A magazine for friends of the Warren Alpert Medical School of Brown University.

The Rookies

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The new MD-ScM program enrolls its first class.

After years of planning, Alpert Medical School’s first-in-the-nation Primary Care—Population Medicine dual-degree program became a reality in August with the arrival of its inaugural class of 16 students.

The program integrates traditional medical education with a new expertise to understand the transformation of the US health care system, says Paul George ’01 MD’05 RES’08, director of the program and associate professor of After years of planning, Alpert Medical School’s first-in-the-nation Primary Care—Population Medicine dual-degree program became a reality in August with the arrival of its inaugural class of 16 students. family medicine. The system that remunerates doctors for treating a high volume of individual patients is giving way to one in which doctors not only provide personal care, but also account for the quality delivered to their entire patient population, he says. Physicians will lead and work in teams of different providers. They will measure quality and test ways to improve outcomes in the context of social determinants of health.

The students who have enrolled in the PC-PM program are looking to get ahead of these trends. Michelle Diop MD’19 of Boston, who studied anthropology at Columbia, applied because the program encompasses a broad, social context for medical practice. “When I become a doctor, I want to be an educator, I want
to be a mentor, I want to be a social worker, and a health care provider who helps my patients holistically,” she says.

Faiz Khan ’15 MD’19 says he became excited about the PC-PM program as it emerged while he studied community health as a Program in Liberal Medical Education undergraduate. “I took a class on the US health care system,” Khan says. “I got to see not just the science of medicine and how medicine is done, but whether it is actually working.”

An Integrated Curriculum

As in Brown’s traditional MD program, the MD-ScM curriculum includes all the training—anatomy, genetics, pathophysiology, and so on—needed for serving patients’ medical needs. But it also covers the science and patient experience of real-world health care delivery, as well as leadership, George says.

Unlike an MD-MPH program, PC-PM integrates material of both fields so that students who learn about an aspect of health care in classes or research will have immediate opportunities to apply their understanding in practice. “The goal is to provide students with an integrated set of knowledge, attitudes, and skills that will allow them to care for individuals, families, communities, and populations when they become practicing physicians,” says Jeffrey Borkan, MD, PhD, assistant dean for Primary Care-Population Health Program Planning and chair of family medicine.

In the first year, students will follow patients, helping them to navigate the health care system. In the third year, rather than rotating through six-week clerkships in various specialties, students will remain engaged in a nearly yearlong longitudinal integrated clerkship where they will spend half a day a week
with a mentoring physician in the community. Students will see how patients come in and out of the system and respond to treatment plans over a meaningfully long term. Two of the master’s degree courses are embedded within this medical experience.

In addition, third-year students will be assigned a panel of approximately 30 patients to follow through the system from primary care through hospitalization, rehabilitation, or home care. If a patient is experiencing a major medical event, such as giving birth or undergoing surgery, that will take precedence over more routine classwork, which will be made up later, George says.

While PC-PM is a distinct program, key lessons about population medicine are integrated into the curriculum of all Alpert Medical School students. “As initially envisioned, it was going to be a separate track, but as we were in the process of implementing the program, we realized that population medicine is something in which all graduating medical students need to have expertise,” says Allan Tunkel, MD, PhD, associate dean for medical education. “We’ve moved to a model of integrating the important principles of population medicine across the curriculum with additional experiences for the students in this program.”

The American Medical Association’s Accelerating Change in Medical Education Consortium supports Brown’s PCPM program. As one of the inaugural 11 members of that expanding effort, Tunkel says, Alpert Medical School is in a position to work with the other consortium schools to provide a model for the future
of medical education. “We’re going to determine whether the program we’ve developed has lived up to the goals and objectives that we expected,” Tunkel says. “The follow-up is important and it really has to be long term.”

Among the goals is whether students in the program pursue primary care careers, although that is not required; any physician can benefit from studying population medicine, George says.

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