AMSA's 2015 Annual Convention
Join Us Next Spring
in Washington, DC!

February 26 - March 1, 2015 

HEART-IM Clerkship


HEART-IMThe Humanistic Elective in Activism, Reflective Transformation, and Integrative Medicine (HEART-IM), is a 4th year clerkship accredited by the University of Wisconsin School of Medicine and Public Health that will provide twenty-five (25) 4th year medical students demonstrating an aptitude and interest in integrative medicine, social justice and activism, intentional community building, humanism, and/or personal growth a unique and wonderful way to conclude their medical school career and prepare for residency.

Students will spend the month in a cooperative living and learning environment. The elective site is The Quaker Center in Ben Lomond, CA. Students will create a community with awareness of norms and rules, they will cook and clean with each other, teach and learn from each other, and experience communal living while expanding their knowledge on a number of important topics not addressed in medical school. Didactic and experiential lectures will be scheduled each day and led by physician leaders in their respective fields, in addition to time for self-reflection and self-care. Lectures will focus on the core curriculum of CAM, activism, community building, and personal reflection. Any clinical site visits will focus on examples of incorporating social justice and patient advocacy into clinical care.

Weekends will be free, with optional scheduled activities each weekend.

Participant posing by waterRationale. Medical school, with its long hours and extensive demands, can leave young physicians with a wealth of knowledge, but an impoverished spirit. U.S. medical schools teach techniques and technologies in great detail, but they, in large part, ignore the human component of becoming a healer. Compassionate interviewing skills, relationship-centered care, cultural competency, and community and professional activism as physician leaders are underemphasized in favor of clinical training and basic science knowledge. Exit surveys of graduating medical students conducted by the American Association of Medical Colleges (AAMC) consistently demonstrate that students feel unprepared in many of these areas. Such an imbalance in training has a noticeable impact on patient care, patient satisfaction, malpractice claims, and compliance.

The American Medical Student Association (AMSA) enjoys a fifty-year reputation as a partner in coalitions based on the ideals of health as a basic human right, support of diversity and elimination of disparities in health, medical student well-being, and patient advocacy. This program is a continuation of these efforts to empower physicians-in-training to develop relationship-centered partnerships in health care, and impart the care to communities.

Goals

Through the program, participants

  • Identify opportunities and cultivate skills of patient advocacy and community activism
  • increase awareness to the ideals of medical practice as a service to humanity;
  • create leadership skills that result in improved direct patient care during residency training and practice.
  • broaden the understanding of suffering and healing to include modalities and treatment approaches complementary to allopathic medicine;
  • cultivate conflict resolution skills and improve communication skills;
  • identify and heal personal conflicts to better improve their relationships with others;
  • Increase awareness of tools for self-care

HEART Program Description

Medicine as a social responsibility, activism:

  1. A discussion on poverty, income inequality, globalization, and what these mean to our work as physicians.
  2. A facilitated introduction health disparities domestically and globally. The discussion will include both individual prejudice and bias and the resultant health disparities along racial lines, as well as structural prejudice and bias.
  3. A discussion of underserved patient populations, specifically addressing work opportunities, sustainability, CAM opportunities, and politics of working within these populations.
  4. A facilitated introduction to creating and implementing community-based programs and practices.
  5. An introduction to community organizing and coalition building with an emphasis on physicians taking the lead in this process.

Humanism in medicine, relationship-centered medicine:

  1. Discussions and personal testimonials from exemplar physicians in compassionate patient care and effective and novel approaches to interdisciplinary team management.
  2. Individual projects in poetry, prose, artwork, and music devoted to healing through creative arts.
  3. Practical approaches to cultivate wellness in self, patients, and team members during residency and beyond.
  4. Discussions on the use of the arts to develop and increase humanism in medicine.
  5. Examination of the leadership structure in America and medicine with emphasis on physicians as community empowering and change agents for more humane leadership.

Complimentary and Alternative Medicine or Traditional Medicine modalities:

  1. One day presentations of healing modalities (didactic lectures and experiential presentations), including homeopathy, nutrition, Ayuvedic medicine.
  2. Student presentations of modalities of interest, personal use, and/or expertise that meet the goals of basic proficiency in responsible referral or collaborative treatment.
  3. Lectures devoted to evidence based medicine (EBM) and its vitality to assessing efficacy in CAM and traditional medicine practices.
  4. Hands-on and experiential workshops in healing modalities

Matriculating interns with skills in community building:

  1. Initiating and instituting community-decided forms of mindful and open communication with follow-up community meetings.
  2. Living, learning, and playing as a community with shared communal responsibilities. In addition to sharing cooking, cleaning, and all other community responsibilities, there will be opportunities to dance, play music, sing, create art, build, write, and relax together as a community or individually.
  3. An introduction to community management and conflict resolution strategies.
  4. Personal reflection and group discussion of spirituality as a personal and communal means of growth and development.
  5. The development and maintenance of community norms based on respect, affirmation, and efficient time management.
  6. Demonstrations of medicine as a way of life devoted to lifelong learning, teaching, and mentoring.

HEART 2009, Jonathan Terry

Imagine 25 fourth-year medical students in a room. Pictures come to mind of pressed, short white coats, fingers quickly flipping through the Sanford Guide, pens scratching away at unfinished progress notes. There's a certain sterility in the air as forced conversations emerge: "Are you on call tonight?" "Sorry, I need to return this page." "What are they serving in the cafeteria today?" "I hope we get off early -- tonight is my son's birthday party." The flow of knowledge is unquestionable, as is the unspoken, yet overwhelmingly tangible adrenaline in the air. This is medical education.

Imagine those same 25 medical students in another room, one month later. This is April 2009: the last rotation these students will serve before starting as interns in the summer. Sunshine warms hardwood floors through sliding glass doors. Outside, a California Blue Jay glides through the valiant Redwoods. This month, 25 medical students have applied and been hand-selected to be part of a fundamentally cooperative, integrative, and intentional community. Instead of racing through patient dictations, these students gently and purposefully work the soil at a local Homeless Garden Project. Instead of toting styrofoam boxes up to the student call room, they work together in the kitchen, preparing organic, ecologically-conscious meals with local produce. At the most basic level, the 60 wholesome meals this group will prepare together represent the one goal of this unique rotation: nourishment. It is not just a nourishment of the clinical mind, but a true feeding of the heart and soul.

Appropriately named, the AMSA Humanistic Elective in Alternative Medicine and Reflective Transformation (HEART) is about this attention to sustenance. When the program started in 2002, the original planners understood how four years of studying textbooks, poor nutrition, and hours away from family were profoundly isolating. A pilot elective was launched by AMSA, dubbed the Living Integral Global Healing and Transformation (LIGHT). Twenty one 4th-year medical students from across the United States were exposed to holistic healing modalities, lectures, and case presentations. The current HEART rotation, modeled in part from the preceding LIGHT rotation, seeks to incorporate poetry, literature, the arts, community health, and humanism, along with evidence-based approaches to complementary and alternative medicine.

This year's HEART rotation was one of the strongest yet. Accredited by the Univ of Florida and AMSA, full-time faculty included accomplished authors, residency directors, and humanism scholars from medical schools across the country. In line with the program's backbone of community-building, guest speakers lived, worked, and ate with the medical students. Topics, ranging from social justice in medicine to establishing pharmaceutical take-back programs were presented in lectures, discussions, and experiential group activities. Speakers came with the expectation that these students had all spent four years learning medicine; this month, in contrast, was to learn how to be a physician, a community member, a volunteer, and a healer.

For me, HEART was unlike any of my other rotations. Like many medical students, I wrote application essays four years ago, laced with humanism, a desire to serve, and a yearning for true human connection. Medical school, while rewarding in countless ways, made few conscious efforts to develop my heart and soul: the tools through which I'll be communicating daily with my patients and their families. I remember being told that I was my "first patient" and being reminded of the proverb from the book of Luke: Physician, Heal Thyself. HEART not only showed me these things, but it also connected me with an essential community of like-minded individuals, eagerly searching for health in our education about disease. As medical students, we know doctors have the ability to profoundly influence the world around us. HEART was about showing us how.

In the year following the HEART rotation, each of the 25 medical students who have participated will have contact with approx. 2000 patients, as well as countless family members, medical students, physicians, and other health care providers. In just the internship year, AMSA's HEART program will have touched the lives of more than 50,000 people. As a HEART participant, I feel that each of the individuals with whom I interact will benefit from the parts of me that came out this month: the volunteer, the writer, the nutrition-oriented chef, and most importantly, the listener and the learner. Yes, medical school has prepared me for how to be, I hope, an excellent physician; now, I have learned what it means to be a healer.