners. With Zucker School of Medicine, their PEARLS program, I think, really pushes you to involve yourself deeper into the material. It really forces you to engage the subject, and then work with your fellow classmates to test your knowledge, and see how much further you can go with exploring the material. Structure lab allows students to explore multiple areas of structural sciences. They are able to take advantage of the materials we have, and we also engage the rest of the structural sciences, such as embryology, histology, pathology, to CT scans, to MRIs, to nuclear medicine imaging, and the faculty are trained to engage the students in the discussion of this information. Our structure course is given to students during their first two years of medical school, and they then are able to take that information from the First 100 Weeks and move seamlessly into the third and fourth years. Right after this course, students are assigned to physician offices, and they’ll be prepared to actually participate in those practices. ICE is the Initial Clinical Experience. In the ICE program, they are paired up with five preceptors in their two years. They basically learn to be a doctor very quickly by following doctors around in their office and seeing real patients. It’s a hands-on experience. Being able to have students see this kind of medicine is priceless I think it gives medical students the ability to see what other doctors do, and how they’re like, and I think it gives them a very, very good exposure to a very, very wide variety of patients. Being a part of the ICE program, I’ve really gotten to work with doctors and see everything that goes on behind scenes. And also, it reminds you of kind of why you came into this in the first place. The Second 100 Weeks is the last two years of the curriculum. It consists of our third year, which we also call the Advanced Clinical Experience, and the fourth year, which is called Preparation for Residency. We do have traditional clerkships just like any other school, but in our case we actually pair them. That really helps to kind of consolidate the material and allows the students to retain the information better. We also do have rotations that we call Selectives, and that really gives them the opportunity to experience different types of career fields that they might not ordinarily be exposed to. So, someone who’s interested in orthopedics might choose to do orthopedics or ophthalmology, dermatology, things like that. We have all of our students do an acting internship in emergency medicine, and then they also do another acting internship in critical care. The non-traditional manner in which the Zucker School of Medicine educates its students is absolutely revolutionary. We have a mid-evaluation where each student is given a chance to have feedback and to give us feedback in a bi-directional manner, so we can evaluate their performance and we can hear feedback from them, how they feel that they’re doing. Depending on what clerkship you’re on, right now I’m on OB-GYN, in the morning you see your patients from the day before, and then during the day, I’m in the operating room with those same patients. I’m checking in and I’m reading, to make sure that the plan for the patient is something that has been studied clinically, that there’s research on it. Our students conduct research at either the Feinstein Institutes for Medical Research, or any of the clinical facilities associated with Northwell Health. During their first year, they’ll have an opportunity to pursue a summer research project. Then, during the fourth year, they’ll be given an opportunity to pursue at least one research block associated with their research of interest. Medicine’s innovation and advancement begins with research. It’s evidence-based medicine in practice, so it actually gives them personalized experiences, so that it will enhance their understanding of medicine. Research allows our students to interact with other medical professionals, even before they start their clinical rotations during the third year. I love the people here. The faculty and the administrators have fostered a certain culture here, that students should be working together. I’ve always felt like I can go to any of my classmates and say, “Hey, what did you think of this?” or “Could you explain this to me?” and they’ll run through it and explain it to me with no problem, and I’ve never felt like I was in competition with my classmates. It’s always a sense of camaraderie, it’s always a sense of community. One thing that I really appreciate was the self-directed learning. Because of that, whatever a student chooses they’re really able to figure out what they want to learn, how they want to learn it, and when they want to learn it. Our students are independent adult learners who really can go to the literature, mine the literature, understand the latest techniques, and they can integrate that didactic information into their clinical practice from day one. We graduate authentic physicians, compassionate physicians, physicians who are using all of their brain power to become the best possible healers that they can be.

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