With the redesign of the UC College of Medicine curriculum, educators are placing more emphasis on exposing students to relevant patient interactions earlier to get them accustomed to taking medical histories and tailoring care to the individual.
Now, students will also learn that, in many cases, there’s more to treating patients than ordering a surgical procedure or prescribing a bottle of pills.
This fall, the Physician and Society 101 and 201 courses—directed by Joseph Kiesler, MD, associate professor of family and community medicine, and Zelia Correa, MD, PhD, associate professor of ophthalmology—began including complementary and integrative medicine concepts to help students learn how to incorporate these practices, many of which are already being used by patients, in medical treatment.
Sian Cotton, PhD, associate professor in the department of family and community medicine and director of the new UC Center for Integrative Health and Wellness, says there is a need for this type of education in medicine to improve the way future physicians practice and care for themselves.
"Conventional medicine focuses on pharmaceuticals and surgical applications to help patients, which certainly have their place and benefit. However, integrative medicine is relationship-centered care that incorporates conventional medical approaches with evidence-based complementary medicine practices for optimal patient outcomes,” she says. "Modalities such as mindfulness meditation, stress management and relaxation, yoga, Pilates, massage, healthy nutrition and other methods have been shown to help both chronic and acute conditions.
"Before now, students at the UC medical college were not thoroughly introduced to these concepts as a way to enhance treatment and improve overall wellness, although many patients are already using them in their day-to-day lives.”
As of this fall, Cotton and other integrative medical faculty have lectured on concepts of complementary medicine—for first-year students, they presented, "Optimizing Patient Wellness,” and for second-year students, they presented, "Integrative Approaches to Rheumatologic Conditions.” In addition, Cotton and her team of experts were invited to provide complementary and integrative medicine content to second-year students’ case material with plans to review additional cases in the upcoming year.
"In the first two years of medical school, students are given weekly cases in which they must determine the best treatment options for a patient based on the personal and clinical information provided,” she says. "They’ve started to include questions like, ‘What non-pharmacological approaches could be used to help this patient?’ It’s really rewarding to be able to teach our students about the evidence for many of these approaches, and frankly, to put them more on par with the training of their peers around the country.”
Cotton and her team have also conducted grand rounds in integrative medicine in three departments within the College of Medicine over the last year, with more planned in 2013.
"Working with Sian and her colleagues is a great opportunity to help medical students expand their skill set as future physicians and improve the health of their patients,” says Kiesler. "As a family physician, I see how our patients want and need additional treatment options. This curriculum will allow students to feel comfortable and competent with addressing the need for integrated care.”
Cotton says about 50 out of 150 medical schools in the U.S. belong to the Consortium of Academic Health Centers for Integrative Medicine (www.imconsortium.org) where they are bringing integrative medicine concepts into clinical, research and educational activities within their medical schools.
"Our medical school administration has really stepped up this year to put Cincinnati in the group of medical schools now leading in this area,” she adds. "We have the unique capacity at UC and UC Health to not only provide outstanding integrative medicine clinical services but also to do high-quality research, becoming leaders in training the next generation of care providers.”
As additional training, Mary Ann Barnes, MD, volunteer assistant professor in the department of family and community medicine, also coordinates a Complementary and Alternative Medicine elective for fourth-year medical students, housed in the department of family and community medicine.
The month-long elective includes didactic and shadowing experiences for trainees in their last year of medical training.
"The students learn to cherish themselves and their patients as bodies, minds and spirits,” Barnes says. "Evaluation of modalities and their evidence-basis is also a large part of the rotation. With this knowledge, they can more confidently help their patients navigate through all of the possible treatments available and make the best choices given each patient’s preference.”
Cotton, who is not only an educator but also an outcomes researcher who has studied the benefits of complementary and integrative medicine, says that with all of this training in place, future physicians will be better equipped to handle patients in all populations, and a well-rounded care model for physicians in training will also be created, increasing patient satisfaction.
"As medical practitioners, we need to be aware of the evidence behind these techniques and learn ways to incorporate them into our practice and into our own lives for best possible outcomes,” she says. "We’re excited for this opportunity to teach thesetechniques to doctors and health leaders of the future.”