THE GROWTH Y3AR
For students at Dell Medical School, the third year of study is pivotal: they become further rooted in Austin's health ecosystem, seeking out collaborative ways to effect change while pursuing their own passions.
From exploring new cancer treatments to supporting aging Austin residents, Dell Med's students are using the “Growth Year” to answer the call to revolutionize the way people — all people — get and stay healthy. Here are four of their stories.
Preparing for Impact
The first 50 students at Dell Medical School at The University of Texas are making their mark on Austin.
By now, each student has taken one year of classroom fundamentals, and spent another year in clinical clerkships (one year sooner than at most medical schools). They have observed many ways the health care system can improve, especially for those without adequate access to care. And this year — known at Dell Med as the Growth Year — they are faced with a new kind of challenge: to take what they have learned and start tackling some of those improvements head-on in the Central Texas community.
“The Growth Year is the turning point for students at Dell Med,” says Sue Cox, M.D., executive vice dean of academics. “They’re learning who they want to become as leaders in the medical field, and our aim is to support them as they make strides in their professional goals, all while contributing to the school’s mission to revolutionize how people get and stay healthy.”
A New Kind of Med School Experience
The Growth Year includes an Innovation, Leadership and Discovery block that allows students to choose one of four distinction options: Population Health, Research, Design and Innovation in Health Care, or Student Entrepreneur in Residence. Or, they can pursue a dual degree such as a master’s degree in business, public health or education.
Each option varies in the level of formal coursework required, and many students will undertake an independent project to transform health over the course of the year. Project possibilities range from conducting basic research to working with a community organization on an initiative to improve health in the city.
For example, Brooke Wagen is earning a distinction in population health and will spend the year working with senior citizens from two public housing developments. Her goal is to learn more about the health and life experiences of those who are aging in a city changing as rapidly as Austin. During her 10 years living in East Austin, Wagen has seen how this change impacts her neighbors and their ability to access the care they need.
“This is the reason I came to Dell Med in the first place,” Wagen says. “I want to be a primary care doctor who pays attention to how housing, health, community and problem-solving intersect. We need to make a dedicated effort to thoroughly listen to the stories of people living in our city, because without their stories, we can't address the real disparities.”
Other students, like Audrey Han, will earn a master’s degree by the end of the year, adding value to their four years in medical school and leaving them with expertise that will shape their path forward.
All the while, these students continue clerkships in primary care, community and family medicine alongside their four-year coursework in interprofessional education, clinical skills and leadership. By working in the clerkships throughout the year — longer than many other U.S. med schools — students build relationships with patients and practitioners, leading to deeper understanding of community needs. In addition to all this, students also study for the U.S. Medical Licensing Examination (USMLE), the three-step exam for licensing doctors in the U.S.
It’s a unique way of approaching medical education — but one that’s crucial to Dell Med’s mission of revolutionizing care, both in Austin and beyond.
“Dell Medical School was created with the goal of transforming health and health care first in the community that supports us,” says Clay Johnston, M.D., Ph.D., dean of the medical school. “Our students are a key part of that mission, and this is the year that their efforts come alive.”
Brooke Wagen, class of 2020, stands in the courtyard of Chalmers Court — one of the public housing developments where she will be learning about the stories and health needs of aging Austinites this year.
Brooke Wagen, class of 2020, stands in the courtyard of Chalmers Court — one of the public housing developments where she will be learning about the stories and health needs of aging Austinites this year.
Now, Where to Begin?
Each of Dell Med’s 50 future physician leaders stands at the beginning of the third-year journey, looking forward to the challenges ahead — and recognizing the ways in which they will indeed grow this year: writing a research proposal for the first time, learning how to obtain project grants and catching up on the fundamentals of psychology and business are just a few of the hurdles ahead.
But by the end of the year, the challenges will be worthwhile as students strive to meet their goals. Mihailo Miljanic, pursuing a distinction in research this year, sums it up:
“Nine months is a blink of an eye for some of the goals I’m trying to reach in my distinction,” Miljanic says. “I’m hoping to make what I think are some pretty important advances in cancer research, and I’m a little nervous because there’s a lot to learn along the way. But I’m excited to get started.”
Collaborating to Serve the Community
Community partnerships have been essential to Dell Med’s work since the school’s earliest days. And this year, the inaugural class of medical students are forming their own bonds with those partners.
Example: Students seeking a distinction in Design & Innovation in Health Care will spend the spring semester partnering with local organizations on design-based solutions to improve health. In January, Dainon Miles and his teammates were already at work with the YMCA of Austin to design a way for local primary care providers to refer patients for services like nutrition, mental health and fitness support and to help providers keep track of patients’ progress.
Miles’s lifelong interest in fitness and wellness prompted his passion for helping people lead healthy lives outside of the doctor’s office, so partnering with a community organization with that very goal — and the resources to make it happen — made perfect sense.
“For nearly a decade, the YMCA of Austin has been working to bring medically integrated programs from local partners into the Y,” says James Finck, CEO of the YMCA Austin. “This new program will enable the Y to wrap complementary services around patients, so that our vision for integrated, holistic care will become a reality. And by partnering with Dell Med, we’ll benefit from a level of expertise and research that we might not otherwise be able to access.”
Dainon Miles, class of 2020, stands in the YMCA of Austin’s Town Lake branch. This semester, Miles and his teammates are working to help local primary care physicians refer patients to holistic health services the YMCA offers.
Dainon Miles, class of 2020, stands in the YMCA of Austin’s Town Lake branch. This semester, Miles and his teammates are working to help local primary care physicians refer patients to holistic health services the YMCA offers.
Growing Stronger Together
Throughout the Dell Med curriculum, students take part in longitudinal coursework in interprofessional education (IPE). The first year introduces students to the core tenets of collaborating across disciplines, while the second year is about demonstrating that collaboration in a care delivery setting while students are on clinical rotations.
In Year 3, students diverge in their specialties and interests, so the curriculum leverages the collaborative opportunities that exist where they are: students across different distinction options and dual degree programs group together to work on a project that will further health and care in the Central Texas community. Projects are grounded to one of Travis County’s critical health indicators issued by Austin Public Health, and students are asked to reach out to community partners who work in a variety of settings to improve health locally.
The result is a series of projects that aren’t simply academic exercises, but are starting points for greater collaboration between Dell Med and its partners. Project examples range from implementing an electronic health records system at the C.D. Doyle Clinic (a student-run clinic that primarily serves individuals experiencing homelessness) to working with Meals on Wheels to complete fall-risk assessments for seniors.
“IPE is not about bringing other people here to teach our medical students how to collaborate and be good team players,” says John Luk, assistant dean for interprofessional education. “It’s really about seeding these relationships where they take place: in the community, in the care delivery setting — anywhere along the continuum of care that involves collaboration.”
The Results Are In
Hours of interviews. Dozens of cell cultures tested. New relationships forged with patients, physicians, community health workers and each other.
This is what progress looks like, at least for third-year students at Dell Medical School.
As summer approaches, Brooke Wagen, Mihailo Miljanic, Dainon Miles, Audrey Han and their classmates are all beginning to see the results of the work they’ve done over the course of the Growth Year. From Wagen’s interviews yielding revelations about aging in Austin to Miles’ work with the YMCA to design a process that helps people meet their health goals, their experiences have helped them develop skills that will fundamentally shape the way they practice.
It’s part of a rising tide in academic medicine: “Leaders are throwing out long-held practices in hopes of creating a pipeline of doctors armed with skills typically not learned until years in the profession, if ever,” writes Maria Castellucci for Modern Healthcare’s May report about six schools reshaping medical education, including Dell Med. “The end goal is to have a workforce of physicians who are innovative and patient-centered, concepts that traditional medical education doesn’t promote very well.”
A New Kind of Med School Experience
Even in research, the finish line is changing. Rather than peer-reviewed publication, it’s getting solutions to impact as soon as possible. Example: In partnership with the LIVESTRONG Cancer Institutes, Miljanic has spent hours in lab working on a research study that’s bringing innovative colon cancer treatments closer to clinical trials in just the nine short months he’s invested in the project.
Mihailo Miljanic, class of 2020, stands in the Developmental Therapeutics Lab of the LIVESTRONG Cancer Institutes at Dell Medical School. This year, Miljanic has made strides in testing an innovative drug combination to more effectively treat colon cancer.
Mihailo Miljanic, class of 2020, stands in the Developmental Therapeutics Lab of the LIVESTRONG Cancer Institutes at Dell Medical School. This year, Miljanic has made strides in testing an innovative drug combination to more effectively treat colon cancer.
“The silos associated with a traditional academic research environment are impeding progress with bringing lifesaving treatments to patients that need them,” says Chris Webb, chief research officer and associate dean for research at Dell Med. “If we’re going to transform the way research is done in academic medicine, we have to show medical students how they can contribute in a highly impactful way.”
Concluding Primary Care Relationships
Throughout the third year, students have continued to forge relationships with patients and mentors during their clerkship in primary care, community and family medicine, which they began in year two. The primary care clerkship at Dell Med is longer than most medical schools — two years — and talking to the third-year students reveals how deeply they care about the patients who walk through the doors of their clinics.
For someone like Miljanic, the end of his primary care clerkship provides an opportunity to pause and reflect. His experience at CommUnityCare’s David Powell Health Center, which provides HIV-specific health services, has confirmed his interest in radiation oncology.
“With a full two years in the clinic, you really learn how to take care of people and learn what kind of support systems they need outside of just direct clinical care,” Miljanic says. “The incidence of certain cancers is much more common in the HIV-positive population, so seeing how people deal with that in person and getting to nurture those longer-term relationships has just made me more motivated to do the work I’m doing with the LIVESTRONG Cancer Institutes and in the future.”
When Students Become Teachers
Dell Med students have been doing some of their best work outside the classroom this year — or in some cases, on the other side of the classroom. They have insights to share with the world, and others are taking notice.
Their body of work from the Growth Year is evident: this year, students have submitted research studies for journal publication, presented unique findings at conferences alongside seasoned professionals, and lent their voices to national conversations around how to help people get and stay healthy.
And students’ leadership is being felt in intangible ways, too: Educators at Dell Med are using the fresh perspectives of those pursuing Master of Education in Education Psychology dual degrees — students like Audrey Han — to help prepare future classes for success. With a lens for educational best practices and firsthand experience with Dell Med’s Leading EDGE curriculum, Han and her colleagues have provided feedback to Dell Med educators and offered study strategies to incoming peers.
All in all, they’re demonstrating that revolutionizing health care needn’t wait until later, when they’ve got the skills and knowledge to get started now.
“The Dell Med curriculum is designed to create graduates who see — and are prepared to close — gaps in health at any level of the health care system,” says Stephanie Starr, M.D., Director for Science of Health Care Delivery education at Mayo Clinic Alix School of Medicine. “Students desire and learn best by application. Early introduction to fundamentals, plus early clinical experience, provide the foundation needed to succeed in new areas.”
Trainees Today, Physician Leaders Tomorrow
As the first class dives into its last year at Dell Med, students are preparing for their transition to residency and, eventually, careers as licensed physicians.
Director for Science of Health Care Delivery education at Mayo Clinic Alix School of Medicine
Did the Growth Year change how they’ll practice medicine? In a few important ways, yes. Although many students entered Dell Med with strong convictions and clear goals for how they want to help others lead healthy lives, many find themselves more prepared — and inspired — to tackle system-wide challenges after concluding their third year of study.
“I feel more comfortable looking at a big problem and breaking it down so it can be solved,” says Dainon Miles. “Whether that’s approaching the right people or just figuring out the right sequence of steps, I think it’s going to make me more proactive as a doctor faced with day-to-day challenges of health care.”
And with a curriculum designed to help students collaborate well, tackling systemic change and making a difference in partnership with others will come naturally to these future physician leaders. Han, who spent her year analyzing educational psychology frameworks while earning her Master of Education in Educational Psychology, sums it up:
“Right from the beginning, our coursework is set up in a way to allows us to be able to ask and answer questions, and builds up to what students actually experience in the clinical setting,” Han says. “I’ve grown close with my classmates because of the early focus on teamwork, and through bonding over specialized interests this year. They’re this group of independent, unconventional thinkers who work together really well, and I’m proud and excited to become a physician alongside them.”
Explore the Third Year
