CARLOS U. ARANCIBIA, M.D.

DISCLAIMER THE OPINIONS EXPRESSED IN THIS PRESENTATION ARE MY PERSONAL OPINIONS AND MUST NOT BE CONSTRUED AS REPRESENTING THE OPINION OF ANY INSTITUTION WITH WHICH I AM OR HAVE BEEN AFFILIATED IN MY PROFESSIONAL LIFE

FOUR MEETINGS… John: “ You know me and my parents since I was a small kid and they suggested that I talk to you. My main concern in considering medicine as a career is the cost. I do not think that I want to finish school with more than 200 K of debt. What if I am married at that time?” “ All this stuff of serving humanity is nice, but why do I have to pay so much?

FOUR MEETINGS… Annie: ( she is a first year student) “ They recommended many textbooks and mentioned that we will need it for the boards. But my upper class friends say that it is nonsense and that most of the information is in the internet. I do not even carry the books because they are too heavy and I study mostly from the syllabus and my notes. Don’t they ask questions in the test that are in the syllabus?

FOUR MEETINGS… Ben (third year student) “ I am very frustrated and I am not sure that I want to continue in the school. I have worked very hard and I thought that it was going to be fun. Instead, all I have done is memorize thousands of pages and the tests are about minute details with no clear application to patient care”

FOUR MEETINGS… Amanda (senior student) “You told me again and again that we need to be respectful of the patients, treat them as professionals, be concerned with their confidentiality. Yesterday I was in the infectious disease clinic and they have patients waiting for hours and then they call them by their full name, for everybody to know who is sick. Why they are not professionals?”

PLEASE, COULD WE DISCUSS THESE ISSUES? THE PRESENT LENGTH OF STUDIES: DO WE NEED 4 YEARS OF COLLEGE AND 4 YEARS OF MEDICAL SCHOOL IN THE USA? DO WE NEED ALL THE COURSES THAT WE HAVE IN THE CURRICULUM TODAY? WE SHOULD TEACH COMPUTER SCIENCES, ADVANCED STATISTICS, ELECTRONIC MEDIA, GENETICS, ETC. THE USE OF SIMULATION (REAL VS. TOYS) AND THE LACK OF MEDICAL GAMES

MORE DISCUSSION FROM PBL TO INVERTED CLASSES AND MOOCs; DO WE HAVE ENOUGH FACULTY? WHAT IS GLOBAL HEALTH? (OVERSEAS TOURS VS REAL EXPERIENCE). SHOULD WE CONSIDER IT IN THE ADMISSION PROCESS TO MEDICAL SCHOOLS? HOW DO WE EVALUATE THE STUDENTS? DO WE MEASURE MEMORY OR COMPETENCY? SHOULD EVALUATION INCLUDE STUDENTS, FACULTY, NURSES, OTHER STAFF AND HOSPITAL ADMINISTRATORS?

AND MORE DISCUSSION… HOW LONG CAN WE CONTINUE WITH DEPARTMENTS AS SILOS? SHOULD WE CONSIDER THE “POSSIBILITY” OF FUNCTIONAL TEAM WORK? WHAT IS FACULTY DEVELOPMENT? WHO TAUGHT THE FACULTY TO TEACH? ANYBODY? NOBODY? IMITATION? HOW DO WE DEFINE “LIFE LONG LEARNERS”? AND HOW ARE WE GOING TO MEASURE IT? ARE WE EVER TOO OLD TO PRACTICE?

AND EVEN MORE… DO WE NEED TO CHANGE MENTAL HEALTH CARE? (THE COUCH VS. THE PILLS) WHY DO WE CONTINUE TEACHING INSIDE THE HOSPITALS WHEN THE PRACTICE OF MEDICINE HAS MOVED TO OUTPATIENT SETTINGS? WHEN ARE WE GOING T O DESIGN FACILITIES TO BE PATIENT CENTERED RATHER THAN HOSPITAL CENTERED?

THANK YOU. ANY QUESTIONS?