QUEENSBURY — Medical student Sunit Misra knew he wanted to tie his medical education to his patients’ lives, believing it would expand his understanding of health care issues and help him become a better doctor.
Misra wanted to experience a side of medicine not found in textbooks.
“A lot of doctors are really smart, but there is more to gain from doctors being empathetic to patients’ needs,” he said, adding that understanding what life is like from the patient’s eyes is important.
So signing up for the innovative, year-long University of Vermont Larner College of Medicine’s Longitudinal Integrated Clerkship through Hudson Headwaters seemed to make sense, even though it was a new program and a new way for a third-year medical student to study medicine.
Last year, Misra — one of three third-year UVM medical students participating in the clerkship with Hudson Headwaters — moved to Glens Falls to live in the community, as did the other two students in the program.
And all three students — Misra, Kal Al-Tawil and Holly Bachilas — were guided by Hudson Headwaters’ physician preceptors while following a group of local patients over the past year.
“Physicians at Hudson Headwaters have been training Albany Medical Students for two decades, but more and more academic centers realize the value of doctors (going) into the community,” said Dr. Tucker Slingerland, Hudson Headwaters CEO and Misra’s preceptor.
According to Slingerland, they started talking with the University of Vermont about the program a few years ago. “It took a year of planning to support this kind of curriculum,” he said. “It has become a community project.”
Traditionally, third-year medical students spend the entire year in hospital rotations, spending about six weeks in a specialty and then moving on to the next. With the LIC, the students experience the various specialties while following their patients during the year.
“Instead of the traditional block format, where students complete rotations in seven different medical specialties, we choose a panel of patients that we follow to every doctor visit, to surgery, through labor and delivery and even navigating through health-related social services,” Misra said. “Their life becomes our life; their goals become our goals.”
Sunit was with Slingerland at West Mountain Center. “He accompanies the patient to CAT scan; he follows patients in the emergency room and reports back to me,” he said. “He becomes an expert on our patient.”
“I think they really build a connection with the community, and they see their patients around town, at the grocery store,” he said. “They get to experience what it’s like to take care of families and neighbors.”
Misra tells the story of a patient who had to go to the emergency room and then was admitted into the hospital for five days.
“I wanted to know what does five days staying in the hospital do to you,” he said. “This is an opportunity we get while some of our classmates have to squeeze out (information) in six weeks.”
The students are required to take exams throughout the year, and Slingerland said they do very well because of their experiences working so closely with patients.
“They have done exceptional on their exams ... This is not a curriculum for someone who needs close supervision. This is one of those experiences that you get the most out of it by what you put into it,” he said. “This is a curriculum for students who have a strong sense of self.”
In addition to following patients, each of the three developed and implemented a community project.
Misra developed a healthy eating program with Warrensburg Elementary School and the after school “In the Zone” program.
“I would bring in snacks and help (the students) understand what they like and how to make choices,” he said, adding that each week he brought in different snacks for the students to explore.
One week they made fruit pizzas, a cracker topped with fruit. “One boy said, ‘this tastes like cotton candy,’” Misra said. “The students called me the ‘Snack Man.’”
Khaled Al Tawil’s project explored how much time is saved in a doctor’s office making a diagnosis by using the handheld ultrasound. And Holly Bachilas evaluated the effectiveness of a tobacco cessation support group, Slingerland said.
“Many of us have said, ‘if only programs like this existed when we were in medical school,’” he said.
According to Slingerland, the three will finish in March. Next year, the program will expand to four students.
“I really enjoy working with students,” said Slingerland. “They ask great questions and bring in a fresh perspective. And the information they bring back from following the patients is invaluable.”
Did the program give Misra what he wanted?
“It was everything I was hoping for and more,” he said.