Broadening the Sphere of Medical Education: Observation and Training in the Private Practice

By Todd E. Schlesinger, MD, FAAD | Dermatology and Laser Center of Charleston

Continuing changes in the healthcare landscape have left medical professionals with gaps in their education.  Healthcare is evolving at a rapid pace, often outpacing the training programs that provide its workforce. One example is in the area of medical economics.  Medical education must be aligned with the practice of medicine that its students will face when the graduate.  Many aspects of the practice of medicine are not taught or given short amounts of time during training. Health information technology (HIT), billing and coding, human resources management, marketing and branding, regulatory and compliance management, legal matters and finance are all important parts of the professional life of a physician.  Surveys show that medical residents feel their training could be improved in these areas.  While advances in technology and compliance promise to offer improved safety and quality of care in the practice of medicine, physicians must be adequately trained, and on the job training may not be enough to provide the knowledge needed. 

Medical education was and is still based somewhat on the apprentice model.  Medical schools, once heavily geared toward the academic and scientific portions of the curriculum have shifted their focus to a more clinical approach.  However, there are some things that cannot be taught in medical school, even residency, or they are learned too late to be useful.  For this reason, I believe it is important for physicians to open their doors to aspiring medical professionals and also those already in training.  One may be surprised how much students and residents can learn from you, even if they are in an observational role.  Additionally, many physicians may find that they too can learn a great deal from their students.  In order for physicians to remain autonomous, rather than another cog in the big machine of healthcare, they have to be knowledgeable about business matters.  Many young physicians today have little confidence in their ability to work either independently or in the physician-owned practice setting. 

In my practice, we have a variety of educational opportunities for different types of students.  Residents from the Medical University of South Carolina (MUSC) rotate through for varying lengths of time to pick up some dermatology skill.  There are physician assistant (PA) students from MUSC that typically come for a month-long rotation where they are engaged full time.  By being in the environment longer, the PA students can gain more in depth experience with respect to the office workflow.  This may ease their transition to the workforce.  College students may consider a summer research rotation where they are exposed to the Research Center and its operations conducting clinical trials.  Hard workers may even complete the rotation with a publishable poster or scientific article.  Last, but not least, there are various other office visitors such as medical students, college students, high school students, cosmetology students, medical assistant students and others who come for a half-day to a day. 

In conclusion, I enjoy working with young medical professionals and pre-professionals, and I believe it to be a duty of all currently practicing physicians.  We can have a hand in helping to shape the future of medical professionals with this type of training.  In addition to caring for my wonderful patients, it is one of the true pleasures of my job and one that I hope to be able to do throughout my professional career.