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Scholarly Concentrations Program expanding medical education

Ask medical students across the country the best way to learn medicine, and they'll point you toward their cadavers.

At Brown, however, medical students are encouraged to take their learning beyond the classroom by participating in the Scholarly Concentrations Program. Since its inception last year, more than 40 second-year medical students have enrolled in the program.

The program allows medical students to pursue a self-directed course of study in addition to the standard medical curriculum. Students work with a mentor to produce a "scholarly product" such as "a published paper, curriculum development, a major literary review and things we haven't even thought of yet," by the end of their four years of medical school, said Richard Besdine, professor of medicine and director of the Center for Gerontology and Health Care Research.

"This is a chance to follow your passions and explore something in-depth," said Jeffrey Borkan, professor of family medicine and chair of the working group that developed the program.

Students can choose from 11 different concentrations, including global health, advocacy and activism, aging, medical ethics, disaster medicine and informatics.

"Students constantly work on projects in the summer and wish that they had more time to continue their work. This is that 'more time,' " Borkan said.

"The overall rationale is that students do all of these things anyway, and a program like this gives them structure and pushes them to take the work to the next level," said Emily Green, manager of the program.

"We're getting credit for things that are not as sexy in the medical world as basic science research," said Jason Lambrese '06 MD'10, who is enrolled in the program's medical education concentration.

Lambrese, who concentrated in Hispanic studies as an undergraduate, has worked on developing and improving the course BIOL 3600: "Doctoring," which all first-year medical students take.

Lambrese, in conjunction with several faculty, has worked to find ways of "reducing, reusing and recycling" parts of the course in an effort to improve medical education at Brown. "We as medical students like to complain about the course, but it's a lot harder to offer constructive criticism, and that was really something that I wanted to do," he said.

"The Scholarly Concentrations Program gives students recognition for going above and beyond the traditional medical school curriculum," Green said. "This provides students with the framework to pursue their passions in a scholarly way."

Students in the program take on a wide range of disciplines in their concentrations. Andrew Allegretti '06 MD'10, a medical humanities concentrator, has worked on collecting "pain narratives" - stories from patients who suffer from chronic lower back pain.

"I wanted patients to talk with me as freely as they could so that I could learn more about their life story," he said. Allegretti then spoke with the patients' doctors to see how the narratives matched up, and if they didn't, "to look to see if there were any holes that could be addressed to help improve their care."

Allegretti, who was a music concentrator as an undergraduate, said he "wanted to keep a little bit of humanities in my medical school curriculum."

The Scholarly Concentrations Program also allows medical students to conduct research in the biological sciences. Nikki Tang '06 MD'10, who is concentrating in aging, spent last summer working on a research project studying cellular senescence.

"I've always wanted to do basic science research, and the development of the Scholarly Concentrations Program was very serendipitous. It allowed my interests to come together in the right fit," Tang said.

"I think that in many ways, what medical education does is to force students to think very narrowly, and we're trying to avoid that as much as we can," Green said.

It's hard to predict how many new medical students will choose to enroll in the program this year, but Green and others are hoping to attract first-year students with information sessions and lunchtime presentations by the first generation of concentrators, who are all now in their second year.

"I think that the program seems really cross-disciplinary, and I'm definitely interested in participating," said Nitin Aggarwal MD'11. Aggarwal said he is not sure exactly which concentration he hopes to pursue but is "glad that the program seems like you can really mold it to your

interests."

The second-year concentrators agree that pursuing a scholarly concentration in addition to keeping up with regular coursework can be difficult at times.

"Pursuing my concentration may be taking time from studying for my next exam, but that's okay with me," Lambrese said.

"It's definitely a matter of maintaining balance," Tang said.

But students say the time commitment for the program is often well worth the while. Lambrese said, "Having a diversity of perspectives is really great for us. We each bring a different experience to the table, and that really enhances the medical students' perspective here."

The program was advertised to prospective first-year students during their "re-visit" to Brown, after they had found out they had been accepted, Green said.

Gregory Radin MD'11, who spent his undergraduate years at New York University, said the program did play a factor in his decision to come to Brown for medical school.

"I definitely feel that the (Program in Liberal Medical Education) and the Scholarly Concentrations Program are making a genuine effort to focus on social and psychological aspects of becoming a doctor that wasn't present at other schools," Radin said.

"I'm a firm believer that the well-rounded physician is the best kind," Allegretti said. "Keeping a broad perspective keeps you well-informed and happier. You can't have your nose stuck in a book all the time. Sometimes, pursuing your passions is just as important as knowing every last fact about a biochemical cycle."




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