The eMedical education of the near future

The hallmark of Net Gen medical students is this mantra: “I want to know what I need to know and ONLY what I need to know, and I want to know it NOW!”

This is the Student-Centric education of the Net Generation, the opposite of the older generation’s Teacher-Centric teaching model based on a one-size-fits-all lecture series.

Let’s fast forward to the future.

First year medical students will not be attending lectures. They will form small groups of five to seven students with a resource person (a former teacher, clinician, or senior resident) solving the problem of a five-year-old girl afflicted with high fever for five days running.

The resource person will present the case and the medical students will use their computer skills looking for the necessary information and direct questions to the resource person. In their research, they will mostly be watching videos of similar cases of children with prolonged fever.

The video will feature a group of expert physicians discussing the problem, the tests they want and why they want them, and the results. It will also show the treatment and evidence-based references supporting the treatment.

All throughout the students’ first year, different patient problems will be discussed every few days. The learning process will feature patient-based problems solved through research on the internet, and treatments based on evidence. The basic science and pathology are discussed at the time of solving the problem of the five-year-old with a prolonged high fever.

Students will learn how to present a case like an expert featured on YouTube which is available 24/7 on their laptops or smartphones. All lectures of the past generation on basic sciences and other clinical topics are available on-demand 24/7 to all students from anywhere.

They will present each case in a templated format unlike that of the past generation that usually showed chief complaint, present illness, past history, family history, social history, immunization, and physical examination.

Instead they will say: “This is a five-year-old girl who came with five days of fever and who we think has Kawasaki disease. The following symptoms and signs are: Fever for more than five days, red eyes, swollen fingers, and an Echocardiogram that showed dilated coronary arteries. We have started the child on high-dose gamma-globulin and aspirin. We have the references supporting this treatment.”

Each student will keep a portfolio of 30 patients he or she has worked up and presented on the first year.

On the second year, they will do another set of 50 patients, solving each patient’s problem using “just-in-time” internet research.

The third and fourth years are a repeat of the second year but now the student is helping to supervise a first- or second-year student.

This 21st-century education is based on watching YouTube and Google Scholar at the bedside, with treatment based on evidence.

The Net Generation medical education will be cheaper and more effective because students will learn like a pilot performing simulation flights.

But most importantly, all of these medical students’ management and treatment are evidence-based, unlike that of the past generation that was based on the experience of the most senior physician.

Who needs the “standard lecture-hall format” medical education when students can watch the “Tiger Woods” of neurosurgery, appendicitis, meningitis, and so on, at one’s convenience from an iPad or any smartphone?

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Leonardo Leonidas is a former assistant clinical professor in pediatrics (retired 2008) at Tufts University School of Medicine, Boston.