A Conversation: The Yale System and The Medical Student Experience Today

Transcript

• 00:03Hello again, ladies and gentlemen.
• 00:05Welcome back.
• 00:08We,
• 00:09I've really, really been looking
• 00:11forward to this portion of
• 00:12the morning.
• 00:14We have,
• 00:15we have through till noon,
• 00:17and so I think, we
• 00:19really have the opportunity to
• 00:20have
• 00:21not just a vibrant discussion
• 00:23up here,
• 00:25but lots of, lots of,
• 00:28interaction and input from you
• 00:29guys. And so we'd like
• 00:31any and all questions.
• 00:32We're gonna have,
• 00:34some sort of formatted questions
• 00:36up here, but we're gonna
• 00:37leave plenty of time for
• 00:38question and answer. So
• 00:39we have two fabulous Yale
• 00:41medical students, and we have
• 00:42two leaders within the institution
• 00:44that I'm about to introduce.
• 00:46So so let's have at
• 00:47it. So this is the,
• 00:49this is, entitled a conversation,
• 00:52the Yale system and the
• 00:54medical school experience today. Okay?
• 00:56And so, my name is
• 00:58Paul Leog. I'm a nineteen
• 00:59ninety nine graduate of Yale
• 01:01Medical School. With us, we
• 01:03have, dean of student research,
• 01:05Sarwat Chowdhury,
• 01:08who has just told me
• 01:09she's a graduate of Pritzker
• 01:11School of Medicine at University
• 01:12of Chicago.
• 01:14We also have, associate Dean
• 01:16of, Student Affairs, John Francis.
• 01:19So
• 01:20in my in my time,
• 01:21I remember Robert Gifford.
• 01:23But, right, John Francis is
• 01:24the Robert Gifford of the
• 01:26present.
• 01:28And, you know, that's a
• 01:29big
• 01:30that's a big role. That's
• 01:31a central role in in
• 01:33the life of students. So
• 01:34we're very we're very enthusiastic
• 01:36to hear your perspectives.
• 01:38And then Morgan Brinker, who
• 01:40is, graduating in twenty seven,
• 01:43and,
• 01:45Katrin
• 01:46Madsen.
• 01:47Hope I got it right.
• 01:48MD twenty six.
• 01:52Alright.
• 01:55Okay. Spectacular.
• 01:56So I want to, kick
• 01:58off the, the discussion with
• 02:00a question to you, Doctor.
• 02:02Francis.
• 02:03So we're here in front
• 02:04of this wonderful group of
• 02:06alumni, and and that inspires
• 02:08our own memories and thoughts
• 02:11about
• 02:11our time here in this,
• 02:13patch of earth at Yale
• 02:15Medical School and what we
• 02:16experienced here and how it
• 02:18and how those experiences influenced
• 02:20us.
• 02:22I know you, of course,
• 02:23as I just alluded to,
• 02:24are right at the center
• 02:26of the of the of
• 02:27the team that's in frontline
• 02:28support for the students.
• 02:30Can you share with us,
• 02:32broadly some of, some of
• 02:33the new enhancements in the
• 02:35Yale School of Medicine experience
• 02:36today?
• 02:37Obviously, there's gonna be common
• 02:39denominators in terms of the
• 02:40institutional memory, but there's new
• 02:42things as well. Give us
• 02:43give us some of your
• 02:44perspectives on that. Absolutely. My
• 02:46my pleasure.
• 02:47So when I think about
• 02:48the things that we could
• 02:49do to make Yale better,
• 02:50and it's already an amazing
• 02:52place to be for our
• 02:53students,
• 02:54we look to the Yale
• 02:55colleges.
• 02:56And we saw
• 02:58not just elaborate buildings,
• 03:00but we also saw a
• 03:02place for community,
• 03:03for belonging, and for networking.
• 03:06And we said, why don't
• 03:07we take some of that
• 03:08and bring it to the
• 03:09medical school?
• 03:10So now each of the
• 03:11students that come are separated
• 03:13into one of six houses.
• 03:16Those houses have head of
• 03:17advisory colleges or head of
• 03:19advisory houses.
• 03:20They also have coaches.
• 03:22And so students have support
• 03:23from their coaches and their
• 03:25head of advisory house
• 03:26throughout their time from first
• 03:28year through their fifth year
• 03:29to their fourth year. And
• 03:31those individuals
• 03:32are there,
• 03:33and if someone needs help
• 03:35with
• 03:36mental health or stress or
• 03:38anxiety or
• 03:40trouble with wellness,
• 03:41we have a behavioral health
• 03:42and wellness team that's embedded
• 03:44in the medical school.
• 03:45So we have two social
• 03:47workers and a psychologist,
• 03:49and those individuals are paid
• 03:50through student affairs,
• 03:52and students can go into
• 03:53their schedules
• 03:54and actually schedule a meeting
• 03:56that week,
• 03:57In the daytime,
• 03:59after hours,
• 04:00or on the weekends.
• 04:01And it's much better for
• 04:03students to have that quick
• 04:04access
• 04:05than to have an actual
• 04:07test in two weeks and
• 04:08have their appointment in four
• 04:09weeks. So that's one of
• 04:10the enhancements that our coaches
• 04:12and our head of advisory
• 04:13house use to link students
• 04:14up. And students can also
• 04:16do that themselves,
• 04:17but sometimes they need advice
• 04:19to go.
• 04:20And we also have, for
• 04:21those that may be having
• 04:23academic challenges,
• 04:24a director of performance improvement.
• 04:26We also have a learning
• 04:27specialist who has a PhD,
• 04:29and we have thirty one
• 04:31tutors.
• 04:31And our coaches and head
• 04:33of advisory houses
• 04:34give students that direction to
• 04:36academic support when they have
• 04:37needs as well too. So,
• 04:39the houses also have fun
• 04:40activities.
• 04:41We have dinners and we
• 04:43have lunches, and sometimes they're
• 04:44going on cruises, or they're
• 04:46going to football games, or
• 04:47they're doing happy hours.
• 04:49What are these cruises?
• 04:52Some some of the houses
• 04:53do what's called the thimble
• 04:55island cruise.
• 04:56It it's not the cruise
• 04:58to Bahamas.
• 05:02It's it's Brantford, Connecticut thimble
• 05:04island cruises.
• 05:06So so But, in those
• 05:08activities,
• 05:09first years can meet with
• 05:11second years, and third years,
• 05:12and fourth years. And, you
• 05:13have the ability to network
• 05:15with upper class men and
• 05:16get advice from upper class
• 05:17men. And, we're also inviting
• 05:19the affiliates
• 05:20of the houses.
• 05:21And those affiliates are residents
• 05:23and
• 05:24fellows and attendings and alumni
• 05:26from various specialties,
• 05:28allowing students to get access
• 05:30to mentorship
• 05:31and support and advice in
• 05:33a different way than they
• 05:34didn't have before.
• 05:36And also, once a year,
• 05:38we have a house cup,
• 05:40and you'll see the colors
• 05:41of the houses,
• 05:42the the red, the yellows,
• 05:43the green, the purples, and
• 05:44the golds.
• 05:46And they have friendly competition
• 05:47amongst themselves with tug of
• 05:49war,
• 05:50dodgeball,
• 05:51video games like Mario Kart.
• 05:54They they have also, for
• 05:55example, trivia,
• 05:57but it's been an actual
• 05:58great addition to see the
• 05:59students have fun at the
• 06:01house cup and and celebrate
• 06:02together. It's been I think
• 06:04this year, there was a
• 06:05tie. Two of the houses
• 06:06tied this
• 06:08year. So so we have
• 06:09the actual housing system.
• 06:11But in addition to that,
• 06:13when you look at, for
• 06:13example, the curriculum,
• 06:15our our students are still
• 06:16doing JDs along with their
• 06:18MD or MBAs or MPHs
• 06:20or MDivs,
• 06:21but there are also now
• 06:22concentrations
• 06:23that are available for students.
• 06:25They can do a concentration
• 06:27in bioethics,
• 06:29and they can do a
• 06:29concentration
• 06:30in medical humanities or medical
• 06:32education.
• 06:33Each of those concentrations have
• 06:35the ability to do scholarly
• 06:37projects.
• 06:38And it also has electives
• 06:40and educational activities, whether it's
• 06:42seminars or workshops,
• 06:43and then there are practicums.
• 06:45So if you're doing medical
• 06:47humanities,
• 06:48you may end up to
• 06:49go ahead and become like
• 06:49an editor of a student
• 06:51journal in that practicum.
• 06:53If you're doing, for example,
• 06:54the medical education,
• 06:55you'll be teaching
• 06:56in the medical school curriculum.
• 06:58And if you're doing the
• 06:59bioethics, you'll going be going
• 07:00into the hospital and doing
• 07:01consults.
• 07:02So that's actually
• 07:03some of the new additions
• 07:05to the Yale system that
• 07:06we have today to support
• 07:07our students
• 07:08who, again,
• 07:09continue to wow and amaze
• 07:11me.
• 07:12That's fabulous. And
• 07:17you know, I felt, when
• 07:18I was a medical student
• 07:19here, I did feel supported.
• 07:21I did feel heard. There
• 07:22are several times during my
• 07:23trip through Yale Medical School
• 07:25that I needed that.
• 07:28You know? But I think
• 07:29what you've just articulated to
• 07:31us is a more integrated,
• 07:33more,
• 07:34a more coherent,
• 07:35piece. And so that's great.
• 07:37You know, maybe when we
• 07:38get to the question and
• 07:39answer sessions
• 07:40later, we have so many
• 07:41things to discuss. But one
• 07:43of the questions that was
• 07:44posed to, to Dean Brown
• 07:46was, you know, jeez, people
• 07:48aren't living in a Harkness,
• 07:49and they're not coming to
• 07:50lecture as much. And sociologically,
• 07:52is the experience rather different?
• 07:54You know, the world changes,
• 07:56and this is not unique
• 07:57to Yale. It's it's it's
• 07:58common throughout all medical schools.
• 08:00But but anyway, we can
• 08:01touch on that later. Doctor
• 08:02Chowdhury,
• 08:04a cornerstone of the Yale
• 08:06system, of course, we all
• 08:07know is the is the
• 08:09existence of the student thesis,
• 08:10which has been part of
• 08:12the Yale system since, I
• 08:13think, almost World War one
• 08:14or something like that.
• 08:16Can you share with us
• 08:18how the experience has continued
• 08:20to
• 08:21to thrive within the Yale
• 08:22student,
• 08:23community?
• 08:25And how does your office
• 08:26assist? You have a very
• 08:27responsible role,
• 08:29in terms of guiding people
• 08:30towards their thesis and their
• 08:32mentors.
• 08:34Yes.
• 08:35No worries.
• 08:37My apologies. I'm on service,
• 08:38as I mentioned. So I
• 08:39I told my supervisor call
• 08:41her call her in a
• 08:41few minutes. Yeah.
• 08:43No. It's a great question.
• 08:45And, you know, one of
• 08:46the things, in fact, that
• 08:48we hear from alum when
• 08:50we have the opportunity to
• 08:52speak one on one with
• 08:53you all is, you know,
• 08:55the thesis. Right? Everyone remembers
• 08:57what their thesis was about.
• 08:58Right?
• 08:59And Paul, as you mentioned,
• 09:00it's a it's an old
• 09:02tradition.
• 09:03In fact, Yale was one
• 09:04of the very first US
• 09:05medical schools that had a
• 09:07thesis requirement as part of
• 09:09the graduation requirements for receipt
• 09:11of the MD.
• 09:14And we're very proud of
• 09:15that long standing tradition, and
• 09:17we're also proud of how
• 09:19the research
• 09:20tradition continues to thrive, as
• 09:22you mentioned.
• 09:23So, in fact,
• 09:25for this coming summer,
• 09:28starting in just a few
• 09:29weeks,
• 09:30we had a record number
• 09:32of applicants for what's called
• 09:34the START research program,
• 09:36which is a six weeks,
• 09:39full time immersive
• 09:40program for students who've been
• 09:42accepted to the medical school
• 09:44who'll be matriculating,
• 09:46in a few weeks as
• 09:46first year medical students.
• 09:48And we were just absolutely
• 09:50delighted once we figured out
• 09:52the problem of how we
• 09:52were gonna fund all those
• 09:53students, which we found a
• 09:54way to do. We were
• 09:56just absolutely delighted because, of
• 09:58course, this is a time
• 09:59when,
• 10:00you know, there's some real
• 10:01challenges
• 10:02with research and with funding
• 10:03from NIH.
• 10:05So we were absolutely thrilled.
• 10:08So in terms of how
• 10:09our research program is structured,
• 10:11as I mentioned, there is
• 10:13the start research program that,
• 10:15begins even before the students,
• 10:17begin their classwork as first
• 10:19year students.
• 10:21Throughout the first year of
• 10:22medical school, the Office of
• 10:23Student Research runs a longitudinal
• 10:26course called scientific inquiry. And
• 10:29it's in that class that
• 10:30students are provided
• 10:32guidance,
• 10:33and assistance in small group
• 10:35settings in coming up with
• 10:38a research question,
• 10:39finding a mentor, and developing
• 10:42a proposal
• 10:43so that they are set
• 10:44up for success in the
• 10:46summer after the first year
• 10:48of medical school.
• 10:49And at that time, students
• 10:51receive support from the Office
• 10:53of Student Research to conduct
• 10:54full time research for up
• 10:56to eleven to twelve weeks
• 10:57depending on the length of
• 10:58the summer.
• 11:00And again really proud that,
• 11:02over ninety five percent of
• 11:03our students elect to take
• 11:05advantage of that opportunity.
• 11:08And then as you know
• 11:09research continues after the clinical
• 11:11years where students then focus
• 11:13on the thesis.
• 11:15Final thing I'll mention is
• 11:17the fifth year,
• 11:19and seventy percent of I
• 11:20think now we call it
• 11:21the flex year. Sorry.
• 11:23The flex year.
• 11:25So seventy percent of the
• 11:26students elect to take that,
• 11:27and every year between twelve
• 11:30to sixteen of them choose
• 11:32to focus exclusively on full
• 11:33time research for the duration
• 11:35of that year.
• 11:36And the the, you know,
• 11:38data speak for themselves.
• 11:40Nationally, the average is about
• 11:41sixty percent of graduating medical
• 11:43students have a publication by
• 11:45the time they graduate.
• 11:47And at Yale, we're very
• 11:48proud that that number is
• 11:49closer to eighty, eighty five
• 11:51percent. So we're doing
• 11:53great as far as student
• 11:54research.
• 11:55You know, that's fabulous. I
• 11:56I really I think the
• 11:57students thank you. We all
• 11:58thank you for the work
• 11:59you do because it's it's
• 12:01right at the it's right
• 12:02at the fulcrum of of
• 12:03the definition of the Yale
• 12:04system. You know, there's the
• 12:06humanitarian aspect in terms of
• 12:08how we educate physicians, but
• 12:09there's also the the desire
• 12:11to encourage our students to,
• 12:14participate in inquiry.
• 12:15And, you know, I I
• 12:16think the the fact that
• 12:17it's so deeply embedded in
• 12:18the Yale culture is very
• 12:20important.
• 12:21You know, in Pacific times,
• 12:22in tranquil times,
• 12:24maybe these things are a
• 12:25little easier to do.
• 12:28Not not at this institution,
• 12:29but I live in Pittsburgh,
• 12:30Pennsylvania, and I've heard from
• 12:32faculty who are literally you
• 12:33know, they've had some sort
• 12:34of stop order on their
• 12:35grant. And boy, you know,
• 12:38this is a digression, but
• 12:39they they sort of running
• 12:40their own gels.
• 12:41And and when a medical
• 12:42student comes and says, hey.
• 12:44Could you teach me? Of
• 12:45course, some medical students arrive
• 12:47with tremendous,
• 12:49preexisting skills, but some it's
• 12:50a learning process. And teaching
• 12:52takes energy and time. Teaching
• 12:54takes work.
• 12:56And,
• 12:57you know, if the PI
• 12:58is stressed,
• 13:00then, then there's just it's
• 13:02a human tendency. Hey, listen.
• 13:03I'm gonna have to pass.
• 13:05And so I think it's
• 13:06incredibly important.
• 13:08Our own alumni,
• 13:09we don't know what's gonna
• 13:10happen in terms of federal
• 13:11funding, but,
• 13:12to the degree that we
• 13:14can step up and and
• 13:16the institution has done so
• 13:17much for us, this is
• 13:19not a bad time to
• 13:20step up and be supportive
• 13:21of the institution. So let
• 13:23me, turn to our our
• 13:24fabulous,
• 13:26medical students,
• 13:27Katrina
• 13:28and,
• 13:29and Morgan.
• 13:31So,
• 13:32we've heard from some of
• 13:34the leaders.
• 13:35We've we've heard from the
• 13:36dean.
• 13:38We'd love for you to
• 13:39share some of your own
• 13:40experiences. You you both come
• 13:42with remarkable backgrounds, all you
• 13:43medical students do. Can you
• 13:45tell us about some of
• 13:46the some of the highlights
• 13:48and some of the challenges
• 13:49you may be experiencing
• 13:51here during your time as
• 13:52as medical students?
• 13:58Oh, okay. So I think
• 13:59for me, a lot of
• 14:00the,
• 14:01like, rewarding experiences I've had
• 14:03here and the challenges might
• 14:04be two sides of the
• 14:05same coin. I think coming
• 14:07to
• 14:08Yale, I I will mention
• 14:10we did not have a
• 14:11welcome cocktail. We had welcome
• 14:13COVID tests. It was
• 14:15less exciting,
• 14:17But there's really no defined
• 14:19track for you to follow.
• 14:20There's no path that they're
• 14:22like, do this and then
• 14:23that is gonna lead you
• 14:24to be a successful Yale
• 14:25medical student.
• 14:27Instead there's
• 14:28a million things that you
• 14:29can do,
• 14:31and you have these really
• 14:32incredible classmates who have done
• 14:35a million awesome things. And
• 14:37so I think coming here,
• 14:39one of the one of
• 14:40the challenges I faced was
• 14:41really trying to figure out
• 14:42what to do with my
• 14:43time, what did I want
• 14:44to choose to to spend
• 14:46this time on.
• 14:49And for me when I
• 14:50started I
• 14:52had come from a background
• 14:53of in college I really
• 14:54wanted to go to medical
• 14:55school and so I was
• 14:56going to take the opportunities
• 14:58that were there, that were
• 14:59available to me, whatever,
• 15:01if if someone was like,
• 15:01you can come join my
• 15:02lab, I wouldn't even think
• 15:03about it. I'd be like,
• 15:04yes, thank you. I appreciate
• 15:05this opportunity.
• 15:07And so I came to
• 15:09Yale and all of a
• 15:09sudden it wasn't like, oh,
• 15:11I have one option. I
• 15:12had a million options, and
• 15:14that was scary. So I
• 15:14did what I was familiar
• 15:16with and that was wet
• 15:16lab work. And so I
• 15:18got involved pretty early on,
• 15:21and then
• 15:22I as I had spent
• 15:23more time here, I got
• 15:24to know students and upperclassmen
• 15:26had given me advice. I
• 15:26was like, you know what,
• 15:27maybe I want to explore
• 15:28a little bit. So
• 15:30I spent some time doing
• 15:31some clinical research, more chart
• 15:33review stuff. I started learning
• 15:35some computational stuff. Oh my
• 15:36god. That was a horrible
• 15:37idea.
• 15:40And then I ended up
• 15:41realizing that I really love
• 15:42doing wet lab work, and
• 15:43I think I approached it
• 15:44from a little bit of
• 15:45a different perspective, not that
• 15:46this was something I was
• 15:47going to do because this
• 15:48was the only thing I
• 15:49was familiar with, but because
• 15:51I really liked this project.
• 15:53I really liked this lab.
• 15:55The only problem is wet
• 15:56lab work takes time,
• 15:58and it's kind of hard
• 15:59to do while you're on
• 16:00clerkships and in medical school.
• 16:02And so I was able
• 16:03to take a fifth year.
• 16:04I'm just finishing up. I
• 16:05have one month left of,
• 16:07my dedicated research year. So,
• 16:10and I'm gonna get a
• 16:11master's too, which is a
• 16:12bonus. Thank you very much.
• 16:13Congratulations.
• 16:14And so I think for
• 16:15me that has been incredibly
• 16:17rewarding. Like, you have so
• 16:18many options finding out what
• 16:19you really are passionate about
• 16:21and then being able to
• 16:22spend time to do that,
• 16:24has been an incredible experience
• 16:25here.
• 16:26Morgan.
• 16:28I think similarly to Katrina,
• 16:30one of the most rewarding
• 16:32things, one of the things,
• 16:33in fact, that drew me
• 16:34to Yale was the wealth
• 16:36of opportunities.
• 16:37I came from an undergrad
• 16:38that had a focus on
• 16:40you are the architect of
• 16:42your own education, and really
• 16:43you chose
• 16:44whatever path you wanna take.
• 16:46For example, there were no
• 16:47general requirements at my college,
• 16:49which,
• 16:50looking back for an eighteen
• 16:51year old, was kind of
• 16:52insane at the time.
• 16:54So one of the things
• 16:55I really liked about Yale
• 16:57is that
• 16:58as someone who is the
• 16:59first person in their family
• 17:00to
• 17:02explore medicine as a career,
• 17:04I didn't really know what
• 17:05I wanted. I had some
• 17:06opportunities
• 17:07to participate
• 17:08in kind of community
• 17:10engagement in Georgia for, folks
• 17:12living with HIV
• 17:14and, other STIs and kind
• 17:16of
• 17:17both look at the medical
• 17:18and the non medical aspects
• 17:19of their care,
• 17:21and but I knew that
• 17:22there
• 17:23were other things out there
• 17:24that I may not have
• 17:26experienced. For example, when I
• 17:27started I thought oh there's
• 17:29no way I could enjoy
• 17:31the OR. I'm like but
• 17:32I'm gonna keep an open
• 17:33mind.
• 17:34Similarly
• 17:36I did not like lab,
• 17:38wet lab research. I respect
• 17:40my colleagues who love that,
• 17:41but
• 17:42I was very more on
• 17:43the policy, the community engagement,
• 17:46and New Haven,
• 17:48While I came from the
• 17:50Midwest,
• 17:50and spent some time on
• 17:51the East Coast and also
• 17:52in Georgia, I really wanted
• 17:54to
• 17:55get to know this community
• 17:56that I would be at
• 17:57for
• 17:58a good part of half
• 17:59of a decade.
• 18:00So I enjoy taking
• 18:03advantage of the opportunities through
• 18:05DICE, the diversity,
• 18:07inclusion, community engagement, and equity
• 18:09office.
• 18:10I had an opportunity
• 18:12to, do some teaching for
• 18:14students from HBCUs who come
• 18:15to Yale for about eight
• 18:17weeks, and not only encourage
• 18:19them that medicine is a
• 18:20place for people who look
• 18:22like them, but also try
• 18:24my head at writing clinical
• 18:26curriculum and
• 18:27getting exposure. What are kind
• 18:29of things I wish I
• 18:30had when I was in
• 18:31their shoes,
• 18:33which kind of made me
• 18:34think, oh, I never saw
• 18:35myself as a potential clinical
• 18:38educator, but
• 18:40that was kind of fun.
• 18:42So I think having
• 18:43mentors who are very supportive,
• 18:46if even I'm at the
• 18:47kind of early stages of
• 18:48hey I kind of have
• 18:49this vague idea and not
• 18:50fleshed out,
• 18:51in undergrad I kind of
• 18:52felt like it was uphill
• 18:54battle. We've talked about the
• 18:55investment,
• 18:56and feel like you need
• 18:58to jump on opportunity.
• 19:00I really
• 19:01think at Yale, it taught
• 19:02me to be strategic with
• 19:03opportunities, what it would not
• 19:05only help me develop as
• 19:07a future clinician, leader, educator,
• 19:10but,
• 19:11right now as a student,
• 19:12and what I can help
• 19:14bring to other communities.
• 19:16And that kind of turns
• 19:16into one of the challenges,
• 19:18I think, is I have
• 19:19a tendency to want to,
• 19:21as many other med students,
• 19:22be the best at everything.
• 19:24You know, I want to
• 19:24be the best educator, the
• 19:26best clinician, the best researcher.
• 19:28And that takes a lot
• 19:29of energy. And we talk
• 19:31about physician wellness and burnout.
• 19:33We've talked about it even
• 19:34today.
• 19:35So,
• 19:36kind of being more strategic
• 19:37with my time, as I've
• 19:38mentioned,
• 19:40with my efforts. My advocacy
• 19:42is something that's both a
• 19:43challenge, but I think, as
• 19:45St. Brown said, we Yale
• 19:47tends to select for students
• 19:48who are self motivated, driven,
• 19:51and know when to ask
• 19:52for help, and, kind of
• 19:53have this,
• 19:55sense of resilience.
• 19:58Wonderful.
• 20:03Thank you. And, again,
• 20:05in the second half of
• 20:06this, I'd love to explore
• 20:07some of those things more.
• 20:08You know, when you hear
• 20:10when you hear it's almost
• 20:11like, you know, I'm not
• 20:13a terribly political fellow, but,
• 20:15you know, you talk to
• 20:16young people and you hear
• 20:17about politics discussed with an
• 20:18intensity,
• 20:20that it wasn't when I
• 20:21was young. I mean, there
• 20:22was always talk about politics,
• 20:23but it with an intensity.
• 20:25And then they it impacts,
• 20:26sort of their sense of
• 20:28what's the world they live
• 20:29in and their well-being. Well,
• 20:30now that's been brought down
• 20:32right into the into the
• 20:33into the intimate level of
• 20:34our biomedical sciences environments.
• 20:37When you when you hear
• 20:38the dean sort of say,
• 20:39well, if it goes the
• 20:40way it does up in
• 20:41Cambridge, that would be truly
• 20:42dramatic,
• 20:43and we'll have to change
• 20:44the way fundamentally we do
• 20:45things. Well, that that those
• 20:47are big words, you know,
• 20:48in an in an institution
• 20:49that's been stable for a
• 20:50long time.
• 20:51And so, again, perhaps later,
• 20:53I'd be interested how young
• 20:54people, when they hear the
• 20:55the titular leadership of an
• 20:57institution, sort of saying, well,
• 20:58we're gonna have to get
• 20:59a bit of helter skelter
• 21:00maybe.
• 21:02How does that, impact your
• 21:03own world view? But before
• 21:05we get to that,
• 21:06so,
• 21:08Dean Francis, there's a lot
• 21:10of talk around the institution
• 21:11about innovation. I think there's
• 21:13been some roles brought on,
• 21:15specifically in that in that
• 21:16light. Can you tell us
• 21:17a bit about how innovation
• 21:19may be impacting,
• 21:21sort of the educational and
• 21:22student experience?
• 21:24Absolutely. The the buzzword right
• 21:25now is like AI.
• 21:27You know, AI everywhere, you
• 21:29know. And so when you
• 21:30look at the curriculum and
• 21:32how AI is starting to
• 21:33impact the curriculum,
• 21:35one of the things that
• 21:36they're doing is ambient listening.
• 21:39If you're working with four
• 21:41medical students doing clinical skills
• 21:43and you're giving them feedback
• 21:44in real time over three
• 21:46hours,
• 21:47and then after that at
• 21:48some point, you have to
• 21:49write the notes to give
• 21:50them written feedback.
• 21:52The written three to four
• 21:53hours later may be somewhat
• 21:55more general than what you
• 21:56did in real time.
• 21:58With the ambient listening technologies,
• 22:01AI can now go ahead
• 22:03and take notes for you.
• 22:05And to go ahead and
• 22:06provide more specific and detailed
• 22:08information that reduces the time
• 22:10that an actual facilitator has
• 22:12to spend on writing to
• 22:14give better feedback to our
• 22:16students. So that's one of
• 22:17the ways that AI is
• 22:18being utilized.
• 22:19In addition to that, you
• 22:20know, you could think about
• 22:22simulated patients, but what about
• 22:23an AI
• 22:25simulated patient that is a
• 22:27voice to voice kind of
• 22:28like AI chatbot?
• 22:30So when you have the
• 22:31ability to have a patient,
• 22:33you wanna gather symptoms.
• 22:35You wanna actually think about
• 22:37their history, their stories,
• 22:38but you have to also
• 22:39be good with responding to
• 22:41them if they are angry,
• 22:42if they are sad, if
• 22:43they are upset or confused.
• 22:45And And so they have
• 22:46actually working now on these
• 22:49voice to voice chat bots
• 22:50so students can now practice
• 22:52with that outside of the
• 22:54curriculum,
• 22:55hone their skills to be
• 22:56utilized with assimilated patient and
• 22:57with real patients. So So
• 22:59that's a second innovation that
• 23:00the curriculum's working on. And
• 23:02the third is,
• 23:04who has used UpToDate at
• 23:05some point in their careers?
• 23:07I know I used it
• 23:08a lot, but UpToDate is
• 23:09pretty good to be able
• 23:10to put in, like, a
• 23:11topic or this disease and
• 23:13to get back information quickly.
• 23:15So they got working with
• 23:16the actual curriculum to make
• 23:17a searchable database for the
• 23:19Yale School of Medicine curriculum.
• 23:20So students can put in
• 23:22a topic
• 23:23and they can put in
• 23:24a diagnosis and they can
• 23:25get all the information the
• 23:26curriculum has on that topic
• 23:29towards studying
• 23:30or relearning.
• 23:31And in addition, if you
• 23:32think about it from a
• 23:33faculty point of view, the
• 23:35faculty can then
• 23:36put in topics from step
• 23:38one.
• 23:38There's a content outline or
• 23:40from step two. And they
• 23:42can see, you know, we
• 23:43teach this very well, but
• 23:44here are some holes or
• 23:46some gaps, some blind spots
• 23:47in the curriculum.
• 23:49We could enhance these parts.
• 23:50Now we all know the
• 23:52goal is to make our
• 23:53students the best options they
• 23:55can be,
• 23:56but students don't mind having
• 23:57a sense of reassurance that
• 23:58learning the curriculum will help
• 24:00you to do well in
• 24:01step one and step two.
• 24:02So this is one way
• 24:03to approach that. Or a
• 24:04student that wants to do
• 24:05research in a particular area
• 24:07can put in a topic
• 24:08and see what faculty teach
• 24:10in that topic,
• 24:11and maybe reach out to
• 24:12those faculty and say, can
• 24:13I get involved with research
• 24:14with you on this?
• 24:16Fantastic.
• 24:18Doctor Sarwat,
• 24:19we,
• 24:21can you give us a
• 24:21little bit of further insight
• 24:23into
• 24:24current trends in medical student
• 24:26research?
• 24:27How is the school of
• 24:28medicine preparing
• 24:30our students such that they
• 24:31can thrive and be on
• 24:32the vanguard
• 24:33of some of these latest
• 24:35trends? Yeah. Well, I think
• 24:37for sure,
• 24:38big trend, as you alluded
• 24:40to is AI.
• 24:42It's
• 24:43everywhere. You know, as I
• 24:44mentioned, I'm on the wards
• 24:46now and everyone's got open
• 24:48evidence. That's the first thing
• 24:49that everyone pulls up. Right?
• 24:52So it's it's,
• 24:53impacting how we teach our
• 24:55students, how students are in
• 24:57residence, are taking care of
• 24:58patients, and of course research.
• 25:00So of course, Yale has
• 25:02a number of experts,
• 25:04in that space.
• 25:05Another
• 25:06big trend is students growing
• 25:09interest in really
• 25:11interdisciplinary
• 25:12work, which is an area
• 25:14I know that you have
• 25:14great interest and care a
• 25:16great great deal about.
• 25:18You know whether it's at
• 25:19the intersection
• 25:21of public health,
• 25:23law,
• 25:24you know climate,
• 25:26a number of areas
• 25:28and you know through your
• 25:31support
• 25:32and others you know we're
• 25:34developing
• 25:35programs whereby we can help
• 25:36to build more bridges from
• 25:38the medical school to
• 25:41some of the other schools
• 25:42across campus.
• 25:44I would say another big
• 25:45trend is students
• 25:47growing interest in use of
• 25:49real world data.
• 25:51Right, you know we have
• 25:53our electronic medical record here
• 25:55at Yale New Haven Hospital
• 25:56and you know most hospitals
• 25:58across the country are similarly
• 26:00on epic now or some
• 26:02form of electronic medical record.
• 26:04And the,
• 26:05power that,
• 26:07data out of the electronic
• 26:08medical record,
• 26:10can bring to the kinds
• 26:11of questions that students are
• 26:13able to ask and answer
• 26:15is tremendous. But they need
• 26:16support along with the power
• 26:18of EMR data. There's a
• 26:20lot of challenges and a
• 26:22lot of messiness that comes
• 26:23along with that. And we've
• 26:24been very fortunate to bring
• 26:26on,
• 26:27within the office of student
• 26:28research
• 26:29a faculty member who has
• 26:30a dual appointment actually in
• 26:32pediatrics and medical informatics.
• 26:34And that faculty member is
• 26:36able to work one on
• 26:37one with students to help
• 26:38them develop very rigorous proposals
• 26:41and data collection plans. So
• 26:43those are some of the
• 26:44trends I would highlight.
• 26:46That's spectacular. You know, I
• 26:47think, we're all aware whether
• 26:49we work in a big
• 26:50integrated system or what have
• 26:52you, but as the as
• 26:53the medical data becomes increasingly
• 26:56digitized,
• 26:57things aren't written, you know,
• 26:58just walled up in charts
• 27:00anymore.
• 27:01You blend the the total
• 27:02digitization
• 27:03of of of the health
• 27:05experience within these large integrated
• 27:07systems, and you integrate it
• 27:08with their financial incentives to
• 27:10a certain degree in order
• 27:11to provide efficient care. And
• 27:13then you bring to bear
• 27:14something like AI.
• 27:16You know,
• 27:17you take a large integrated
• 27:18system with thirty hospitals. You
• 27:20you could sort of, in
• 27:21some sense, ask all questions
• 27:23simultaneously.
• 27:24You know? Are are we
• 27:25admitting the right patients with
• 27:27syncope or not?
• 27:29You know?
• 27:30Let's ask that right now,
• 27:32all day, every day.
• 27:34So, you know, the world,
• 27:36the world is a changing.
• 27:37It's not like a chart
• 27:38a retrospective chart review with
• 27:39a very, very formalized question.
• 27:41But so the last question
• 27:43before we open up to
• 27:44q and a,
• 27:46to our medical students,
• 27:48you know, you're at you're
• 27:50at some point within your
• 27:51medical school education.
• 27:53When you when you look
• 27:54forward now to completing that
• 27:56and then moving into your
• 27:57future,
• 27:59what do you what do
• 28:00you what do you see
• 28:01down the line? What are
• 28:02you most excited about? What
• 28:04are you what do you
• 28:05have some concerns about?
• 28:07What do you see?
• 28:11So, yeah, I have one
• 28:12year left, which means I'm
• 28:13applying to residency
• 28:15very soon as Dean Francis
• 28:16continues to remind me.
• 28:20So I and also as
• 28:21I mentioned, I'm at the
• 28:22end of a research year,
• 28:23so I'm very excited to
• 28:24be back in the clinic.
• 28:25I'm very excited to work
• 28:26with patients again.
• 28:28I think one of the
• 28:29things I've missed most,
• 28:31as lovely as my cells
• 28:32are, but, one of the
• 28:34things I've missed most being
• 28:36in wet lab is having
• 28:38this experience of
• 28:40these one on one interactions
• 28:41with patients that really,
• 28:44determine
• 28:45where you put your energy
• 28:47and your passion. So,
• 28:49at Yale New Haven, but,
• 28:50especially at SRC, which is,
• 28:52rotation a lot of us
• 28:53go through,
• 28:55and then I also work
• 28:56with, Yale's, patient navigator program,
• 28:59which works with def different,
• 29:00refugee families in New Haven.
• 29:03And I think through all
• 29:04of those experiences,
• 29:05I,
• 29:07I've really gotten the chance
• 29:09to work with patients and
• 29:10families and see
• 29:12how their individual
• 29:13situations,
• 29:16guide what is, like, important
• 29:18for me to work on
• 29:19in the future. So,
• 29:21an example I'll give is
• 29:22that,
• 29:23working with some of the,
• 29:24Afghan refugee families in New
• 29:26Haven,
• 29:28we ended up
• 29:29seeing how they are currently
• 29:31being affected by what's going
• 29:33on in in the US
• 29:34right now.
• 29:36So we are able to
• 29:37work with Fairhaven,
• 29:39the pediatrics program there. We
• 29:41are able to work with
• 29:41IRIS, which is the refugee
• 29:42service in New Haven,
• 29:44and actually, like, get into
• 29:45contact with lawmakers.
• 29:47So I think
• 29:48something like that I would
• 29:49never have imagined getting involved
• 29:51in and it only comes
• 29:52out of those, individual interactions
• 29:54with patients that really shows
• 29:55you where where something is
• 29:57important and where your time
• 29:58and energy, can be well
• 29:59spent. So I'm super excited
• 30:00to kind of take some
• 30:01of those experiences that I've
• 30:03had here at Yale and
• 30:04some of the skills, that
• 30:05I have been
• 30:06empowered to learn through all
• 30:07of our amazing, faculty and
• 30:09all the mentors I've had
• 30:10and take those with me
• 30:11in the next stage of
• 30:12my
• 30:14career.
• 30:16I would like to speak
• 30:18to kind of this, sense
• 30:20of humanity and medicine that
• 30:21was brought up a lot
• 30:22during the q and a
• 30:23in state in the state
• 30:24of the school.
• 30:26So,
• 30:27I finished my clerkship year
• 30:29this past December
• 30:30and I've been taking time
• 30:32for boards, but just experiences
• 30:34I've had the past year
• 30:36have really
• 30:37something I've been processing and
• 30:39continue to process.
• 30:40And one thing's, one thing
• 30:42that I think Yale has
• 30:43really,
• 30:44something I will take with
• 30:45me for my medical career
• 30:47but just life in general,
• 30:48is to really meet people
• 30:50where they are. And one
• 30:52of the things I'm interested
• 30:53in is, kind of pediatric
• 30:55anesthesiology,
• 30:56which is very niche. But
• 30:57I kind of stumbled my
• 30:59way into that,
• 31:00not in a typical OR,
• 31:02but also in my pediatric,
• 31:05just general medicine,
• 31:06rotation.
• 31:07I'll tell a very brief
• 31:09story, but I had kind
• 31:10of a thirteen year old
• 31:11girl who came in and
• 31:13she was kind of embarrassed
• 31:14to talk about kind of
• 31:15changes with her body starting
• 31:17with the menstrual period,
• 31:19and I noticed she had
• 31:20like some type of theater
• 31:21shirt
• 31:22and I'm a little bit
• 31:23of a theater, kid. I'm
• 31:25not gonna lie.
• 31:26And I one of the
• 31:27ways I explained the menstrual
• 31:29period to her was, like,
• 31:30oh, think of it as,
• 31:31like, a dress rehearsal
• 31:32that you go through every
• 31:33month for this process that
• 31:35will happen way way down
• 31:36the road when you're older,
• 31:39and
• 31:40it was something
• 31:41that you know I didn't
• 31:42think much of it. I
• 31:44was like how can I
• 31:45meet this girl where she
• 31:46is, how can I make
• 31:47it so even if I
• 31:49don't interact with her
• 31:51for years on, she can
• 31:52now, next time she interacts
• 31:53with the medical system, kind
• 31:55of be a little bit
• 31:55more open, a little bit
• 31:57more confident, and able to
• 31:58advocate for herself
• 32:00and walk away with this
• 32:01conversation?
• 32:03And when I was debriefing
• 32:04with my preceptor who was
• 32:06also a Yale alum,
• 32:07she gave me a lot
• 32:08of kudos and said like
• 32:09that's what we need in
• 32:11medicine.
• 32:12And I spoke about it
• 32:13earlier, but
• 32:15I struggle with seeing myself
• 32:16in medicine, seeing myself as
• 32:19a doctor, since I didn't
• 32:20have any mentors,
• 32:22especially mentors who look like
• 32:24me. So being more confident
• 32:26that I am in the
• 32:27right field,
• 32:29I'm able to have the
• 32:31potential to do what I
• 32:32want to do, whether it's
• 32:33a couple years down the
• 32:34road, maybe being a Dean
• 32:35Francis or a Dean Alusi,
• 32:37at Yale or another institution
• 32:39to really inspire and continue
• 32:41to cultivate,
• 32:43and bring the Yale system
• 32:44to other generations,
• 32:46is an opportunity I never
• 32:48thought of. So that's something
• 32:49I think about.
• 32:51Beautiful.
• 32:53Lovely.
• 32:54So wonderful.
• 32:56Now listen, I'd love to
• 32:57open this up to questions
• 32:58from the audience.
• 33:00What's in your heart? What's
• 33:02in your mind? Throw out
• 33:02some tough ones.
• 33:04Yes, sir.
• 33:05This question. Hand go up
• 33:07first.
• 33:08Hi. My name is Reid
• 33:09Heffner.
• 33:10I graduated
• 33:11in nineteen sixty five.
• 33:13So my question to you,
• 33:15actually I have several, they're
• 33:16all,
• 33:21they're all related. They have
• 33:23to do with the basic
• 33:24science curriculum.
• 33:25So with the basic science
• 33:27curriculum, I understand it's a
• 33:29year and a half.
• 33:30And I wondered, first of
• 33:31all, how much of the
• 33:32curriculum is lectures?
• 33:34How much is other things?
• 33:36Are there grades?
• 33:43Who wants to tackle that?
• 33:44Dean Francis?
• 33:49So so,
• 33:50there there is a mixture
• 33:51of lectures and small group
• 33:53learning and being in the
• 33:54anatomy lab and doing workshops.
• 33:57But but a lot of
• 33:58the things that are present
• 34:00are actually
• 34:01voluntary.
• 34:02They're the things that are
• 34:03actually things that you need
• 34:05to go to involve
• 34:07actual patients.
• 34:08And so the patient
• 34:10centered activities and the curriculum
• 34:12students all come to.
• 34:14We we are looking right
• 34:16now
• 34:16at the curriculum
• 34:18through an actual lens. And
• 34:19what we're seeing is that
• 34:20students like more interactive
• 34:22workshops,
• 34:23and they did pilots
• 34:25where they actually were looking
• 34:27at more small group team
• 34:29based learning activities,
• 34:31and they recognize that students
• 34:32tend to really engage with
• 34:34that and enjoy that type
• 34:35of learning. And so I
• 34:37believe that there's gonna be
• 34:37a move towards incorporating more
• 34:40of those activities
• 34:41and reducing a little bit
• 34:42more of the large
• 34:44room,
• 34:45you know, didactic tile type
• 34:47teaching.
• 34:48So it's pass fail in
• 34:50the curriculum. It's pass fail
• 34:52in the actual clinical year.
• 34:54And, also, when you reach
• 34:55the senior year in that
• 34:57last year, there's honors in
• 34:59your sub internships. You can
• 35:01get honors or in four
• 35:02week electives, but if two
• 35:03week electives are pass fail.
• 35:05So most of the curriculum
• 35:06is pass fail, and, of
• 35:07course, there's no ranking in
• 35:08the l system.
• 35:12Sir?
• 35:13My name is, Cesar Molina
• 35:15from the class of nineteen
• 35:16eighty.
• 35:17It appears that the Yale
• 35:18system is doing well.
• 35:22The Yale system
• 35:24attracts individuals who are interested
• 35:25in self learning.
• 35:27And as we sit here
• 35:28on this side of the
• 35:29auditorium
• 35:30and you explain and describe
• 35:32the way you educate your
• 35:33students now,
• 35:35there is increase at least
• 35:37I salivate. I would love
• 35:38to have access to what
• 35:40you have created
• 35:41for continuing education.
• 35:43Is that available to us?
• 35:48In case we have some
• 35:49remedial work to do.
• 35:56I I I think that
• 35:57there is,
• 35:58continuing medical education
• 36:00through, Dean Janet Hafler.
• 36:03And so I know she's
• 36:04involved with some type of
• 36:05activities.
• 36:06I'm not sure to what
• 36:07length those activities extend beyond
• 36:09Yale,
• 36:10but she may be someone
• 36:11to talk to about that.
• 36:16Yes, sir. Oh, sorry.
• 36:18Yes, sir. My name is
• 36:19Brendan Graber. I'm from the
• 36:20class of two thousand five.
• 36:22And in my class and
• 36:22subsequent to it, there were
• 36:24lots of conversations
• 36:25about the system of assessment
• 36:26here and our experience of
• 36:27it. So I wanna hear
• 36:28from the students.
• 36:30What is the system of
• 36:31assessment like for you now?
• 36:33What is your experience of
• 36:34it both preclinical and during
• 36:36the clinical years?
• 36:40Thank you for that question.
• 36:42So my experience in a
• 36:43preclinical
• 36:44that we have,
• 36:45what, seven or eight master
• 36:47courses and are kind of
• 36:48like blocks, for example, homeostasis,
• 36:50which is the heart, kidneys,
• 36:52and the lungs.
• 36:53And at the end of
• 36:54those, which can range anywhere
• 36:55from, like, six weeks to
• 36:57longer, I think ten weeks
• 36:58or twelve. Is that the
• 37:00longest? Yes. Longest block. You
• 37:02have one kind of they
• 37:04call it, a qualifier
• 37:05exam.
• 37:06And, I think this is
• 37:08what is a strength to
• 37:09the Yale system and something,
• 37:10though, that requires kind of
• 37:12some mentorship.
• 37:13For example, I'm a very
• 37:14kind of I don't wanna
• 37:15say type a. I think
• 37:16a lot of people in
• 37:16medicine are type a, and
• 37:17that could be a bit
• 37:18of a negative connotation, but
• 37:20I like a bit more
• 37:21structure.
• 37:22So I take advantage of
• 37:23the optional quizzes and, that
• 37:24they offer every week just
• 37:24to do a check-in and
• 37:24make sure that I'm grasping
• 37:24the material as
• 37:26offer every week just to
• 37:27do a check-in and make
• 37:28sure that I'm grasping
• 37:29material, especially if it's something
• 37:31that's complicated like neuroscience
• 37:33or what have you. There's
• 37:35also opportunities. It could be
• 37:37one to two kind of,
• 37:39self assessments
• 37:40throughout the block to, that
• 37:42are put. Think of them
• 37:43as kind of midterms, but,
• 37:45they're basically to prep and
• 37:46everyone has to take them
• 37:48from my understanding,
• 37:49and, they're really for you
• 37:51to see how you're doing.
• 37:52Oh, like for example in
• 37:54the hemo,
• 37:55when is it homeostasis,
• 37:56if you feel like, oh
• 37:57wow we just covered the
• 37:59cardiology,
• 38:00I realize I don't understand
• 38:02this, you have to know
• 38:03that after taking the self
• 38:04assessment and be able to
• 38:06identify the resources that have
• 38:08been provided and reach out,
• 38:09which sometimes I think can
• 38:10take some activation energy
• 38:12for students, but I think
• 38:15having
• 38:16built in systems of support
• 38:18can be and something that
• 38:19they've even expanded since I
• 38:21was, a preclinical student is
• 38:23really helpful. Their tutors, as
• 38:24mentioned,
• 38:25they're also within the houses.
• 38:27If there could be a
• 38:28cardiologist and if you feel
• 38:29comfortable talking to them about,
• 38:30you know, EKG that you
• 38:31can't understand,
• 38:33have at it.
• 38:34And also our lecturers will
• 38:35give them, like, personal numbers
• 38:37or emails to say, even
• 38:38if you're in clinical spaces
• 38:39and I haven't talked to
• 38:40you in two years,
• 38:41reach out. In a clinical
• 38:43space,
• 38:44as Dean Francis mentioned, it
• 38:45is pass fail,
• 38:47for your evaluations, but we
• 38:49get narrative feedback.
• 38:50And I do think there's
• 38:51an opportunity,
• 38:52we talked about kind of
• 38:53in a preclinical
• 38:55state or, curriculum how,
• 38:58having kind of more generic
• 39:00comments. I do think that
• 39:02when you spend time with
• 39:03someone and you are inundated
• 39:05with a bunch of clinical
• 39:06or research opportunities, sometimes the
• 39:07feedback can be a bit
• 39:09more on the general side.
• 39:11But,
• 39:11I think there are opportunities
• 39:13for us as students to
• 39:14really advocate
• 39:16for ourselves and really make
• 39:18those relationships even in a
• 39:19short two to three week
• 39:21block with our preceptors.
• 39:23There are, no shelf exams,
• 39:25as I'm sure you all
• 39:26know,
• 39:27but there are still exams,
• 39:28like knowledge assessments, I would
• 39:30call them, at the each
• 39:31of every clerkship blocks, or
• 39:32there are four.
• 39:33And, I'm studying for step
• 39:35two right now. Wish me
• 39:36luck,
• 39:37and I found that,
• 39:40that they're incredibly helpful, particularly
• 39:42the OB GYN
• 39:45portion where they provided a
• 39:47question bank for students. That
• 39:49was a little tough. I
• 39:50will admit it was geared
• 39:50towards residents, but as I'm
• 39:52approaching the questions in step
• 39:53two, I'm like, wow.
• 39:55I've retained a lot, surprisingly.
• 39:57And I think they're open
• 39:59to feedback and constantly
• 40:01evolving a curriculum to meet
• 40:03students' need and what they
• 40:04think is working or not.
• 40:07The only thing I'll add,
• 40:08because that was a very
• 40:09comprehensive answer,
• 40:11is that
• 40:12since I,
• 40:14did the pre clerkship,
• 40:15curriculum, they have actually changed
• 40:18the self assessments and the
• 40:19qualifiers a little bit,
• 40:21based on student feedback. So
• 40:24some of the feedback we
• 40:25gave my year was, you
• 40:26know, we have,
• 40:27a lot of these amazing
• 40:28lecturers and they have very
• 40:29different styles and some of
• 40:30them are like, listen to
• 40:31this super cool niche research
• 40:33project I did,
• 40:34and some of them are
• 40:35teaching more towards boards.
• 40:37And so having those qualifiers
• 40:40be a mix of submitted
• 40:41questions from each professor could
• 40:44be hard to study for,
• 40:45and I think one of
• 40:46the concerns that students had
• 40:48was how relevant is this
• 40:49for
• 40:50the actual material I need
• 40:51to know to be successful
• 40:53on the wards and also
• 40:54be successful in my step
• 40:55exams. So that is a
• 40:56change that has been made
• 40:57recently.
• 40:58There are now, like, student
• 41:00groups that review from upper
• 41:02years that review all of
• 41:03these qualifiers,
• 41:04and look, see.
• 41:06We feel like this is
• 41:07relevant, helpful information that will
• 41:08help me down the line.
• 41:09So I think that has
• 41:10been a really positive change
• 41:11that's been made.
• 41:14Let me just follow-up with
• 41:15this gentleman. You said there
• 41:16was a lot of discussion
• 41:17in two thousand five. And
• 41:18what you've just heard,
• 41:20does that compute? How does
• 41:21that compare to were there
• 41:23were there thoughts or concerns
• 41:24in two thousand five? What
• 41:25was prompting all the discussion?
• 41:27The the sense that in
• 41:29our time was that
• 41:30the system was moving more
• 41:32towards the structure of the
• 41:33system
• 41:34or qualifier is for self
• 41:36assessments.
• 41:37And, of course, there was
• 41:38a feedback from the student
• 41:39body at the time. This
• 41:40has been a topic at
• 41:41points in AYAM as well.
• 41:43So I just was curious.
• 41:44It was great to hear
• 41:45about your experience now. Of
• 41:46course, it's going to have
• 41:47changed. It sounds like it's
• 41:48changed a bit. But I
• 41:49also get the sense that
• 41:51the philosophical
• 41:52underpinnings are still the same.
• 41:54And I'm glad to hear,
• 41:54so no high pass or
• 41:55honors in clinical rotations anymore.
• 41:57Interesting, because that was still
• 41:58the case in my time.
• 41:59Yeah. Good to hear. Thank
• 42:00you. I mean, and I
• 42:01want to get to the
• 42:02other questions, but the wax
• 42:03and waning in the Yale
• 42:04system, exact you two thousand
• 42:06and five, you graduated? Yeah.
• 42:07So that was one of
• 42:08the errors where our organization
• 42:10predecessors in the AYN became
• 42:12concerned.
• 42:13That it was that ecosystem
• 42:16that precipitated Doris paper
• 42:18in some sense. It was
• 42:19that system that, you know,
• 42:21you don't just get up
• 42:21and start making a hundred
• 42:23videos because you you you
• 42:24want to memorialize something or
• 42:25another. We're also trying to
• 42:26send a message.
• 42:28So
• 42:29who's oh, boy.
• 42:31You choose. Yeah.
• 42:34Yeah. So,
• 42:35Alan Astro, class of nineteen
• 42:37eighty.
• 42:38At that time, the anatomy
• 42:40labs were in the Sterling
• 42:42Hall of Medicine,
• 42:43and above the anatomy labs
• 42:45was the chaplain's office.
• 42:47I believe that chaplain was
• 42:49Dave Duncombe.
• 42:51And we used to if
• 42:52you got freaked out or
• 42:54just needed a break, you'd
• 42:55go up to his office
• 42:56and you'd have a cup
• 42:57of coffee and you could
• 42:58talk to him. He was
• 42:59he was he was a
• 43:00very lovely person. Is there
• 43:02still a chaplain's office here
• 43:03at the medical school, and
• 43:04do the students make use
• 43:05of it in the way
• 43:06that it was
• 43:08back then?
• 43:09The chaplain's office is through
• 43:10the main university.
• 43:12They actually have free ice
• 43:13cream. And so students can
• 43:15go there at any point
• 43:16and go and get ice
• 43:17cream and chat with chaplains
• 43:19from, multiple different denominations.
• 43:22And so it's definitely still
• 43:24availability
• 43:25to the students. And we
• 43:26also bring the chaplains to
• 43:28the campus for certain occasions.
• 43:30We had a death on
• 43:31campus
• 43:32and the chaplains came.
• 43:34And then, for example, there
• 43:35were other times when there
• 43:36was high stress, and we
• 43:38brought chaplains on campus as
• 43:39well too. So they're still
• 43:41here. But the chaplain is
• 43:42not prepared for permanent office
• 43:44there with the members?
• 43:45Not to the best of
• 43:46my understanding. I think we
• 43:48tend to utilize the university
• 43:49chaplains and there are many.
• 43:58Next question. Hi. My name
• 43:59is Lee Elmore, now Matt
• 44:01Laga from class of two
• 44:02thousand.
• 44:03I was just curious with
• 44:04the Yale system,
• 44:05if you still offer AOA
• 44:07and how that works now
• 44:08that most of the clinical
• 44:09clerkships don't have the honors
• 44:11or high honors distinction.
• 44:13There's no AOA?
• 44:15Hello.
• 44:20No ranking.
• 44:22Alright. Where's the mic? We're
• 44:23down to him. Wonderful.
• 44:36Okay. Here we go. Sorry.
• 44:38I could have given him
• 44:39mine.
• 44:40I'm Mark. Yes, sir. Please.
• 44:42Martin Stein, class of, sixty
• 44:44five.
• 44:46You talk about pass fail.
• 44:47How many people fail?
• 44:49Oh, how many people fail
• 44:51in this pass fail system?
• 44:52I don't remember anybody failing.
• 44:56So so no. Please. Students
• 44:58go
• 44:59first. It's more of a
• 45:00pass now, pass later,
• 45:02if you will.
• 45:06I
• 45:07I I can't speak exactly
• 45:09to how many
• 45:10students might not pass the
• 45:12first time they take a
• 45:13qualifier.
• 45:14That's not something that
• 45:16we really are have, are
• 45:18privy to that knowledge.
• 45:20But I will say that
• 45:21I know very, very few
• 45:23students personally who have mentioned,
• 45:26that they really struggled with
• 45:27a qual or a self
• 45:29assessment,
• 45:30and usually I think they
• 45:31always found the what we
• 45:33call remediation process, which is
• 45:34essentially where you go you
• 45:35meet with the the course
• 45:37director, you,
• 45:39go and review some of
• 45:41the material that you struggled
• 45:42with. It's not supposed to
• 45:43be like a punishment. Right?
• 45:44It's just to help you
• 45:45catch up on that material.
• 45:46I feel like everyone I've
• 45:47talked to has found that
• 45:48system extremely beneficial.
• 45:50But I don't know if
• 45:51there's numbers that
• 45:55I'll also say that, one
• 45:56of the the the actual
• 45:58blessings of the Yale system
• 46:00is that if a student
• 46:01has failed a qualifier and
• 46:03then they remediated it and
• 46:05passed,
• 46:06if it's just one or
• 46:07two,
• 46:08that never shows up on
• 46:10a record that goes to
• 46:11the program directors.
• 46:12As opposed to at other
• 46:13schools, if you've failed an
• 46:15actual course,
• 46:16that gets reported out.
• 46:18And so our our students
• 46:20are sheltered in that,
• 46:23actual situation
• 46:24unless they hit maybe, like,
• 46:26four qualifier failures.
• 46:28And then at that point,
• 46:29by policy, it does get
• 46:31reported out. But up until
• 46:33four, we protect the Yale
• 46:34students
• 46:35as opposed to another schools.
• 46:36They would have been shown
• 46:38with a light.
• 46:41We have time for a
• 46:41few more questions. Donald Moore.
• 46:44Yeah. Well, you heard my
• 46:45name, but, class of nineteen
• 46:47eighty,
• 46:49you know, I love this
• 46:50conversation
• 46:51because this conversation
• 46:53started,
• 46:53you know, at least in
• 46:54my time in two thousand
• 46:56and five.
• 46:57And, what we heard
• 46:59at the A Y
• 47:01AYAM
• 47:02at that time is that
• 47:04when the students reached out,
• 47:06thousands
• 47:07of the alumni
• 47:10actually responded,
• 47:12and that started the deep
• 47:13dive.
• 47:14And, I want to mention
• 47:16some names because many of
• 47:17them are not here, but,
• 47:18peep
• 47:20doctors like,
• 47:21Kane, Richard Kane, who was
• 47:23president when those videos were
• 47:25made. And, we made over
• 47:26a hundred videos.
• 47:27And it wasn't just videos,
• 47:29but they were I remember
• 47:31Paul. That's how we met
• 47:32Paul. Paul was so eloquent
• 47:34when he,
• 47:35as an alum,
• 47:37basically said, this is what
• 47:38the Yale system
• 47:39meant to me. So I
• 47:42I'm,
• 47:43Doug Berv, Lillian Oshawa. Those
• 47:45are the ones who
• 47:46really and it was a
• 47:47lot of work. I mean,
• 47:48you can you imagine making
• 47:49a hundred videos over a
• 47:51two day period?
• 47:53Actually, we did over two
• 47:54years in a row. So
• 47:56it took time and it
• 47:57took money, it took effort,
• 47:59and, certainly, the university supported
• 48:02us to some extent at
• 48:03that point. So, you know,
• 48:04I wanted to mention those
• 48:06names because many of them
• 48:07are not here and,
• 48:09they are your alumni. And
• 48:10I just since I'm here,
• 48:11I wanted to highlight that.
• 48:17Yes.
• 48:18Thank you. Absolutely, Donald. Thank
• 48:20you, Lillian. Thank you, Doug.
• 48:21They stood out on the
• 48:23the this thousands of hours
• 48:24of work.
• 48:25Please.
• 48:26Is it yes, sir.
• 48:28I'm, Rob Shen. I'm, class
• 48:30of, nineteen ninety five. I,
• 48:33have been heavily involved in
• 48:34graduate medical education at the
• 48:36recruitment of residents
• 48:39and advanced fellows.
• 48:41I'm a thoracic surgeon and
• 48:42I've been I was the
• 48:43program director for over ten
• 48:45years.
• 48:45And so one of the
• 48:47important
• 48:48parts of recruitment of medical
• 48:50students into,
• 48:52subspecialty training programs is
• 48:55is recruitment and and being
• 48:57able to assess
• 48:58and compare medical students from
• 49:01different institutions across the country
• 49:03is is challenging.
• 49:05And particularly with Yale Medical
• 49:07School and others like it
• 49:09that have a a pass
• 49:11fail system. When I was
• 49:12a student here, the clinical
• 49:14rotations
• 49:15were all still graded on
• 49:16a honors pass.
• 49:18And
• 49:19and now that the USMLE
• 49:22is no longer even going
• 49:23to report,
• 49:24numerical scores and quartiles, but
• 49:27that's also going to a
• 49:28pass fail system,
• 49:29it's difficult for us as
• 49:31program directors to then compare
• 49:33Yale students to other institutions
• 49:35that have grades all the
• 49:37way through the preclinical and
• 49:39the clinical.
• 49:40And I'm curious, maybe this
• 49:41is a question for the
• 49:43deans
• 49:44as to whether you've gotten
• 49:45feedback from residency program directors
• 49:48as
• 49:49to how it, how it
• 49:51affects Yale students
• 49:53competing for competitive residency programs
• 49:56when they're going up against
• 49:58students that have,
• 49:59very,
• 50:02qualitative
• 50:03data
• 50:03to to to compare?
• 50:07A very good question. You
• 50:08know, our our students on
• 50:09our match list, they're doing
• 50:11phenomenally.
• 50:12And every year, I continue
• 50:14to be amazed at the
• 50:16wonderful residencies that they're matching
• 50:17into, and I'm very, very
• 50:19proud of the students.
• 50:21It is true, when you
• 50:22look at some of the
• 50:23information that comes out of
• 50:24the school,
• 50:25they're not ranked.
• 50:27They don't have the grades,
• 50:29but what they do have
• 50:30is actually a portfolio that
• 50:32shows their passions.
• 50:34And our students choose very
• 50:36unique passions compared to other
• 50:38students at other schools.
• 50:39We have students that are
• 50:40interested in becoming
• 50:42physician astronauts.
• 50:43And they go off and
• 50:44do a PhD at Oxford
• 50:46in astrophysics.
• 50:47And we have interested students
• 50:49in doing MPPs, and they
• 50:50go off and think about
• 50:51going to London,
• 50:53or going to Princeton, or
• 50:54going to Hopkins, or Harvard
• 50:56via MBAs.
• 50:57And so our students are
• 50:58doing things that students don't
• 51:00typically do around the country.
• 51:02And when you look at
• 51:02the publications of some of
• 51:04our students as they're graduating,
• 51:06they look more like assistant
• 51:07professors.
• 51:08They don't look like a
• 51:09medical student, you know, hearing
• 51:10that maybe they have one
• 51:11paper. Some Some of our
• 51:12students have thirty and forty
• 51:14papers when they're graduating from
• 51:15medical school after doing a
• 51:17full year of research.
• 51:19And,
• 51:19not necessarily in the wet
• 51:21lab. Not necessarily in wet
• 51:22lab. So so
• 51:24and their step scores for
• 51:26step two remain,
• 51:28and those are not gonna
• 51:29go away. Step one went
• 51:30to pass fail. Step two
• 51:31still has scores. And our
• 51:32students are doing phenomenal
• 51:35on step two compared to
• 51:36the national
• 51:37information.
• 51:38So
• 51:39in the very, very
• 51:41competitive specialties, our students are
• 51:43also doing away rotations.
• 51:45And in those situations, they're
• 51:47getting a letter
• 51:48from their away rotation.
• 51:50So they have letters from
• 51:51their sub internship and their
• 51:53departments at home, but they
• 51:54also have letters from their
• 51:56away rotations.
• 51:57And I think that that
• 51:58information
• 51:59can show how they're performing
• 52:01clinically
• 52:02in conjunction with their step
• 52:03two scores,
• 52:04and then their research and
• 52:05service and leadership opportunities.
• 52:07Hopefully, in a holistic
• 52:09approach, our students will still
• 52:11be shown out to be
• 52:12very special.
• 52:13And I believe that the
• 52:14match list, you know, gives
• 52:16us that data that they
• 52:17are being seen as special.
• 52:19But have there been concerns
• 52:20or complaints from program directors
• 52:22saying we would like to
• 52:23be able to know their
• 52:23ranking?
• 52:25Yes. That there have been
• 52:26people that have said it
• 52:27would be nice to know
• 52:28this is the top twenty
• 52:30five percent or the middle
• 52:31or the lower. That's not
• 52:32the Yale system.
• 52:37I I would like to
• 52:37make one quick comment before
• 52:39we get to the last
• 52:39question. It's my own personal
• 52:41observation. I think that question
• 52:43you've asked, sir, is very
• 52:44pertinent.
• 52:45Listen.
• 52:45I'm I'm, you'll never find
• 52:47a bigger support of the
• 52:48Yale system than me, But,
• 52:50you know, most things in
• 52:51life involve some element of
• 52:52trade offs. I'm sure there's
• 52:54some program directors,
• 52:56that are like, we trust
• 52:57Yale, the generations of fabulous
• 52:59people. Let's bring this kid
• 53:00in,
• 53:01to train here. But there's
• 53:03gonna be people somewhere, someplace
• 53:05that sort of say, I
• 53:06just don't have anything I
• 53:07just don't have anything to
• 53:08look at here, or less
• 53:09so.
• 53:11You could go one step
• 53:12beyond that. If you take
• 53:13a medical school in my
• 53:14family, I have I have,
• 53:16my wife went to a
• 53:18a school with a more
• 53:19traditional curriculum.
• 53:20She went to the Baylor
• 53:21College of Madison, fabulous medical
• 53:23school in Texas. And, you
• 53:24know, there's a lot of
• 53:24grading going on and and
• 53:26and all of that.
• 53:28Could you hypothesize
• 53:29that somebody who goes through
• 53:30a medical school
• 53:32in which they're graded up
• 53:33the wazoo all through the
• 53:35classes and everything else like
• 53:36that, and then that that
• 53:37young person shows up in
• 53:38their internship year or their
• 53:40second year of residency or
• 53:41third year of residency, and
• 53:42somebody asked them, I don't
• 53:43know, what's the fourth step
• 53:44of the Krebs cycle or
• 53:45something like that?
• 53:46Something ridiculous like that. Okay.
• 53:49Some preposter anyway. So, or
• 53:50ask some, you know, what's
• 53:52the what's the seventeenth thing
• 53:53on the differential? And if
• 53:54you've been in an environment
• 53:56in which you've, you know,
• 53:56human beings are pliable to
• 53:58the environment they're in. And
• 53:59and if you've been in
• 54:00an environment that there's been
• 54:02reward and and punitive measures,
• 54:04whether you know the eighteenth
• 54:05thing on the differential, I
• 54:06I would speculate. I've known
• 54:08graduates from our school that
• 54:09showed up for the first
• 54:10twenty four months of their
• 54:10training, and they're like, woah.
• 54:12I may know how to
• 54:13formulate a question, but right
• 54:14now, they just wanna know,
• 54:15you know, what's the seventeenth
• 54:16thing that could cause pancreatitis
• 54:18or something like that. And
• 54:19they felt a little bit
• 54:21a little bit like they
• 54:22they needed to double down.
• 54:24So is there a negative
• 54:25element in the trade off?
• 54:26There there might be. But
• 54:28what about the positives?
• 54:29You jettison the caustic competitive
• 54:31environment. Taking care of patients
• 54:33is not graded on a
• 54:34curve. It's not a contest.
• 54:36And, you know, the imagination
• 54:38and the and the sensitivity
• 54:40and the creativity
• 54:41and and and the culture
• 54:42that comes with this. Ultimately,
• 54:44is there some element of
• 54:45a trade off? There's nothing
• 54:46in this world that has
• 54:47no element of a trade
• 54:48off. But I think I
• 54:50think, you know, I think
• 54:52the preponderance of our of
• 54:53our students and our graduates
• 54:55feel it's worth the trade
• 54:56off for what we have
• 54:57here. So that's my personal
• 54:59observation. Sir, your last question.
• 55:00So, actually, I would like
• 55:01to I'm from the class
• 55:02of nineteen eighty, sir Molina.
• 55:04I would like to follow-up
• 55:04on your statement about the
• 55:06outcomes.
• 55:07So when we were here
• 55:08and graduated in nineteen eighty,
• 55:10there were no tests
• 55:12before the boards.
• 55:14We actually just studied,
• 55:16on our own. We tested
• 55:18our or some people developed
• 55:20their own system.
• 55:22And there was a very,
• 55:23very small percentage of people
• 55:25who did not pass the
• 55:26first part of the boards.
• 55:28Most of them had personal
• 55:29reasons for that. They were
• 55:31not really academic reasons. They
• 55:33both they subsequently passed, and
• 55:35some of them have become
• 55:36stars
• 55:37in medicine.
• 55:39So
• 55:40is there any when you
• 55:41look back at the way
• 55:42we got an education and
• 55:44the way now that you
• 55:45test during the preclinical years,
• 55:47is there any difference
• 55:49in outcome
• 55:50in the first part of
• 55:51the boards?
• 55:54That's a good question. You
• 55:55know? I I haven't looked
• 55:56at
• 55:57the passing percentage rate from
• 56:00the eighties to the nineties
• 56:01to the different decades.
• 56:03What I can say, looking
• 56:05at the
• 56:06national passing rate, Yale students
• 56:08are doing better than medical
• 56:10schools across the country
• 56:12for our students passing step
• 56:14one and step two. And
• 56:15on step two, we're also
• 56:16doing better grades than the
• 56:18rest of the country on
• 56:19our scores for step two.
• 56:21So higher passing rates and
• 56:23also higher scores at Yale.
• 56:25So,
• 56:26that's what I can talk
• 56:27about without going back and
• 56:28and knowing the data from
• 56:29other years.
• 56:31Can I can I follow-up?
• 56:33So
• 56:34as a as a reminder,
• 56:36during the war times we
• 56:38did not have pass fails,
• 56:39but we were all highly
• 56:41rated by our attendings.
• 56:43And we worked really hard
• 56:44to impress our attendings.
• 56:46And we then went to
• 56:47our attendings to get letters
• 56:48of recommendation. So
• 56:49the system was two two
• 56:51two tier,
• 56:52preclinical
• 56:54and then after. And there
• 56:55was enough opportunity to generate
• 56:57great letters and great experiences
• 56:59for the training programs to
• 57:01analyze and, evaluate us later
• 57:03on. And I assume that
• 57:05that's still going
• 57:07on. Wonderful.
• 57:08Well, I just want wanted
• 57:10to add one thing about
• 57:11the,
• 57:12step one and how you
• 57:13mentioned it. Like Dean Francis
• 57:14said, we don't know about
• 57:16the rates, but one thing
• 57:16I wanted to bring up
• 57:17is that the school
• 57:19is piloting.
• 57:20It's kinda funny because it's
• 57:21the traditional way other schools
• 57:23have in step one instead
• 57:24of,
• 57:26after
• 57:26your clerkship year, how I
• 57:28did it and Katrina did
• 57:29it, to moving it, to
• 57:31right before you start your
• 57:32clerkship year. Again, which is
• 57:34like the traditional way what
• 57:35has been done. And I
• 57:36don't know the numbers. I
• 57:38know they're still analyzing it
• 57:39because it was just the
• 57:40first three months of this
• 57:41year. But it was interest
• 57:42in studying for the boards
• 57:43at the same time as
• 57:44the students, kind of the
• 57:45year below me, and seeing
• 57:47how their preparation for being
• 57:50closer to the preclinical
• 57:52curriculum was different than mine,
• 57:53having taken some time off
• 57:54from no more basic science,
• 57:56but at the same time,
• 57:57having time to incorporate the
• 57:59basic science with clinical medicine.
• 58:01Sometimes I knew a question
• 58:03on an MBME or a
• 58:04practice exam because I had
• 58:05seen it firsthand in a
• 58:06patient, and it resonated with
• 58:08me. Whereas
• 58:10perhaps if you're in a
• 58:10preclinical, maybe you came across
• 58:12a student like that or
• 58:13a patient like that, but
• 58:14you're really remembering
• 58:16your book learning, your didactics.
• 58:18So it's just different type
• 58:19of learning. I hope that
• 58:20helps.
• 58:21One last question, ladies and
• 58:23gentlemen. Wilma, our vice president,
• 58:25please.
• 58:25It had to be me
• 58:26and it had to be
• 58:27just nitpicking.
• 58:29But
• 58:29when you talk about, you
• 58:31know, the test scores and
• 58:33relativity and so on, just
• 58:35keep in mind too
• 58:37that these days Yale
• 58:40admits students who do very
• 58:42well on test taking.
• 58:44Your average
• 58:45MCAT scores are well above
• 58:48the majority of schools.
• 58:51So
• 58:52it may not be as
• 58:53important
• 58:54to worry about the tests
• 58:56as it was back
• 58:58in the 1970s
• 58:59and 1980s
• 59:01when
• 59:01Yale didn't pay quite as
• 59:03much attention to MCATs coming
• 59:05in.
• 59:06Spectacular.
• 59:07I appreciate the panel very
• 59:09much. Each each of you,
• 59:10thank you so much. I
• 59:11appreciate the audience.
• 59:18Thank you.