Dell Medical School

Summary

Established in 2012, and enrolling its first class of students in the summer of 2016, Dell Medical School at The University of Texas at Austin rethinks the standard medical school curriculum in the United States. While still operating on a four-year model, Dell Medical School has altered several core aspects of its curriculum to better train students in the competencies that they see as most important for the coming generation of healthcare leaders – skills including leadership, collaboration with members of various professions, community engagement, public health awareness, understanding of health systems, and more.

The curriculum contains several components that break, or at least stretch, the common mold of a four-year medical institution. For example, in their third year, students engage in a 9-month curriculum focused on “Innovation, Leadership, and Discovery.” The subject of leadership is an explicit curricular focus throughout the entirety of the four years as well.^[1]

As part of this third year, students can participate in a dual-degree program, meaning that they can earn a coordinate master’s degree in public health, business administration, biomedical engineering, or educational psychology in addition to receiving an MD.^[2] Students can also choose to engage in an independent project in one of three “areas of distinction”: Healthcare Innovation and Design, Population Health, or Clinical/ Translational Research.^[3] Students who opt for the independent project track are required to reach the “pilot” stage for whatever initiative they develop.^[4]

Finally, Dell Medical School takes several innovative approaches to exposing its students to not only the physiology of health and medicine but also the real world of public health and individual patient experience. Students regularly work on projects that engage directly with the local Austin community, with an explicit focus on understanding health disparities and making Austin a model community for health.^[5]

Similarly, the curriculum works from the very beginning to place medical learning in a real-life context. Rather than formatting the basic science around an organ system-by-organ system approach, students are immersed from the beginning in a case-based learning format, in which scientific and medical knowledge is developed through model cases.^[6] To further deliver medical education in a way that represents a real-world care context, Dell Medical School delivers a sustained, four-year focus on Interprofessional Education, giving medical students practice in collaborating with other professionals who are integral to the care process.

Keys to Success

Education on leadership and collaboration

Dell Medical School is founded upon the goal not only of training tomorrow’s doctors but more broadly preparing the leaders who will shape and change medicine and public health at a systems level. The curriculum works to train doctors who not only strive to enact the best care in their own future practices but also to impact health and healthcare at scale. Dell Medical School’s focus on training the next generation of health leaders is exemplified in its unique third-year Innovation, Leadership, and Discovery curriculum, as well as in its ongoing Interprofessional Education track.

The Innovation, Leadership, and Discovery block allows students to pursue particular focus areas of health innovation that interest them, either through the completion of a coordinate master’s degree in one of four areas (Public Health, Business Administration, Biomedical Engineering, and Educational Psychology) or through an independent project in one of three areas of distinction (Healthcare Innovation and Design, Population Health, or Clinical/ Translational Research).^[7] In allowing students to invest such significant focus in a specific area of interest, Dell Medical School places deliberate emphasis on (and dedicates resources to) building the skills necessary to enact change at a broader level than just one doctor with one patient.

Similarly, students at Dell Medical School participate in a track of Interprofessional Education (IPE) throughout their four years, in which they work in teams with students of other health professions, including social work, nutrition, psychology, and pharmacy. The physician, in these collaborations, is not necessarily the team leader, but rather a member of a collaborative group.^[8] Through the IPE curriculum, students gain experience collaborating for team-based care and learn to see patient care from multiple perspectives.

Local engagement

Dell Medical School’s emphasis on working with the Austin community, and making Austin a “model health city,”^[9] demonstrates an understanding that the future of healthcare relies on broad change in the underlying determinants of health, not just in changes in the way physician’s deliver care.

Case-based learning

Built around example patient cases, rather than modules focused on specific organ systems, Dell Medical School’s curriculum aims to teach, from day one, that health is rooted in a complex environment. In each example case, students are asked to develop their own learning objectives, at least one of which must be focused on social determinants of health, not just pathology or physiology.^[10] This continual focus on the interconnection of health and environment prepares medical students to handle the complexity of the patient experience and to understand that sickness, health, and care affect different patients in different ways. As such, Dell Medical School aims to prepare students to deliver personal care in ways that emphasize the priorities of patients.

Ability to Inspire

In trying to improve the dominant model of medical education, Dell Medical School wants to inspire other medical schools. Of course, being still in its very early days, it remains to be seen what impact Dell Medical School will have on the norms of medical education. Nonetheless, there is hope based simply on how the effort is elevating the conversation around this topic.

Drawbacks & Limitations

Dell Medical School cost over $400 million to build,^[11] and with its first class of future physicians comprising only 50 students,^[12] the school does not necessarily represent an easily scalable model in the typical sense of the phrase. Dell Medical School’s impact will largely have to come in the form of leadership and modeling. This can of course play out in more than one way – Dell Med can produce health leaders who guide system-wide improvements, it can model medical education techniques that are replicated in other settings, or its community engagement can help to develop models for cost-effective public health interventions. However, as a new institution, the actual impact remains to be seen.

One other major question concerns what happens to its students after they graduate. While Dell Medical School’s goal is to train the innovators of tomorrow’s health systems, its graduates will largely go on to participate in traditional residencies built mainly on the very model that Dell Medical School’s mission aims to change. As a result, it remains to be seen whether the lack of a logical “next step” in the training of these future healthcare leaders will undermine Dell Med’s original mission.