The Doctor’s Prescription to Founding Curriculum

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When the medical school at the University of Texas Rio Grande Valley was founded, the idea was that our region should have more doctors — individuals who are committed to improving the health of the people who live here. However, a brand new school needs a brand new curriculum, and when people’s lives are on the line, the determination of what our future doctors will be learning is a responsibility not to be taken lightly.

“I’m honored and excited about the opportunity to be involved at the very early stages of our school,” said Dr. Stan Fisch, the first appointed chair of the Curriculum Committee at UTRGV’s new school of medicine. He was one of the roughly 30 science science faculty (researchers, professors, and practicing physicians) responsible for determining the founding curriculum for the medical school, and they are all quite familiar with the standards established by the LCME for medical education and professional training. The Liaison Committee on Medical Education is the U.S.D

Department of Education-recognized accrediting body for programs leading to the M.D. degree in the United States.

“You can’t just open a medical school and start handing out degrees,” said Fisch, a pediatrician with 43 years of experience currently practicing in Harlingen. “When creating the curriculum, we wanted to be creative and use students’ time productively, but also had to be systematic in making sure that we were complying with all the requirements for a new medical school. All of us had to come together and figure this out.”

The road to doctorship is a long one. Medical school is a four-year program after a four-year bachelor (or additional two-year master) degree. After a student is awarded a medical degree, they can then specialize if they choose to through a salaried residency (in-training) program.

The traditional curriculum that Fisch and many other practicing physicians experienced consisted of two years entirely spent in the laboratory and lecture hall with courses in the basic medical sciences like anatomy, genetics, and immunology.

screen-shot-2017-01-05-at-9-59-32-am“We never saw a living patient for the first two years,” Fisch said. “Then in our third year we went out and spent the entire third and fourth year in hospitals seeing patients, but never going back into a laboratory and only rarely to a lecture hall.”

Though there are some strict regulations about the curriculum, there’s also a certain amount of leeway that medical schools are given so that they can differentiate themselves. Most medical schools today allow students the opportunity to see patients in some way, such as shadowing in clinical settings. UTRGV medical students will get their first exposure shadowing at a clinical practice in their first year. Their medical preceptorship will consist of one half-day a month at a clinic of a practicing physician; as they move along into their second year, students will have experiences almost entirely in hospitals or clinics in all of the major areas of medicine including internal medicine and psychiatry. However, they will not be far from professors and their academics.

“In the last two years when they’re doing primarily work in clinical medicine, we still need to bring basic sciences into their daily experience so that they develop a full understanding,” Fisch said.

Medical school students typically come into the program idealistic, wanting to serve and do great work for people and the world, with aspirations of being scientists and healers.

“We want to let them preserve those feelings and not become cynical by teaching in a way that retains those positive values that brought them into medicine in the first place,” Fisch said. “We also want our students to think of themselves as community advocates, as wanting  to be concerned about the health of all the individuals.”

He explains that one way of encouraging these ideas, besides addressing the issue directly, is to send them out to have some direct contact with patients and practicing physicians.

“With good faculty teaching around these experiences, they get a realistic sense of what they’re getting into,” Fisch said. Giving students exposure to the community early entails a certain amount of engagement with community groups and agencies, but in our underserved area, there is never a lack of interest. UTRGV will help place students in community service learning projects that are mutually beneficial to community as well as the student’s development as a medical student.

“We want our young doctors to be active in the community in whatever capacity suits them and is appropriate for them,” Fisch said. The school is also working on creating summer internships and research opportunities that could be lab-based or community-based clinical research, looking at issues related to public health.

“We have lots of ambitions,” Fisch said. “The team at the school is very keen on making this a successful undertaking and graduating confident and strong contributors to their profession.”