NPR’s Adrian Florido speaks with Dr. Catherine Lucey, vice dean for medical education and professor of medicine at UCSF, about how COVID-19 has changed the way future doctors are trained.
ADRIAN FLORIDO, HOST:
If you’ve been to the doctor or to a hospital since the start of the pandemic, you’ve surely noticed that the way we get medical treatment has changed. And so it might not be a surprise that training and education for the doctors treating us is also changing. That’s because new doctors are entering a health care landscape so vastly different from what it was just two years ago, facing concerns about their own health and safety, stressful working conditions and patient skepticism.
We thought it would be a good time to talk about how the pandemic is changing medical education, so we called Dr. Catherine Lucey. She’s the vice dean for education at the University of California San Francisco Medical School, where she’s also a professor. Dr. Lucey told me the pandemic has already ushered in lots of changes in medical education, and that’s partly because the virus is also changing the kinds of doctors we need.
CATHERINE LUCEY: People are really rethinking what the workforce needs to look like. I would say that one of the things I was most proud about as being a member of the medical profession in academic medicine was how well individual physicians responded to the pandemic. They rolled up their sleeves. They left their families. They did everything they could to respond as an individual or a member of a team to make sure that people in their environments could get the care they needed during this pandemic. And whether that was through research that they were doing or patient care or teaching, the – their efforts were extraordinary and invaluable.
And one of those efforts that highlighted, I think, a real gap in our workforce strategy as a group of medical education organizations, meaning medical schools and the organizations that regulate, accredit, supervise, those types of things, was the tremendous problem with lack of access in many communities to any types of physicians. One of the things we’ve been talking a great deal about in the medical education circles is the need for a national workforce plan for physician – the physician workforce. We need a structure that engineers a system that guarantees that everyone in the United States, regardless of where they live or who they know or what power or privilege they have, has access to the type of a physician that we’d choose to care for somebody that we loved. We don’t have that yet. And it would be an amazing world if – and the pandemic would have been different if every community had access to physicians who they trusted.
FLORIDO: I’d like to ask you about how you see medical school programs changing to address and prepare physicians for the rampant spread of skepticism and hostility toward things like vaccines and often toward, you know, medical practitioners themselves.
LUCEY: You know, in the past, I think, perhaps in the 20th century, the model physician had this sort of, you know, very modulated effect, never talked about politics, didn’t have strong opinions about things. And what I think we need to see as a result of this pandemic is much more advocacy at the level of government – state governments, local government, federal governments – for social change that would benefit the health of all of the members of the United States. And I think things like, for example, advocacy around the need for a much stronger public health infrastructure is going to be really critical going forward.
The public health medical enterprise sort of separated them – what they call the great schism – about 50 years ago. And that devastated public health. And I think we need to overturn that. I think a big issue is not only the interpersonal cultural humility that is needed to teach our residents and our students, but the social advocacy for better social systems that would eliminate the need for a catch-up during situations of pandemic.
FLORIDO: Are medical school curriculums already set up to sort of address – to prepare doctors for when someone comes in and says, no, I don’t believe that that vaccine or that procedure is going to help me? And are those parts of the curriculum being revamped?
LUCEY: Yeah. So I think the answer is really no. I mean, for a long time, you know, the old phrase is, trust me, I’m a doctor. And I think this wave of skepticism, scientific skepticism, really took people by surprise. And this idea of, trust me, I’m your doctor, I think we can no longer take for granted. Trust has to be earned. And I think what we see in today’s environment is that people are trusting individuals who they think relate to them better and have more respect for them. And I think we, as physicians, need to recognize the challenge in front of us.
We haven’t been as effective at creating those respectful, trustful, trustworthy relationships. And I think a real focus on trust, for example, as the American Board of Internal Medicine Foundation has focused on for the last couple of years is going to be essential to our success going forward – and not just trust with people who look like us or who vote like us, but trust in every encounter that we have, which means being open to hearing and listening, being curious, being humble, being respectful and creating the environment in which people can share their concerns and fears and we can look for an opportunity to meet in the middle.
FLORIDO: What are your students telling you? Are they excited to graduate and get out there and start working? Are they nervous, given, you know, the political and social environment that we find ourselves in? What are they telling you?
LUCEY: They’re excited. Our students are wonderful. Our students, our residents, our fellows, the next generation of medicine is going to be just fantastic. And it’s going to move with much greater speed than we thought was ever possible. I think that’s one of the things the pandemic showed us. When you have a sense of urgency, things that you never thought were feasible, you can actually do overnight. And this generation that’s coming through now, I think, is purpose-driven and compassionate and impatient, appropriately impatient. They want to see the changes that need to be made in medicine to meet all communities, particularly those that have been marginalized in the past, where they are and work with them to build a better framework for health and a framework for society in which everyone has opportunities to succeed.
FLORIDO: That’s Dr. Catherine Lucey. She’s the vice dean for education at the University of California San Francisco Medical School. Dr. Lucey, thanks so much for your time.
LUCEY: Thank you very much for having me. And have a happy new year.
(SOUNDBITE OF BLOOD ORANGE SONG, “IT IS WHAT IT IS”)
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