A Holistic Approach to Medical Education

Medical school is a journey of self-discovery.  Between studying, clinical duties, and many long tests, it can be easy to lose sight of the bigger picture. I often pause to think about what I hoped to gain from becoming a doctor, and I always return to the physician-patient relationship. We care for patients when they are in their most vulnerable state, and knowing patients trust me this way is what inspires me to be my best.

As I entered my third year at the University of Vermont Larner College of Medicine, I discovered the Longitudinal Integrated Clerkship (LIC). This program, developed with Hudson Headwaters Health Network, places an emphasis on building lasting connections with the patients we encounter. For 12 months, we serve as part of a healthcare team in one location, with a primary care practice as a home base, and we follow a panel of patients through all of their appointments and procedures. This allows us to see medicine from the patient’s point of view. We learn about our patients’ social struggles, ailments, and coping skills, seeing them as people, not just the disease they have that day.

Getting to know a patient over the course of an entire year changed my perspective. In the beginning of third year, my clerkship year, nearly every patient was a new face, but following my panel allowed me to engage with people in a more intimate fashion. An example that comes to mind includes a particular patient struggling with depression. While medical references spell out first line treatment for depression, it fails to address unique environmental factors contributing to this patient’s problem. My familiarity with his situation allowed me to offer him more than medication and a therapy referral. We were able to integrate his values while considering his physical and mental limitations, and his family, to create a more complete treatment plan. I felt like I was more than an interpreter of medical terminology; I felt I was becoming an important part of his life. It became clear to me that caring for someone in this manner sets them up for long term success. Adapting this holistic approach allows us to provide more comprehensive care to our patients, and as a LIC student I feel fortunate that I was able to have this experience.

I was also able to build valuable relationships with my educators through this program. We were directly observed, allowing our teachers to know where we struggle and our strengths.  Personally, I struggled with presenting patients in an organized manner after seeing a patient. After understanding where I struggled, my mentor and I worked together to come up with a specific strategy to organize my thoughts while talking to a patient by changing the structure of my notes. A few months of persistent work got me compliments when presenting patients to physicians I just met. This is feat that would difficult to identify, let alone master, if I hadn’t had so much time with a mentor.

The LIC fosters an indescribable community that feels like home. Our commitment to the upstate New York area served by Hudson Headwaters allows us to root into our environment, build strong relationships with our healthcare team, and care for the patients in our community. This is not something that can be taught in any medical school lecture. It comes as a result of our values and goals changing throughout our education, shaping the kinds of physicians we will be one day. Participating in the LIC has allowed me to preserve and embrace the passion that inspired me to become a doctor.

Read more about the Longitudinal Integrated Clerkship at the University of Vermont Larner College of Medicine and Hudson Headwaters Health Network.