Early Exposure, Lasting Benefit

Medical students get hands-on clinical training

An externship program in the Department of Anesthesiology is providing some first- and second-year medical students with significant time and experience in the clinical setting, an aspect of medical education more typically reached by students in their third year during clinical rotations.

“We started this program in 2003 after we noticed that some of the strongest applicants to our anesthesiology residency were Iowa Medical School graduates who had completed an anesthesiology externship,” says Christopher Turner, M.D., Ph.D., an associate professor in the Department of Anesthesiology. “We decided that this type of exposure for beginning medical students would be worthwhile.”

Each fall, the externship recruits two or three new first-year students by sending an e-mail to all members of the new class explaining the benefits, responsibilities, and pay scale of the program. Turner normally receives 15-20 applications, and he and his team choose those who they feel will benefit most from the experience.

There are five externs in the program at one time; each works a five-hour shift one weekday evening. All begin as first-year students and continue through their second year.

“The externs function as anesthesia technicians in the operating room,” explains Turner. Their duties include stocking carts, cleaning anesthesia machines, turning over rooms between cases, bringing drugs and equipment to anesthesiologists and assisting with the transport of critically ill patients.

As students gain experience, they can run intraoperative labs and provide some direct patient care, such as assisting with placement of central venous or pulmonary artery catheters or airway management duties — under close observation. “It starts with basic technician work,” Turner says, “but by the end of the second year, they’re providing patient care side by side with the anesthesia residents.”

Megan Krajewski, M.D., who graduated in May and will do her anesthesiology residency at Brigham and Women’s Hospital in Boston, Massachusetts, says that the externship was an integral part of her success. “The benefits were enormous,” she says. “It enabled me to gradually develop my confidence. After being in the program, I felt very comfortable, not only interacting with the staff, but also being in clinical situations.”

Amy Li, who just completed her second year, values the experience. “I’ve watched all kinds of procedures, including neurosurgeries, laparoscopic surgeries, ENT, and orthopedics.” First-year student Kevin Duan feels the same way. “It’s allowing me to see the different specialties in a way that you don’t normally see until your third year. For me, it’s about exposure.”

“The externship wasn’t developed as a way to recruit students into anesthesiology,” Turner says. “We set the program up to give students an exposure to critical care medicine. If they go into emergency medicine, medical or surgical critical care, or any of the surgical specialties, including trauma and burn, these are skill sets that they will put to use every day.”
—NICK CHARLES

CNN medical correspondent Sanjay Gupta (M.D. 1993, Residency 2000) addressed the Medical School Class of 2009 at the May 8 commencement ceremony in Hill Auditorium. Read more about his remarks, watch a podcast of the event and view photos from the ceremony.

Going Global

On June 1, Joseph C. Kolars, M.D. (Fellowship 1989), began a new appointment as the Medical School’s first senior associate dean for education and global initiatives. An internationally recognized expert on physician education and global health, Kolars will lead efforts to adapt and enhance the full spectrum of training at the Medical School — from students to continuing physician education to biomedical research education — and integrate it with global impact. Before beginning his U-M appointment, Kolars, a professor of internal medicine, was a member of the Mayo Clinic faculty and also developed medical education initiatives for the Bill and Melinda Gates Foundation.

Jessica Schwartz, Ph.D., professor of molecular and integrative physiology, and Graciela Piwien-Pilipuk, an investigator at the Leloir Institute in Buenos Aires, Argentina, have received a Fogarty International Research Collaboration Award designed to encourage collaborative research on global health issues between scientists in the U.S. and those in developing countries. Schwartz and Piwien-Pilipuk will study genes and proteins that regulate fat cell differentiation. Graduate students from Argentina will complete part of their studies in Schwartz’s U-M laboratory.

Medical student Matthew Simpson was one of several U-M students selected to participate in the Clinton Global Initiative University, held in February at The University of Texas in Austin. Working with students from the School of Dentistry, School of Information and the Gerald R. Ford School of Public Policy, the team presented a plan to make the Medical School’s two-year pre-clinical curriculum available via the Web as an open educational resource for local health care professionals working in Africa.
—SP