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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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Thursday, November 1, 2007

Short White Coat: Decisions, decisions

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

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On Tuesday night, I witnessed a near-riot -- during yet another class meeting to explain how we’ll be affected by the med school’s new curriculum.

In the next two weeks, we’ll have to rank our choices for the hospital where we’ll spend almost all of our waking and sleeping hours in our third year of medical school. Though recent pilot programs have tested out the so-called longitudinal approach to our clinical training (read: spend the year in one hospital instead of several), it will be required for the first time for the class of 2010. This translates into what would seem an important choice.

But any merits of the new plan aside, the administration managed to ruffle some feathers in communicating this information to us.

Students clamoring for information about what to expect while faculty seemingly don't want to ruin the surprise -- it’s been a bit of a theme ever since the curriculum was unveiled last fall. This time, we were left wondering how to make the decision, and whether it even mattered in the first place.

For Tuesday’s meeting, we packed into our familiar lecture hall, plied with Sicilian pizza and bottled water. The event began unpromisingly, with a PowerPoint slide explaining how the changing practice of medicine -- and not the “otherwise excellent” HMS system -- should be blamed for any grievances we might have with our third year. We heard the usual curriculum buzzwords like integrative and multidisciplinary, and were presented with impossibly quantitative demonstrations of how they planned to “make our lives palatable” in the coming year.

The crowd was soon frothing at the mouth for something tangible on which to hang our decisions. We wanted to see the heads of each hospital's third-year clerkship affirm or deny the stereotypes so often heard in passing from third-year veterans -- for example, that Massachusetts General Hospital is for pre-surgery gunners who relish overnight stays, while the Beth Israel Deaconess program caters to the overly self-reflective.

But such distinctions were obfuscated by administrators who urged us to focus on the similarities between the programs and dismissed factors such as parking and geography as inconsequential. Data were thrown at us to prove that all students were happy wherever they went. Demands for pro/con lists and bullet-pointed hospital highlights were deftly sidestepped. And then they told us we had to make a decision.

(A hapless fourth-year envoy, not picking up on the palpable hostility in the air, took this moment to remind us how magical our wards experience would be, no matter where we were. Surprisingly, nothing was thrown at him.)

Near the end of the two hours, one particularly grounded hospital medical education head conceded that this issue had been anticipated in planning meetings. But the frustrations remain. Until all of our administrators sort out their mixed messages, perhaps we should just shake off this self-imposed burden of informed decision-making and embrace the bliss of random choice.

Excuse me while I find a hat to pick out of. But wait, did you just say Mass. General has parking? It’s going to be a long two weeks.

Posted by Ishani Ganguli at 04:18 PM
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