To Train Physicians of the Future We Can’t Be Stuck in the Past
Robert A. Harrington, MD: Hi, I am Bob Harrington from Weill Cornell Medicine and I’m here at the American College of Cardiology (ACC) Meetings in Chicago. And I always use these meetings as a chance to catch up with friends, colleagues, and talk about something that’s really in the cardiovascular news. Today, I’m really fortunate to be with a good friend, Dr. Jeff Kuvin, who is the chief and professor at Hofstra/Northwell in New York. So, thanks for joining us.
Jeffrey T. Kuvin, MD: Thanks, Bob. Great to be with you.
Med School is Just the Start
Harrington: You are the perfect person to have this conversation, because you’ve really been out in front trying to help all of us in this notion of maintenance of certification training for cardiologists, lifelong learning. But I want to go back earlier, and we’ll eventually get to cardiovascular boards, et cetera. But what I want you to actually help our audience think about, Jeff, is how do we educate, train, and maintain education for cardiologists of the future?
You and I are from the previous generations, but before we came on screen, I was talking to you about a mutual friend, Joe Green, who had been at the American College of Cardiology for many years. He’s very big in the continuing medical education (CME) world. And Joe once showed a graph that showed undergraduate medical education: 4 years, 5 years. Graduate medical education: 5, 6, 7, 8 years. CME: 40 years.
And he said all of our attention is on the first two, not the last one. So give me your broad view of how we should be training cardiologists. Not so much what they need to know, because that’s going to change, but how we should be educating and training them.
Kuvin: First of all, thank you for having me and I can’t think of a more topical issue to discuss. It’s so important to teach the next generation how to be clinicians, how to be competent cardiologists, and as you said, this is a lifelong journey. You don’t finish your education in the pre-medical world or even after graduate medical education. We’re never done being educated.But we need to know what we need to know and how to address the issues that we don’t know. We need to be involved in our own education and embrace it. This is good. It shouldn’t be a punitive approach to education. So we have to embrace the concepts that we need to continue to learn.
But how we teach and how we learn is evolving. The way you and I learn through textbooks and lectures — it doesn’t exist anymore. Generations now have grown up with cell phones and computers, and now AI. How do we incorporate all of these into our educational offerings? I think we don’t know the exact answer, but we need to engage our students.
Harrington: I was in a session yesterday at the convention center on harassment in the workplace, and you’ll see the relevance — one of my colleagues made the comment that we have so many generations in the workforce. I think about my own place. We have people in their twenties, we have people in their eighties and everything in between. They learn differently, and people like you and I who are interested in education really have to be able to accommodate that, don’t we?
Kuvin: First of all, students and graduate medical education trainees are smarter than they’ve ever been before. Remember, knowledge is what we know, but it’s the application of knowledge. How we actually translate that to the patient. That’s competence. So how do we make that bridge, from what you know in your brain or what you can find out on your phone, to actually taking care of patients and ultimately affecting outcomes of patients.
Harrington: I love the way you said that, because what we know is going to change and the listeners have heard me say over the years about Dr Gene Stead at Duke, who formed the Duke Data Bank, for example: very visionary thinker about education. He used to say never teach anything that you can look up. He said this in the 1970s when looking things up was not that easy. But today we’ve got AI, we pull out our phone and look something up.
On rounds it used to be, “why don’t you look that up and on Friday give us five minutes”. Somebody can look it up and give you five minutes on it right now.
Kuvin: That’s right. And our patients are demanding it, right? Our patients know a lot more than they used to know. I would argue medical knowledge is not just about answering a test question, it’s about the other competencies. Are you professional? Can you communicate? Can you work in a system of medicine? And the system of medicine is getting so complicated. We need to teach that, and then we need to make sure that people can adapt to changes in medicine every single day. And as we practice, the medical world continues to change.
Harrington : I mean, just think about a meeting like ACC and the things that we learned over the weekend, we’re going to go ahead and do them next week.
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