You Majored in What? Unusual Backgrounds for Med Students

The new Dell Medical School at the University of Texas at Austin didn't set out to recruit students with unconventional degrees. However, that is exactly what happened: Of the 50 students in the school's inaugural class, scheduled to begin in the fall of 2016, 21 have majors outside of the typical premed choices. Psychology, philosophy, and Spanish majors are represented, as are nurses and engineers.

"We looked for initiative, and for leadership, and for experience working in and with communities to improve health outcomes in those communities," Stephen Smith, PhD, associate dean for student affairs at Dell tells Medscape. The diversity of majors was a side effect of finding people who had already become leaders in their communities, he explained. For example, some had worked on policy committees.

Dell is one of a growing number of medical schools trying new approaches to the way they educate future physicians. As a result, they're attracting students with experiences and backgrounds that go beyond the expected biology or chemistry majors.

"They need to think differently, they need to approach problems differently, they need to think outside the box in new ways. They need to really be a broad thinker and also have tremendous depth in many different fields of science and technology," M. Katherine Banks, PhD, engineering vice chancellor and dean at Texas A&M University, tells Medscape regarding the physicians she envisions graduating from the school's EnMed (engineering and medicine) program. In this program, engineers will become "physician engineers," able to design devices, apps, and surgery robots without the tedious back-and-forth between an engineer and a doctor. That program is set to begin in the fall of 2017.

Approaches like Dell's and EnMed's are trying to do more than fill a need for more doctors; they are working from an idea that the healthcare of the future will be based on more than traditional medical skills. With technology playing a bigger role than ever, public and community health approaches are getting more recognition as essential tools in keeping people healthy.

It's not just new schools that are taking these approaches. The American Medical Association's Accelerating Change in Medical Education Consortium has been awarding grants to schools that take new approaches to education. Dell is one of them, along with 30 other schools, including big names like Harvard and the University of California, San Francisco.

The consortium's "key areas" for changing medical curricula read like a road map for transforming medicine. Students are learning to solve problems and constantly reassess their knowledge; to understand sociologic and economic factors that affect patients' health and access to healthcare; and to analyze data on costs and outcomes, to name just a few goals.

Dell's recognition in the consortium relates to its leadership-focused curriculum. The school aims to take advantage of its students' initiative with case-based learning and have them work in small teams. In choosing students, Dell designed an assessment whereby small groups would have to solve a problem together. They were evaluated not just on the result but also on how they worked with others and resolved disagreements.

In their third year, Dell students have a choice of either pursuing a master's degree (in public health, business administration, biomedical engineering, or educational psychology) or undertaking a project to improve healthcare in the local community. The school assists students in designing projects that meet an identified need. Then, after a vote to decide which ones will be implemented, students work in teams to carry out the projects and evaluate their outcomes.

The EnMed program, likewise, expects students to begin working on innovative projects while they're still in school. "We feel that every one of our graduates should invent something before they graduate," Dr Banks explains. Unlike traditional MD/PhD programs, which already exist for engineering, the EnMed program integrates medicine and engineering into the same curriculum. The school plans to develop a “makerspace ”where students can work on their inventions, as well as an office of technology commercialization to help bring those inventions into real-world use.

Administrators see these new programs as adding to students' options in medical schools, not rendering other approaches obsolete. "Engineers can go to medical school now, and if they want traditional medical school, they should [attend]," Dr Banks says.

Adam Eickmeyer, who recently completed the University of Michigan's undergraduate program, is looking at medical schools that incorporate nontraditional programs and is finding plenty of options. He designed his own major, titled "Determinants and Inequities in Healthcare." It melds biology with humanities courses, culminating in a thesis on inequities in lesbian, gay, bisexual, transsexual, and queer health.

Eickmeyer sees medical schools becoming more welcoming to students who want to add humanities and social sciences to their pursuit of medical education. For example, the MCAT now includes a section on social and behavioral sciences. He explains, "I think that shows that the medical field is starting to realize that doctors don't just have to be really good basic scientists; they also need to be able to think about these issues from a social perspective and a humanitarian perspective."

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