University of Miami accelerates path to medical specialties

The University of Miami’s Miller School of Medicine NextGenMD Program is accelerating the path for students to get hands-on in their desired specialized medical field with dual degrees and sub-degree concentrations, a method other medical schools are implementing nationwide.

UM’s NextGenMD is a medical scientist training program (MSTP) that aims to graduate students with a scholarly concentration, such as biomedical engineering, business of medicine and patient safety, diagnostic pathology and laboratory medicine, and global health and surgery; or dual degree programs such as M.D./Master of Public Health (MPH), M.D./Ph.D., and M.D./Master of Business Administration (MBA).

“In the way this program is structured, the initial part, before students actively begin seeing patients more full-time – usually the first half of medical school – has been shortened,” said Gaudi Agarwal, associate dean for curriculum and associate professor of medicine at the Miller School of Medicine.

“We try to integrate a lot of that classroom knowledge while seeing patients.”

The new medical program is composed of three phases. The first phase reduces the typical 24 months of foundational and translation sciences to 14 months, “traditional classroom-type learning” learned through “symptom-based virtual clinics that incorporate health systems science, social determinants of health, core clinical skills, and professionalism,” according to the university’s website.

“What we’ve learn is that healthcare isn’t really delivered in a lecture hall in an auditorium,” said Dr. Agarwal. It is delivered in a social setting, “and you have to learn how to collaborate well; how to critically think and reason through a problem together. So, more medical schools are going towards more small-group learning.”

Within that first phase, the university developed a plan called University of Miami Collaborative Learning (UMCL), where students spend time during the week studying in teams, “working through problems, questions, cases together, which we really think will help them prepare, not only for exams, but for the health care environment and working in teams,” said Dr. Agarwal.

The first phase also includes early clinical experiences and time to explore scholarly concentrations, to attend research rotations or to identify a possible Ph.D. mentor.

The second phase consists of four 12-week blocks of integrated clinical clerkships, according to the university’s website. One of those clerkships must be in the practice of medicine – internal medicine, family medicine, geriatrics, or palliative care – and then another in either emergency medicine, anesthesia, or surgery; neurology or psychiatry, and obstetrics-gynecology or pediatrics. During these clerkships, students also take the time to study for their USLME (United States Medical Licensing Examination) Step 1 exam, and if they choose to, transition to their Ph.D. training for three or four years.

“In the final 18 months of their four years (phase three), the students are spending their time doing a very individualized type of training in the areas that interest them,” said Dr. Agarwal.

Here is where students can complete dual degree programs and other scholarly studies, becoming ready to be medicine interns.

Students in the third phase also complete electives and two four-week courses in advanced integrated sciences, critical care, or sub-internships, followed by their application for medical residency, research projects and the UMSLE Step 2 exam.

Additionally, they would count on a longitudinal clinical educator, or LCE, a practicing physician who mentors a group of up to eight students once a week.

“That mentor is responsible not only for their professional development, but for teaching them clinical skills and delivering a lot of the content of what it means to be a physician,” said Dr. Agarwal. “Students feel like they have a coach, an advisor; someone they can go to for questions. And we’ve really seen that bear fruit when they start to see patients, because they become very savvy for only being second-year medical students, and they really hit the ground running when they begin that second phase of their education.”

Some students can also choose to follow an “accelerated pathway to residency,” finishing medical school in three years, if they can commit early to a medical specialty and to be interviewed by the residency program directors and go through the national match program, she added. “They can also focus on that area of interest, spend a summer between that first and second phase with a residency program [of their choosing] so they get to understand what it’s like seeing patients in that discipline. It’s a nice option for students who are very sure of what their future path looks like.”

The university continues to build a more expansive list of dual-degree programs, Dr. Agarwal said. Other prestigious universities following a medical scientist training program include Emory University School of Medicine, Yale University School of Medicine, Colorado State University, John Hopkins University School of Medicine, Harvard Medical School/Massachusetts Institute of Technology, and the University of Michigan Medical School, among others.

In January, the results of the first UM NextGenMD Program class USMLE scores will come out. “But in the interim,” Dr. Agarwal said, “I am comparing their clinical exams scores, and they’re achieving A-level outcomes a year ahead of time, [compared to] past students in the prior curriculum.”

In 2022, the Miller School of Medicine matriculated 204 students out of 11,017 medical school applications received. Matriculated in the M.D./MPH program are 52 students; 120 students are in MD-only programs; seven students are in the M.D./Ph.D. program; and 25 students are in the M.D./MBA program. Out of all medical students, 94 are male and 110 are female; 93 are Florida residents and 111 are non-Florida residents; 109 are considered minorities and 55 are underrepresented minorities, according to a university spokesperson.

The goal is for medical students to be transdisciplinary, she concluded. “We want them to be ready for a really complex healthcare system, be transformational leaders in those healthcare systems, and you can’t do that if you’re not exposed to really interesting research or other disciplines that think about things in a different way.”