Total Integration

At one medical school, radiologists are adding value throughout students' education and reinforcing the radiologist's central role in patient integration

When Oakland University William Beaumont School of Medicine was established in 2008, the administration approached its curriculum in an unorthodox way.

In addition to basic structural innovations, the new curriculum relies in large part on radiologists not just teaching imaging, but lending their expertise to a variety of subjects.

David A. Bloom, MD, FACR, a pediatric radiologist at Beaumont Health Systems, which is a founding partner with the school, explains how radiology came to be so central to the school's approach and what he and his radiology colleagues hope to gain from working so closely with future clinicians.

How did the radiology department get involved in the medical school?

When the administration began thinking about creating the medical school, they were looking for physicians at Beaumont Hospital who were interested in being involved. As soon as I heard about it, I went to my chair, Duane G. Mezwa, MD, FACR, and told him I'd like to be considered. We created a medical school curriculum committee within our department and came up with ideas of how we could contribute to the curriculum.

How does radiology factor into the curriculum?

We're involved in virtually every facet of the school. I can't think of a place where there's not a radiologist teaching or involved in a committee. Many of our radiologists are on the interview and admissions committees for students applying to the school, so many prospective medical students are meeting radiologists when they come to interview.

Once students are accepted, they come into contact with radiologists at key points throughout their education. As part of each organ-based basic science course, radiologists interact with the students and teach them anatomy from a radiologic perspective. So, for example, in their neuroscience course, we give lectures on brain anatomy and neck anatomy. And as they're learning anatomy and doing their cadaver dissections, we're there showing them that same anatomy via imaging.

As our first group of students enters their third year, we have implemented a required fourth-year rotation entitled Diagnostic Medicine, supported by our chair and created by our clerkship director, Rachel M. Van Hulle, MD. It will take a case- and problem-based approach to imaging and will be done in conjunction with clinical pathology here at the hospital. The plan is to have a new diagnostic challenge each day, focusing on common medical problems that students may encounter if they were a primary-care provider — like headache, chest pain, or shortness of breath. In the morning, students will have a lecture that introduces them to some of the pertinent imaging that can help with that clinical problem and then they go over individual cases and try to work them out from both a clinical and an imaging perspective. In the afternoon they will go over the clinical pathology correlating with those individual cases.

Why does it make sense to have radiologists involved in so many aspects of the curriculum?

The way I look at it, clinicians and patients interact with radiology all the time. If we're such an important part of clinical care, there's no reason we shouldn't start to talk about what we do right from day one of medical school. I've always said that the person who knows anatomy and physiology the best, aside from the anatomist and physiologist, is the radiologist. This is what we do every day. So we found that we had value to add and the anatomists agreed.

The goal is not to make all 50 students in the first class become radiologists. As a matter of fact, I don't believe we will have an unusually high percentage going into radiology. The important thing is they're going to perceive radiologists differently.

How does this arrangement benefit radiology as a specialty?

Medical students need to be educate about imaging right from the beginning and they need to be educated by us, not by others. I hope our students will have a greater appreciation for a radiologist not just as a picture taker but as a physician who can help with a whole host of clinical situations.

When they graduate, even if they don't go into radiology, the goal is for our students to appreciate the value that radiologists can add in caring for patients.

What advice would give to someone who wants to start something similar at a preexisting medical school?

In a more traditional medical school, it's a matter of being visible and present. Most schools are constantly revising and updating their curriculum, so find out how you can help. If you're willing to pitch in, I find that people are generally very happy for the support. And small steps will lead to bigger strides.

By Lyndsee Cordes

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