Steven Abramson, MD, senior vice president and vice dean for education, faculty, and academic affairs, and chair of the Department of Medicine at NYU Langone Health discusses innovations in medical education.
How has the Curriculum for the 21st Century reinvented medical education at NYU School of Medicine?
Most important, we’ve personalized learning pathways, moving away from the model that says everybody has to study exactly the same thing at the same time. We’ve taken the first 2 years of medical school and condensed them into 18 months, freeing up a semester to allow students to do what I call “finding their major.” We ask them to take an area of passion and really engage in it—do research or a scholarly project. Topics have ranged from neuroscience and molecular biology to health disparities and the business of medicine. And we’ve added over 10 new “selectives,” rigorous courses in diverse fields that also allow students to pursue their individual interests.
“We’re innovating ways to follow our students right through residency—as if they’re still with us.”
How do the learning pathways work?
We have several from which students can choose as they personalize their education. Certain students can accelerate and graduate from our three-year MD pathway—their direction is clear, they know what they want to do. Or a student can opt for the traditional four-year pathway. And then there are people who want to take five years to graduate in order to get an advanced degree.
What does a typical class look like?
When we conceived the Curriculum for the 21st Century, one of our primary goals was to create alternative pathways to graduation beyond the traditional four-year MD degree. We've so far had great success in achieving that goal. For example, our last class consisted of 70 percent traditional four-year students, 13 percent five-year master’s degree students, 12 percent three-year MD students, and 5 percent MD/PhD students. We strive for a healthy, dynamic mix that's consistent with our notion of “personalized education.”
How else is the revamped curriculum meeting the needs of today’s medical students and society?
We’ve tailored our curriculum to teach the science of medicine in the context of disease. For example, in the first year, students may learn in the morning about insulin and how pancreatic cells work, and that same afternoon, they’re seeing patients with diabetes. We have also developed didactic programs for seven common disease areas that we call “pillars,” which unfold over the course of a student’s training. These “pillars” exemplify learning not only in the pathogenesis, diagnosis, and treatment of disease, but also in its genetic, environmental, and sociobehavioral determinants.
Finally, we’ve spent a great deal of time dealing with the challenges we face in health disparities and developing cultural sensitivity around disease. Students learn the basic and clinical science, but you can’t effectively treat disease if you don’t understand the cultural behaviors of people with different racial and ethnic backgrounds. You simply can’t treat patients effectively without understanding the issues surrounding access to care.
You’re also passionate about bridging the gap between undergraduate and graduate medical education. Why?
Right now, students finish medical school, show up at a residency program, and essentially start all over again. Not much attention is paid to the development of the individual’s particular knowledge or skills as they progress into residency. How do you hand off a student from medical school to residency? What kind of portfolio do they need to carry with them? What skills have they mastered? These are the kinds of questions we want to answer to help make the transition to residency as coherent as possible. We’re innovating ways to follow our students right through residency—as if they’re still with us.