Second-year M.D. student Nattaly Greene leads AMA workshop on student-driven curriculum

September 23, 2016

Creating change in medical education sometimes means letting students be the teachers. During a mid-August meeting of the American Medical Association's Accelerating Change in Medical Education (ACE) consortium schools, one OHSU medical student played the role of instructor in an area known as structural competency.

Nattaly Greene, second-year M.D. student, leads AMA consortium workshopNattaly Greene, a second-year M.D. student, led two, one-hour workshops on an innovative, student-driven portion of the YOUR M.D. curriculum aimed at empowering medical students to consider how social structures impact population health. As a participating school in the consortium, the OHSU School of Medicine is eager to learn from – and share lessons with – other ACE schools. Paul Gorman, M.D., assistant dean for rural medical education, OHSU School of Medicine, attended with Greene.

The AMA meeting, hosted by University of California – Davis, was organized around the theme of students serving as advocates for health equity and community-based learning. Greene came well prepared, thanks to peers in the classes who've gone ahead of her. Beginning with the M.D. Class of 2017, whose members initiated the idea while OHSU was overhauling its undergraduate medical education program, the structural competency course has been planned by and taught by OHSU medical students for three years running.

Dr. Paul Gorman attended AMA consortium workshop with GreeneExpanding on the notion of cultural competency, structural competency "asks us to dive into the causes of the causes" as Greene described it. For example, students may analyze a case in which a patient is houseless and ask what has contributed to the situation. "Policy, gentrification, high rental rates, these all affect how our patient presents during a visit," said Greene.

Structural competency is one way the YOUR M.D. curriculum helps prepare OHSU students to be physician leaders in a changing health care and policy landscape. Greene said 38 members of the M.D. Class of 2019 have signed up as facilitators, meaning they will go through a four-hour structural competency training and lead small-group sessions within their class. Greene said "it's made better listeners of all of us. It's a horizontal model of leadership. We find a lot of value in that. It makes it more visceral."

Greene would like to acknowledge members of the Class of 2018 and 2019 structural competency planning teams, and in particular the following members of the Class of 2017 for making the structural competency curriculum a reality at OHSU:

  • Brianna Muller
  • Michelle Beam‎
  • Justin Lee‎
  • Melanie Prestige
  • Josiah Perez
  • Mariah Peterson
  • Molly Rabinowitz
  • Jeffrey Baitis‎
  • Anushka Shenoy‎
  • Larissa Guran‎
  • Robin Brown‎
  • Sylvia Peterson-Perry‎
  • Annie Buckmaster‎
  • Neil Mistry‎
  • Scott Hoffmann‎
  • Glenn Kautz‎
  • Mary Clare Bonnet

A special thank you to faculty members who have helped implement or continue this work at OHSU: Dr. Gorman, who is also professor of medical informatics and clinical epidemiology, OHSU School of Medicine, John Stull, M.D., M.P.H., assistant professor of public health and preventive medicine, OHSU/PSU School of Public Health, and Atif Zaman, M.D., M.P.H., professor of medicine, OHSU School of Medicine.

Video from the meeting: