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Faculty gather to translate student reflections into resource for study of health care systems
During the years 1999-2005, more than 60 medical students participated in the United States-European Union-Medical Education Exchange (US-EU-MEE), a unique program that allowed students from a consortium of American and European institutions to spend time in another country’s health care system and examine the ways in which the system’s policies affected the care of patients. More than the standard clinical rotations that comprise most student exchange programs, the US-EU-MEE program called for each student to follow an individual patient through the workings of the health care system, and prepare a case study based on their experiences.
In April, representatives from the consortium, including faculty from Harvard Medical School, gathered in Boston to discuss how to translate those experiences into an informative and eye-opening collection that could be disseminated to educators and students engaged in the study of health care systems.
The US-EU-MEE program was spearheaded by Dr. Elizabeth Armstrong, of Harvard Medical School, and Dr. Martin Fischer, of Ludwig Maximilians University in Munich, Germany. They received grant support from the U.S. government’s Fund for the Improvement of Post-Secondary Education (FIPSE) and the EU Consortium on Higher Education to develop a program that would, through student exchanges and written case studies, promote comparative analysis of the health care delivery systems in the U.S., Denmark, Germany, Sweden, and the United Kingdom, leading to enhanced awareness and potential mechanisms for improving these systems.
“The students selected for the program were directed to look at the experiences of the patients they followed as a window into the workings of the health care system of that country,” said Armstrong. “The students had time to get to know their patients as individuals and observe how health care policy affected their day-to-day lives. In their written case studies, they reflected on the integration of the medical, ethical, and socioeconomic aspects of health care.”
These reflections—and what learnings to draw from them—were the subject of the April conference. Among the group that gathered were faculty that have been involved in the delivery of the US-EU-MEE program in the countries represented, as well as three members of the Harvard Medical School faculty who completed the program during medical school. Armstrong said the group’s mandate was to work together to determine how to accomplish goals set forth in the original grant: to use the students’ case studies as the basis for developing curricular materials, and to prepare and package these materials—potentially in publishable book form—so that they could be used in undergraduate and graduate medical education.
“The case studies are a treasure trove of analytical reports from medical students caring for patients in a country different from their own. One of the goals of this working group is to collect these stories in a book that will provide rich original material not otherwise available for study and reflection by medical students and others in the health care field,” said Armstrong.
More than 30 of the case studies have been collected and edited. They include a comparison of the experiences of two patients in Denmark in need of heart transplants, the story of a German man whose illness forced him to retire in order to qualify for coverage by a public “sickness fund,” and the different paths taken by two New Yorkers in need of surgery to treat morbid obesity.
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