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Too Much Medical Knowledge?

Debra Barnes is a 28-year-old who moves from city to city a lot. She doesn't know why she's rapidly dropping weight and struggling with nervousness. A team around a table hashes out a possible diagnosis.

Patrick Duffy: How do you think you could present this to Debra in such a way that could keep her from skipping town?

But Debra doesn't really exist. And Patrick Duffy and the others talking around the table aren't medical professionals - yet. The first-year med students at Case are pouring over a patient case written for their new curriculum.

Terry Wolpaw: Certainly (the) medical curriculum hasn't changed since computers were invented.

That's Dr. Terry Wolpaw, the Associate Dean for Clinical Affairs. She says it's been 50 years since Case changed it's curriculum, and a lot has happened in medicine in those 50 years.

Terry Wolpaw: There's a logarithmic increase of knowledge and discovery going on, and so I think a lot of it was just adding and adding and adding to the curriculum. And so I think we reached a point where it isn't working that well. There's just too much now. You can't stuff it in.

Medical professionals across the country say students are struggling to absorb too much information and med school is in need of serious redesign. Dr. Molly Cooke from the University of California is one of authors of the New England Journal of Medicine Report.

Molly Cooke: Students are expected to learn vastly, vastly more content. So it's just enormous volumes of info, a lot of which is very unfamiliar.

Cooke says on her first day of medical school, a professor told her: "Half of what you're about to learn is wrong. We just don't know which half." Med students are still getting that story. It caused Case leaders to rethink their teaching method. With new discoveries transforming medicine every day, why keep teaching things that are likely to be outdated? Instead, their new method, focuses on teaching students 'how' to learn. Again, Terry Wolpaw.

Terry Wolpaw: The details will change - they will. There'll be new discoveries all the time, but they need, that really facile ability to access information that will change constantly before their eyes.

The Case Med School has abandoned big classrooms - now, students are organized into small groups of 15 to 20 students. Instead of thick text books to memorize and hours of lecture, they are exposed to a steady diet of medical cases originated by local doctors about actual patients. Only the names and some personal details have been changed. Morgan Richards is a student at the med school.

Morgan Richards: Rather than getting as many facts as possible and regurgitating them weeks later - learn and forget, learn and forget - it's a much longer process of really figuring out what those inner concepts are & teaching those to each other.

Dr. Amy Jenkins is one of the professors teaching the new curriculum. She says by focusing all learning around real patients, it forces students to think about how they would feel if they were those situations.

Amy Jenkins: I like seeing them think through the process and not just regurgitate facts. 'Cause that's what I want my physician to do.

Case has also abandoned some of the traditional core classes. There's no physiology or biochemistry class. It's part of a curriculum trend that teaches sciences in a comprehensive way, and only as they apply to the whole patient. It's quite an adjustment for some professors and for some of the doctors in training.

Brian Rothstein: How can you not have a lecture in medical school? That's really progressive and crazy. How can you not have a biochemist teach you biochemistry?

Brian Rothstein is using the new curriculum. He says he gets some questions from friends at other med schools.

Brian Rothstein: But I'm very confident that what we are getting is just as good, if not better, because we don't have just one layer of a stack of pancakes, it's not just the short stack, we get biochemistry and etc and how it relates to disease.

Case is one of several med schools in transition. Duke just changed its curriculum, and Harvard and Johns Hopkins are seriously considering reforms similar to Case. But most medical schools are still relying on traditional methods.

Case faculty and students admit adjusting to the unconventional teaching style has had it's challenges. And only two months after the new teaching style began, Ralph Horowitz, the dean who called for the new curriculum, resigned for unrelated reasons. Dr. Dan Ornt, the vice dean for Education and Academic Affairs at Case, remains convinced that Case is still on track with the new curriculum.

Dan Ornt: Disbelievers can be convinced, some of them, when they see this in process, we haven't convinced everyone.

The author of the New England Journal of Medicine Report says Case's changes are a move in the right direction - they will groom students to be the sort of doctors we need. Life long learners. Again, Dan Ornt, from Case.

Dan Ornt: You can't just stop learning, that's why we say we 'practice' medicine. It's something you need to learn everyday of your life.

Elaine Falk, 90.3.