Leaders in Medical Education

Dr. Amin Azzam, Director of "Problem-Based Learning" Curriculum, UC Berkeley-UCSF Joint Medical Program

Osmosis Team
Jun 27, 2014

Dr. Amin Azzam, Health Sciences Associate Clinical Professor at the Berkeley and San Francisco campuses of the University of California, is devoted to improving the quality of medical education. He serves as director of the "Problem-Based Learning" curriculum at the UC Berkeley-UCSF Joint Medical Program, co-director of the "Foundations of Patient Care" course at UCSF, and co-director of the "Health Professions Education" Pathway to Discovery at UCSF. He is consistently pushing the boundaries of medical education, and we were excited to interview him for our Leaders in Medical Education series.

How did you decide on a career in medicine?

I got interested during college, when I was drawn to the notion of clinical research after doing behavioral research with monkeys during a summer between my junior and senior year.  I came to realize that it might be more fascinating to do this kind of research with human subjects, so I applied for MD-PhD programs.  I didn't get into any combined programs, but did at least get into medical school!

What made you pick psychiatry as your specialty?

During my MS-3 year I remained interested in clinical research.  During my psychiatry rotation I did the consult/liaison service, and grew interested in how patients' emotional health impacted their physical health (and vice versa).  I realized that there were specific aspects of psychiatry that were uniquely human and could not be replicated easily with animal models of disease.  And I found the intrinsic individuality of each patient wonderfully humanistic and not "cookie-cutter." In psychiatry my therapeutic tools are not my scalpel or stethoscope, but rather my abilities to observe and comment on my patients' behavior. It's a fantastic area of medicine to specialize in!

What do you enjoy most about teaching undergraduate medical education?

I love working with pre-clerkship medical students because generally they are incredibly enthusiastic to work with patients. They are not yet burned out or bitter about the aspects of our health care delivery system that are not perfect.  And they are willing to accept my suggestions for improving their patient-doctor communication skills.

As director of the Problem-Based Learning Curriculum at the UC Berkeley-UCSF Joint Medical Program, what do you think are the biggest challenges to students in medical school today?

Certainly we understand a tremendous amount about the "foundational sciences" underlying medicine today so the sheer volume of information we try to squeeze into the pre-clerkship years of medical school is overwhelming.  But in this information rich era, it is increasingly less important for our students to conjure up that knowledge from the depths of their own grey matter.  Instead, I believe that a more challenging task is learning how to filter the large volume of information readily available at one's fingertips, and then determine the reliability and validity of that information in the context of the specific patients one is trying to serve.  These are the skills students learn through Problem-Based Learning (PBL), so I firmly believe in this model of medical education.  One downstream challenge all medical school graduates will continue to face (at least for a while) is the complex and still discontinuous health care system that they will matriculate into during and after their residencies.

In the past year, you have pushed for medical schools to offer credit for editing Wikipedia pages. This teaches our future physicians to communicate in a language that is understandable to patients. What other changes would you make to improve communication between the doctor and the patient?

The health technology landscape is changing quite rapidly— some might say we're up for disruptive innovations (the death of the stethoscope in favor of bedside phone-app ultrasound technology, the birth of electronic patient-owned medical records, big-data repositories of genetic and all laboratory datasets of whole populations, etc.).  All of this will ideally be good for patient health.  But certainly the core of a great patient-doctor relationship (or patient-any-other-health-provider) is effective communication.  As a psychiatrist, I strongly believe that in spite of all the current and imminent technologies we will still need to train our students in the twin arts of therapeutic listening and healing touch— be that through direct physical contact or in the words we exchange, synchronously or asynchronously.  As such, the changes I would make to improve communication include less time in medical school on "Medical Knowledge" and more time on "Interpersonal & Communication Skills."