“Healing Beyond Science”

By Robert Folberg, MD

The title of this post is framed within quotation marks because the words are not mine. They were delivered by Mary Fisher, an author, artist, and AIDS advocate on the occasion of receiving an honorary degree as part of the commencement of the Charter Class of 2015 from the Oakland University William Beaumont School of Medicine (OUWB). Wing of Zock invited me to provide a follow-up to my post published earlier this year, “Kindness Beyond Curriculum,” where I described the underlying innovations that OUWB brings to medical education as a new medical school. I invite you now to pause and listen to Fisher’s address. [Fast forward to the 4:40 mark to skip the conferral of the degree if you wish.]

Fisher asked our graduates, “I understand that you must ask me to show you my body, but do you understand it is an act of intimacy, and that I would like you to show me your soul?” As Founding Dean, I and my leadership team asked ourselves, “Did we prepare our students for this challenge?”

We built OUWB on the premise that mastery of science and skills is essential, but a medical education limited to science is incomplete. Every aspect, every detail invested in building OUWB – the curriculum, the people, the learning environment, the community engagement – was designed to prepare our students to engage in healing beyond science through careful attention to how they live their lives in medical school.

Is there any evidence to suggest that we are succeeding?

At commencement, my thoughts turned to a time when I toured the construction site of a new OUWB classroom. After learning about the new technology being installed, the foreman turned to me and related that earlier in the week, OUWB students took the same tour and thanked him and his crew for building a beautiful classroom in which to study. He told me, with some emotion, that this was the first time in his construction career that anyone had thanked him for his work. Perhaps, he reflected, wearing a hard hat meant to some that he wasn’t educated, or had no need to be appreciated.

OUWB views the expression of gratitude to construction workers and custodians, among others, as critical practice for thanking nurses, pharmacists, social workers – all members of the health care delivery team. This practice lays the foundation for teamwork. Moreover, the institutional expectation that gratitude be expressed is an antidote to physician arrogance: It is difficult to be arrogant while thanking someone.

Although the question of whether a medical student should attend his or her own graduation has been debated, the OUWB student body (M1-M3) volunteered to attend commencement, dressed in their white coats. Why? They wanted to support the graduates and to be inspired by their example. The student body intends for this to be an annual OUWB tradition. OUWB is a community. The students refer to OUWB as family, a support system. We suspect that this sense of community elevates the heightened attributes that led to their selection as compassionate and empathetic people.

And then there is the matter of the oath that our graduates recited. The class worked for four years on their graduation oath. Based on the framework of the Declaration of Geneva, this Oath of the Class of 2015 included promises that are not found in the classic Oath formulation, promises that inspired us: “I will care for myself so that I am able to care for others. I will advocate for my patients’ best interests … I will acknowledge my limitations and ask for help when I need it … I commit to lifelong scholarship and will let evidence be my guide … I will be brave in the face of adversity …”

Did the Charter Class excel in the traditional medical education? Each member of the charter class placed into a residency position in the discipline of their choice, including the “super-competitive” fields. OUWB sent graduates to the most competitive and prestigious residency programs in the United States. Our full match results are online.

In my previous post, I made reference to a medical student who was interviewed by the Detroit News in August 2014, who said, “Not only are they showing me how to be a kind and compassionate doctor, but they show me all the time how much they care about me as a person… They model the behavior that they want from us.” Just a few weeks ago, this student became one of 55 medical students nationwide selected for the year-long NIH Medical Research Scholars Program between the third and fourth year of study. The OUWB first match and the experience of this OUWB medical student and others suggest that anxiety over the ability of new medical schools to achieve excellence in the medical sciences may be unfounded. One can generate medical students who are both brilliant and kind.

The occasion of the OUWB charter class graduation generated interest by the local press. In publications like the Detroit News and the Detroit Free Press, students revealed that they chose to come to OUWB because of its distinctive vision. Just as we selected them for experiences and attributes that would predict academic success coupled with empathy, compassion, and engagement, they selected us for pairing science with mastery of the personal characteristics of physician capable of showing one’s soul to a patient.

folberg_robert_2012_smallerRobert Folberg, MD, is Founding Dean, Oakland University William Beaumont School of Medicine, and Chief Academic Officer, William Beaumont Hospital. He can be reached at rfolberg@oakland.edu.

5 thoughts on ““Healing Beyond Science”

  1. The work described by our colleague Dean Folberg at our sister school, the Oakland University William Beaumont School of Medicine (OUWB), is an example of innovation, a hallmark of the new medical schools. As a now 3-year old “new” school, Cooper Medical School of Rowan University (CMSRU), we are creating a brand based on innovation in medical education, service to underserved communities and the creation of physician leaders. Our focus on community-based service learning in Camden NJ and a four-year student-run ambulatory clerkship are among the new approaches to teaching and learning that we have adopted.

    Medical science is the foundation of the curricula in the new schools and as a group, new medical school graduates are capable of the same level of scientific achievement as graduates from legacy schools. Consider the 54 medical students selected into the NIH Medical Scholars Program in April, 2015 . Four came from medical schools that graduated their first classes in this decade alone. Given the very small enrollment of the new medical schools, one might suggest that our graduates are over-represented in this talented cohort.

    Let us acknowledge that all medical schools contribute mightily the health of our country. But let us also acknowledge that “membership” in NIH’s Top 25 or US News & World Reports “best” medical schools likely ignores the significant contributions of new schools who are committed to producing a “different” kind of physician.

    Paul Katz, MD
    Dean, Cooper Medical School of Rowan University

    1. Congratulations to the recent graduates of OUWB. Just as Deans Folberg and Katz have emphasized that students graduating from the smaller new schools ( the so called not in the top 25 in USNWR rankings) have to ensure that the graduates are well grounded in medical sciences, so do those in the top 25 list have to ensure that their graduates are compassionate, kind and caring. At the University of Chicago, we take this latter responsibility quite seriously. We are fortunate to have the Bucksbaum Institute of Clinical Excellence on campus that serves as a center for fostering social skills ( communication, ethical behavior, compassion). The Institute supports student scholars, junior faculty scholars, master clinicians and senior faculty scholars http://bucksbauminstitute.uchicago.edu/about/

      Vinay Kumar, MD
      Professor and Chair, Department of Pathology
      University of Chicago

  2. Powerful comments. My hope is that the students and graduates will carry them with them through their careers. Thanks for sharing, Dean Folberg.

  3. Of my resident mates at Wills Eye Hospital in the late 1970s, none have left a more important or indelible legacy on the education of the next generation of American physicians than Robert Folberg. He has given real meaning to the motto of Wills Eye Hospital, “Skills with Compassion”. Bob has helped us not only become more complete physicians, but more compete human beings. For this I am sincerely grateful.

    Richard K. Parrish II, MD
    Edward W. D. Norton, M.D. Chair in Ophthalmology
    Associate Dean for Graduate Medical Education
    University of Miami Miller School of Medicine
    Designated Institutional Official
    Jackson Health System/Jackson Memorial Hospital

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