The earlier that future doctors are sent into local clinics to hear patient stories, the better their listening skills may be in the future.
That’s the conviction that drives Dr. Clive Slaughter, who organizes community training for medical students at the Athens, Ga. site of the Georgia Health Sciences University-University of Georgia (GHSU-UGA) Medical Partnership.
In its second year, the Partnership’s non-traditional curriculum, including a small entering class size and early community involvement, appears to be benefiting both students and low-income residents of Athens-Clarke County.
“What we want to do is train doctors who listen,” said Slaughter, an associate professor and faculty coach for students working within the community.
He believes that for these future physicians serving, and learning, in a place as impoverished and medically underserved as Athens-Clarke County will undoubtedly have an effect on their future practice.
If a future physician has early contact with complications of poverty and healthcare, those encounters stay with them, says
Boris Kovalenko, a first-year med student from Atlanta, had no idea Athens was among the poorest cities in the nation. He was shocked when discussions in his Essentials of Clinical Medicine (ECM) course landed on social determinants of health and their consequences on the local population.
“We know that poverty influences whether we’re healthy or not,” and we’re talking about that, said Dr. Laurel Murrow, community health director for the ECM course at the Partnership.
Through this course, Murrow helps organize the entering class of 40 students into five teams of eight, and then guides them as they work with selected community partners.
This month, Kovalenko ventured out into the community for the first time as a member of the team serving the Athens Nurses Clinic, a non-profit nurse-run organization providing free health care to homeless and uninsured people. While there, he spoke with a patient one-on-one about a near-death experience owing to lack of insurance.
A 20-minute conversation with a patient, knee-to-knee in a room that has seen better days, makes a far deeper impression than reading about population health in a textbook, said Kovalenko. “It puts more emotion into what we’re learning about.”
Second-year med student Nitya Nair agrees.
“It’s personally affected me,” Nair recalls of her first-year community-based learning experience in Athens. Nair was undecided about her future specialty when she started medical school, then her clinical team worked at a local Early Headstart program where asthma is a huge problem and parents and kids need help avoiding crisis.
“I was thinking more of specializing in other things before I walked in, but when you start working with these kinds of projects it pushes you toward primary care and towards doing things that will affect those right around you,” said Nair.
Graduating doctors who want to stay nearby is exactly what the Georgia Health Sciences University hoped for when it partnered with UGA to open up the Athens campus.
Georgia suffers from a shortage of primary care physicians. And, according to recent national studies, the state’s need for doctors is growing, not shrinking. The latest poverty report from the Census Bureau gave Georgia the third-highest poverty ranking in the nation and reported an even greater number of Georgians without insurance.
Unmet medical needs are especially acute in Athens, where 36.3 percent of residents live under the national poverty level.
In Augusta, the sister site of the Partnership, the poverty rate is 22.6 percent. In Atlanta, where Emory and Morehouse are training doctors, the poverty rate hovers at about 17 percent.
At the Partnership, educators like Slaughter and Murrow are trying to make the best of this sad situation by stepping up contact between physicians in training and people who need care. Their curriculum fosters two-way communication, so that doctors listen to patients and patients return the favor. Each learns from the other. The end result, they hope, will be physicians who listen, who hear what is needed, and who resolve to remain in Georgia and provide quality care.