Catherine Lucey, MD, graduated from Northwestern University’s medical school 40 years ago. Her time there was transformative, and it set her on a path toward success for decades to come. Now, as vice dean for education at the University of California, San Francisco School of Medicine, she recognizes the undergraduate medical experience needs to change.
“We have to redesign the content in medical schools so that our graduates are capable of addressing the problems we expect them to solve during the course of their next 40 years,” she said.
Many of those problems have been brought under harsher light during the COVID-19 pandemic, including health inequities, systemic racism, and distrust of medical authorities. Dr. Lucey talked about those challenges and how medical schools can address them in a recent episode of “AMA Moving Medicine.”
UCSF School of Medicine is one of member schools of the AMA Accelerating Change in Medical Education Consortium that is working to create the medical schools of the future.
More than adding a few lectures
The pandemic revealed gaps in medical school curricula, Dr. Lucey said. She highlighted social determinants of health and crisis management as just a couple of the major topics that future physicians must understand.
“The pandemic showed us our communities are suffering,” she said. “Our health systems are under siege. The well-being of our physicians and our learners is at risk. We have to help them tackle the pervasive problems of chronic disease and health care disparities, and to tackle issues of race and racism that exist in medicine as well as society today.”
To do that will require more than adding additional classes or bringing in guest lecturers about health equity or racism in medicine.
“It’s a total redesign—it isn’t tweaking at the edges,” she said. “It’s really a revolutionary change in the way we think about the content needed to be a doctor.”
Learn how UCSF is working to overcome bias in clerkship grading.
Working with skeptical patients
One of the most glaring issues physicians face today is patient skepticism. Dr. Lucey said that when she was in medical school, there was a general feeling of trust toward doctors based on their position and expertise. Anti-science aggression throughout the pandemic has weakened that trust.
To repair the damage, Dr. Lucey said medical students need be taught what it means to be trustworthy.
“First and foremost, you have to be competent,” she said. “But even more important than that, in the eyes of people who you want to trust us, is you have to care about them. Trusting people to not only rely on their competency, but to actually exhibit caring behaviors and to do so in a way that meets every patient in every community where they are is a critical element of how we will begin to get past the scientific denial.”
Beyond being trustworthy, Dr. Lucey believes students need to develop a broader set of communication skills.
“We need to train people to be citizen advocates so that they're making a difference, not only in the exam room,” Dr. Lucey said, adding that “professionalism means advocacy as much as it means altruism, respect, social justice and things like that.”
“AMA Moving Medicine” highlights innovation and the emerging issues that impact physicians and public health today. You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version, which also features educational presentations and in-depth discussions
