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Department of Medical Humanities

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Medical Humanities Curriculum

DOCTORING: MEDICAL HUMANITIES CLERKSHIP-YEAR 4
SOCIETY, LAW, AND HEALTH CARE: THE PHYSICIAN AND SOCIETY

INTRODUCTION

The Doctoring:  Medical Humanities curriculum is designed to provide students with core knowledge in the humanities, emphasizing application of the content and methodologies of humanities disciplines to the practice of medicine. Substantive areas of teaching emphasis include ethics, health policy, law, medical history, and psychosocial care. During Year Four, the Doctoring: Medical Humanities Clerkship is a two-week learning experience entitled, “The Physician and Society.”

The first part of the Clerkship focuses on the legal aspects of the physician's role in society with emphasis on the judicial process and the administration of justice. During this time, students will expand their knowledge of the interplay between the medical and legal systems through learning about the physician as an expert witness in civil and criminal proceedings, and the regulation of medical experts. Students also will witness an evidence deposition designed to introduce them to the reality of physician involvement in civil litigation.

During the second part of the Clerkship, students will be provided with an overview of the United States health care system. Strengths and inadequacies of the present system will be considered. Students will examine a variety of important policy issues including the following: access to and availability of health care in the United States; the economics, financing and cost of health care; the setting in which health care is delivered; responsibility and accountability of physicians; assuring quality in health care; access to care for underserved, uninsured, and vulnerable populations; parity in mental health care services; and other compelling clinical, ethical, legal, and policy issues in health care delivery.

GENERAL LEARNING OBJECTIVES

Students will be able to:

Discuss the physician’s role in the administration of justice, with emphasis on describing an overview of the judicial process, including physician involvement as an expert witness in civil and criminal litigation.

Explain the legal and professional structures that regulate the conduct of physicians as expert witnesses.

Evaluate how physicians participate in civil litigation through an evidence deposition.

Describe the health care system in the United States, discussing its strengths and inadequacies, and comparing it with other health care systems.

Describe the economics, financing, and cost of health care in the United States.

Discuss policy issues of access to and availability of health care for vulnerable populations in the United States.

Explain the concept of parity for mental health care services and describe social and economic barriers to achieving parity.

Discuss issues in ensuring quality in medical practice and patient-centered clinical decision-making in the context of the current health care environment.

Compare ethical, legal, and policy issues arising in fee-for-service medicine and in managed care.

Describe mechanisms through which health care industries seek to influence physician behavior, the conduct of clinical research, and the regulatory powers of the federal government.

FORMAT

Two classroom approaches will be used throughout the learning experience: (1) plenary sessions (e.g., seminars, panel discussions); and (2) tutor groups. During plenary sessions, core material will be presented. The information provided complements required reading assignments. In conjunction with required readings, the content of plenary sessions will constitute the major basis for written examinations.

Tutor group sessions are designed to allow in-depth exploration of the material covered during plenary presentations. Approximately seven students are assigned to each tutor group. These students will meet with the same tutor during all sessions. Each student will be responsible for formally presenting assigned cases in the tutor group setting. Because tutor group participation constitutes an important part of the overall performance evaluation, significant responsibility is given to students in the tutor groups to identify relevant learning issues, present individual cases, and elucidate learning issues that pertain to those cases. All students are expected to interact as informed participants in the discussion of cases presented by other students during each tutor group session.

Mandatory attendance at all scheduled activities is required.  A sign-in sheet will be utilized for each class period.  Students with unexcused absences during the two-week Doctoring Clerkship will receive consequences, such as a lower overall grade for the Clerkship.

TUTOR GROUP SESSIONS AND ASSIGNMENTS

Tutor Group Faculty and Student Assignments are listed on page viii and Tutor Group Room Assignments are listed on page ix. Tutors will assist students in identifying and defining pertinent issues for discussion based on the General Learning Objectives. Students will identify and define other issues based upon their own perspectives as individuals newly entering the medical profession.

At each of the Tutor Group Sessions, case presentations should focus on issues drawn from plenary sessions and required readings. Students will be responsible for formally presenting at least two assigned cases. Students will be expected to undertake independent research in support of their case presentations. Active participation in the discussion of all cases is expected.