Empatia na Formação Médica

USF seeking medical students nicer than 'House'
 

KATY KUEHNER/STAFF

Student Alexandra Printz, with husband George and their sons, is one of the first 19 students in what USF calls its SELECT program.

By LINDSAY PETERSON | The Tampa Tribune
June 17, 2011

Alexandra Printz was honored to be accepted into the University of South Florida College of Medicine last year, but she had her eye on something else.

She'd heard about a new kind of doctor training USF planned to offer, other than its traditional medical school. She wanted it so intensely, she was terrified when she finally got a chance to interview.

The interviewers weren't focused on her knowledge of anatomy or organic chemistry. She'd already proven that. Instead, they probed for evidence of her compassion, personal values and ability to lead – her emotional intelligence.

She's now one of the first 19 students in what USF calls its SELECT program. It's the result of an idea medical college Dean Stephen Klasko began working on 15 years ago, while he was earning a masters of business administration at the Wharton School of the University of Pennsylvania.

"We've created a lot of doctors that are like House," he said of the brilliant but caustic television doctor. They get into medical school based on their science grades and performance on standardized tests, "then we wonder why they're not more empathetic."

Many of them also lack the skills they need to survive in today's turbulent health care environment, Klasko said.

 Hugh Laurie - "Dr. House"

* * * * *

A USF survey of doctors on the job for three years or less showed that 60 percent felt they hadn't learned some of the things they needed most – the ability to collaborate with other health professionals, to function in a complex organization, even how to simply run a meeting.

Klasko's trying to change that with SELECT, which stands for Scholarly Excellence, Leadership Experiences and Collaborative Training.

A central piece of the program is that after spending two years at USF, students spend another two 1,100 miles away at Lehigh Valley Health Network, in Allentown, Pennsylvania, one of the country's top hospitals.

Lehigh's president and CEO Ronald Swinfard said his center has been working for a while on instilling humanity in its student doctors. As ephemeral as it may seem, it can be taught, he said.

"You model it."

His doctors don't talk down to nurses or expect breaks other employees don't get, he said.

"You have to have an emotionally intelligent, collaborative, interdisciplinary team practicing if you want young trainees to adopt that as their model."

Henry Sondheim, of the Association of American Medical Colleges, tracks new programs and in recent years he's seen several med schools break from tradition and look at more than applicants' grades and test scores.

Some have developed specific missions, admitting people interested mainly in primary care or patient-based research, for instance.

But none he knows of has picked emotional intelligence as a criterion, as USF and Lehigh Valley have done.

"These are very interesting times in medical education," he said.

* * * * *

Printz is more excited about this than any opportunity she's had, she said, and her life so far has been pretty full. She's 25 and the mother of two boys, five and 15 months.

She heard about the SELECT program in her interview for USF's traditional medical school track, and she set her heart on getting in.

Its focus on empathy and the skills needed to change the system "was everything I wanted," she said. "I think I annoyed them a little bit, I wanted it so much."

Medicine has interested her for a long time, but she hates the way the poor are treated.

"How can you feel good about being a doctor when you're only taking care of people who can afford it?" she asks. "Or when you're incentivized to give less care" because of the way you're reimbursed.

She's closer to these questions than a lot of people. As a teen, she watched her grandmother fight as cancer spread from one part of her body to another, then another.

"I watched her fight with illness in a system that didn't work for her."

Printz's family had no money, but she had the intelligence to get into Sarasota's Pineview, a public school for the county's smartest students. As elite as it was, she felt bored most of the time, so she skipped class a lot.

She wound up with a GED, and was taking classes at State College of Florida, then called Manatee Community College, when she had her first child, at 20.

It was about that time, 2006, that she announced to her husband, George, that she had decided to aim for medical school.

She transferred to USF, moved into pre-med and graduated in May, the USF Alumni Association's choice as Outstanding Graduate.

* * * * *

Printz could have gone almost anywhere. The SELECT program helped keep her at USF.

"It still amazes me I got in. I'm just blown away," she said. She also received a scholarship.

USF chose Printz and the 18 others through an interview process it devised with the help of Teleos Leadership Institute, based in Elkins Park, Pennsylvania. Among the aspirations listed on its website: "We want to change the world."

Teleos founders, two Wharton professors, have studied leadership and identified its essential parts.

High on the list are self-awareness, awareness of others, empathy and the ability to be flexible and guide people amid change.

Though she was counseled not to say too much about the interview process, Printz recalled being asked about what she wanted to accomplish and what made her think she'd succeed.

They were the type of things she'd already thought about a lot.

For more than a year she's worked for the Hillsborough Kids Healthcare Foundation, a nonprofit group that tries to find coverage for children without insurance.

"It's just not acceptable to me that you will have two children with the same issues, but they'll have two different outcomes because of whatever choices their parents made," she said.

She dreams of sorting out the dysfunction in the U.S. health care system and fixing it, at least for the most vulnerable.

* * * * *

After finding Printz and her 18 future classmates, USF's next challenge will be keeping their dreams alive through the next four years, which at times will be grueling.

They'll have to learn all the things traditional medical students do, but USF hopes to stoke their ideals with small group discussions of ethics and current health care dilemmas.

"They'll be stimulated, even pushed to understand in more depth the implications of actual health policy," said Robert Brooks, associate vice president of Health Leadership at USF.

They'll have mentors to help them stay focused. They'll spend the summer after their first year with people handling real life issues, a hospital administrator or the director of a county health department.

"The focus will be on leadership, not just content," Brooks said.

If all plays out as Klasko envisions, they'll emerge in four years with all the knowledge of any doctor, but also the skills to bring change to dysfunctional systems.

Whether the average patient will one day see a difference because of this and other new programs is a big question, said Sondheim, of the medical college association. But he's optimistic.

Studies of "mission driven" programs in Europe and Israel show that they produce graduates with measurably different attitudes about their responsibilities.

"People are watching this in the United States," he said. "They're really beginning to talk openly about personal characteristics in medicine."

Printz and the 18 other SELECT students start next month.

"I can't wait," she said.

"I don't know if I could have dreamed bigger than this."