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Pioneering the Model of the New Physician

What qualities and attributes do patients want in their physicians? How can a patient know his doctor is fully competent?

These are questions being addressed with medical students at the University of Rochester School of Medicine and Dentistry. After an in-depth inquiry and analysis, two leaders in physician education, Ronald M. Epstein, M.D., a practicing physician in the Department of Family Medicine, and Edward M. Hundert, M.D., dean of the School of Medicine and Dentistry have created an innovative approach to educating today's doctors and assessing their competence. Their goal is to instill in physicians the kinds of qualities patients want: trustworthiness, good judgment, good communication, and the ability to keep up-to-date with changes in the field.

Their approach is realized in Rochester's innovative Double-Helix curriculum. Dean Hundert, the architect of the curriculum, and Dr. Epstein, who has spent his career researching and teaching about the patient-physician relationship, share their views on what makes a good doctor in an article in the Journal of the American Medical Association (January 9, 2002 issue). Hundert and Eptsein believe educators must make sweeping changes in medical education programs to ensure physician competence in typically overlooked areas such as teamwork, interpersonal skills, clinical reasoning, and managing ambiguous clinical situations (a necessary real-world skill that traditional schooling doesn't teach).

Training and assessment in these areas is already part of a medical education at the University of Rochester, where the Double-Helix curriculum gets medical school students involved early in the practice of medicine. At Rochester, students work with patients starting in their first year, not in their second or third year, which is the traditional approach. Basic science and clinical work are intertwined throughout training like the strands of a double helix. At the end of their second and third years, students have a professional-competency assessment that lasts two full weeks and embodies all of the elements of competence laid out in Epstein and Hundert's article.

At its heart, the work of Epstein and Hundert is an attempt to remind the health care industry that medicine is more than knowing the facts and demonstrating skill. "Medicine, no matter how technological it is, is always a human enterprise," says Epstein.