A growing elderly population has led to an increased need for doctors with adequate training in treating seniors, and a revamped curriculum at Tufts School of Medicine attempts to address this rise in demand.
First-year medical students this semester took a course that, for the first time, included a component on medical interviews in both hospital and residential settings. This is part of an increased focus on geriatric patients throughout the curriculum.
A medical-school course on patient care has been taught at the Tufts medical school for almost 15 years, but has focused on the doctor-patient relationship only in the hospital setting. This semester marked the first time students interviewed patients outside of the hospital, according to course director Wayne Altman, an associate professor of family medicine.
Part of an 11-week course called "Foundations of Patient Care," the readjusted approach to medical interviewing came about in the context of a redesign of the School of Medicine's four-year curriculum.
"In medicine, we get caught up in being disease-focused; we teach about the disease of cancer, of heart disease, and forget that the patient who has heart disease is of critical importance," Altman said.
Incorporating interviewing early in medical students' training could improve doctor-patient relationships in the future, Altman said.
Jody Schindelheim, a clinical professor of psychiatry who leads the medical-interviewing part of the course, said that it gives students an appreciation for the elderly and is part of an effort to train doctors for future trends in medicine. The need for doctors who are skilled at working with older patients is also widely recognized by those outside of the medical community.
"I hope that exposing [medical students] early will get more of them interested in geriatrics," said Molly Cohen-Osher, site director at Brighton's Jewish Community Housing for the Elderly (JCHE). Students conducted their "at home" interviews with JCHE residents. These accounted for half of the students' interviews; the other half were conducted with hospitalized patients.
Interviewing patients in their homes builds strong relationships between students and the people they care for, Schindelheim said.
"Hearing the life stories of people who have had a lot of life experience proves to be very inspiring to the medical students, as is the opportunity for the elderly patients to tell their stories," he said.
Faculty felt students needed to spend more time with patients earlier in their education, Altman said.
"All the students get to interview elders who are not necessarily sick or having an acute concern," he said. In this way, students become closer to people who they might otherwise have just seen in an outpatient practice, Schindelheim said.
Many JCHE residents, such as those from Russia or China, "have fascinating stories to share with students," and the interviews benefited residents and medical students alike, Altman said.
JCHE residents even gave the students cookies, Cohen-Osher said.
The residents benefited from the interviews, too, she added.
The interviews gave patients "a sense of purpose by sharing their stories with these young students and being involved in their education," she said.
The course and the medical interviewing revealed "how many rich, hidden things that you could find out about people if you take the time to talk to them," she added.
