How Richard Belitsky led medical education at Yale into the 21st century
The way students learned medicine and doctors practiced it looked quite different in 1979. That was the year Richard Belitsky, M.D., HS ’82, FW ’83, the Harold W. Jockers Associate Professor of Medical Education, associate professor of psychiatry, and deputy dean for education, arrived at Yale as a psychiatry resident after graduating from the University of Florida’s medical school. After his residency, Belitsky stayed on as the unit chief of an inpatient psychiatric service at the Connecticut Mental Health Center. He logged tireless hours for his first passion: patient care. “I was moved by how hard it is not just for patients to cope with their illness, but also the stigma that goes with it,” Belitsky said. As he guided and mentored medical students, residents, and other trainees, he discovered a second love: teaching. His supervisors picked up on this, too, and afforded him opportunities to become further involved in medical student and residency education.
In 2006, he became the school’s third deputy dean for education. Two years after his appointment, Dean Robert J. Alpern, M.D., Ensign Professor of Medicine, charged Belitsky with spearheading a strategic planning process for medical education. Belitsky, who has twice won the medical school’s top teaching award, did not hesitate. He began an in-depth assessment of the school’s medical education and resources that recommended building a new curriculum and creating a Teaching and Learning Center that would provide expertise in best teaching practices, program evaluation, student assessment, and use of technology to promote learning. Starting in 2010 until the curriculum rollout in August 2015, Belitsky and countless colleagues redesigned how medical students are taught at Yale. “One of the proudest and most wonderful moments,” Belitsky said, “was seeing the shift from all of the understandable worries and concerns about a new curriculum to seeing the excitement and enthusiasm of our faculty sitting around the table, planning parts of the curriculum.”
At the end of the curriculum’s first year, Belitsky and the faculty await data and assessments to know how the rebuild is affecting student learning.
Why did you decide to do the curriculum rebuild? We looked at the explosion in scientific knowledge—like proteomics and genomics—that was changing our understanding of the disease process. We looked at the shift from inpatient to ambulatory care, the increase in chronic illnesses like hypertension, diabetes, and obesity. We looked at the change in structure and financing of health care. We considered the changing expectations of society—more patient-centered care, greater communication, more attention to cultural competence, greater fiscal responsibility, and more attention to patient safety. We were also aware that technology was changing the way students receive and expected to get information. They want it remotely, they want it immediately, they want it always accessible, and they want it to be up to date at all times. With all the changes going on, it made the most sense for us to build a new curriculum from the ground up.
What was one of the most challenging aspects of the rebuild? It meant bringing together people with very different ideas and opinions about medical education, what we should be teaching, and how we should be teaching it—bringing those people together to share ideas, to plan, and to achieve consensus. That really was the biggest challenge. We were able to achieve this by a steadfast commitment to an open, inclusive process with ongoing communications, meetings, conversations, and discussions over several years.
What has been your proudest moment so far? We have Second Look Weekend, which is when applicants who have been accepted to the school come back and take another look. During the most recent Second Look, we had a panel discussion, and our students who had just completed their first year in the new curriculum talked to prospective students about their experience. They highlighted how much they liked the integration of material and how well thought out it seemed to be. They explained that it gives them context and helps them understand the importance of the basic sciences in becoming a physician. It meant that our students understood what we were trying to accomplish, and even though not perfect, they understood the value of the changes that we were making.
How will you know whether the new curriculum is working well? This is very important to us and we are continuously monitoring the effectiveness of our new curriculum. We have a thorough review process that carefully looks at a variety of data, including student and faculty feedback as well as results from qualifiers, self-assessments, and other tools designed to assess student learning. This helps us to know how successful our students are in the new curriculum—how well they are learning, progressing, and achieving their goals, and it provides the kind of information we need to continuously revise and improve on what we are doing.
Click here to watch a video of our interview with Richard Belitsky.