Associate Dean of Student Affairs Peter Katsufrakis has been scanning columns of numbers, looking for hints about how the USC School of Medicine compares with the nation’s other medical schools.
The long lists of statistics may also give him ideas about USC’s strengths, areas that may need improvement and a student’s-eye view of the medical training program that USC faculty have carefully laid out.
The numbers under scrutiny are the results of the 1997 American Association of Medical Colleges survey of graduating medical students. The national student exit poll asks new MD’s about themselves, their educational experiences and future plans. The 1997 respondents totaled more than 14,000 students, with some 156 USC medical students taking part.
Some of this year’s findings were no surprise: USC students stood out in terms of diversity, community service and a commitment to practicing in California. And though some 10 percent of students felt they spent an “excessive” amount of time on some areas – such as patient-interviewing skills – those kinds of responses don’t necessarily bother Katsufrakis. Patient interviewing is one of the skills the USC program means to emphasize.
On the other hand, some student responses reflect aspects of the program that have already been changed – such as the complaint that not enough time was spent learning about out-patient care during internal medicine rotations. “In fact, we now have a required out-patient component in internal medicine that wasn’t in place a few years ago,” Katsufrakis said. In summarizing the findings for campus administrators, Katsufrakis focused on areas where USC student responses differed significantly from national averages. He is quick to point out, however, that “these don’t indicate whether we’re doing a good job or not. But in some cases they do point to areas that we could do better,” he said.
At best, Katsufrakis believes the survey can be used as a tool to focus faculty attention. “To use a medical metaphor – it’s really more of a screening tool than a diagnostic test,” he said. A few of the highlights: USC serves as training grounds for a diverse cohort of future doctors, with 18 percent of the 1997 class self-identified as part of an underrepresented minority (African-American, American Indian/Alaskan Native or Hispanic) compared to just 10 percent at other schools. Asian or Pacific Island students also made up a greater portion of the school – 17 percent – when compared to the 4 percent national average. USC students also stood out from the nation’s medical students in their volunteer efforts. Nearly half of USC students reported spending free time during their medical training to care for underserved populations. A full 60 percent of USC students reported making themselves available as a role model for those interested in health careers by giving talks to high school and college students about medical careers.
The vast majority of USC graduates – 91 percent – planned to practice in California. In terms of education, USC students gave higher than average “approval ratings” to their basic science education and Family Medicine clerkships.
Some of the disappointments voiced by the 1997 graduates are mirrored by many other medical school graduates and may touch on more general issues in medical education than anything specific to USC. For example, large numbers of students everywhere felt that they didn’t spend enough time on patient follow-up, long-term health care, teamwork with other health professionals, geriatrics, alternative medicine, medical law, termination of pregnancy, medical genetics and working with community health and social service agencies. But more USC students than average felt they spent too much time training in the care of hospitalized patients, with 19 percent expressing dissatisfaction compared with 12 percent from other schools.
And only 8 percent of USC students (compared with 25 percent nationally) had been trained in using computer-based clinical record keeping, but 42 percent (compared to 25 percent) used computerized case simulations in their training. Both of these were red flags to administrators, who were already focused on the problem. Katsufrakis says he expects both of these numbers to go up as the school pushes for more emphasis on computer technology. In fact, when the class of 2002 arrives on campus next fall, he anticipates they will each be required to have a computer, in part to facilitate more high-tech learning.
USC students were also more likely than their peers to say that attending faculty were not adequately involved in teaching and evaluation during clerkships and that residents played too large a role in their teaching. USC students reported higher than average indebtedness, with 29 percent owing $150,000 or more upon graduation compared to the 6 percent national average.
Katsufrakis gained some insights from the survey, but said he tries to take it with a grain of salt. These are opinions, he said, and subject to change with each class. In addition, students across the country want more instruction in things like practice management and cost-effective medicine. But these simply aren’t priorities for the medical school. “It could be argued that there’s already too much material. Things like learning about cost containment or medical business may just be more appropriately taught during residency,” Katsufrakis said.