Patient, physician & society: Northwestern University Medical School

Northwestern University Medical School's Patient, Physician & Society (PPS) course was introduced in 1993 as part of a complete restructuring of the first- and second-year curriculum. The PPS course meets two afternoons per week throughout the first two years, with one afternoon focusing on the relationship between patients and physicians and the other on that between physicians and society. The course is designed to provide a comprehensive, integrated introduction to professional skills and perspectives. Fourteen distinct curricular units address personal and professional ethics, medical humanities, behavioral sciences, physician-patient communication, physical diagnosis and clinical reasoning, health services organization and financing, preventive medicine, and the health of vulnerable groups. Health promotion as a primary goal of medicine is an underlying theme throughout the course. Active and interactive learning formats afford many opportunities for personal reflection and discussion. The overall response to the course has been positive, and survey data indicate that students completing PPS report more progress toward the school's fundamental educational goals than do students who had progressed through the first two years before the new curriculum was introduced. Still, a number of students are clearly uncomfortable with educational strategies that give them responsibility for finding answers on their own. Contrasts between PPS and the basic science courses--in content, presentation, and evaluation--highlight the importance of coordinating and integrating the overall medical school curriculum. Plans for enhancing the course include focusing on faculty development and student evaluation, as well as explicitly extending PPS material into the clerkship years.