Advertisement

 

 

Why Are There Intern “Boot Camps”?

Author Information (click to view)

Skeptical Scalpel

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last three years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog averages over 1000 page views per day, and he has over 7000 followers on Twitter.

+


Skeptical Scalpel (click to view)

Skeptical Scalpel

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last three years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog averages over 1000 page views per day, and he has over 7000 followers on Twitter.

Advertisement
Simulated patients who are critically ill and have alarms flashing; telling a "patient" played by an actor that he had terminal cancer...why can't we just teach "boot camp" skills during medical school?
Share on FacebookTweet about this on TwitterShare on LinkedIn

A concept that has been percolating in the medical literature boiled over into the mainstream as the New York Times published this story, “Chicago’s Intern ‘Boot Camp’ ” is a rehearsal for life or death medical issues.”

The article describes a new internal medicine intern having to deal with a simulated patient who is critically ill and has alarms flashing.

Another intern had to tell a “patient” played by an actor that he had terminal cancer.

The performances of both of the young doctors were evaluated by instructors. The 81 interns in the program must “pass graded tests in procedures and communication skills before being allowed to move ahead.”

The boot camp described in the Times piece was the subject of a paper published in Academic Medicine earlier this year. It concluded that “Boot-camp-trained interns all eventually met or exceeded the MPS [minimum passing standard] and performed significantly better than historical control interns on all skills (P < .01), even after controlling for age, gender, and USMLE Step 1 and 2 scores (P < .001).”

Here is how the Mayo Clinic describes its boot camp for fourth year med students, “An intensive 1-week course, Internship Boot Camp has simulated, longitudinal patient-care scenarios that use high-fidelity medical simulation, standardized patients, procedural task trainers, and problem-based learning to help students apply their knowledge and develop a framework for response to the challenges they will face as interns.”

They compared survey results from students who had done the boot camp to those who had not and found the boot camp prepared students for internship better than conventional sub-internships did.

Similar “boot camps” are being held in many surgical residencies.

At the University of Connecticut, surgical interns undergo “a 2-month (July and August 2011) boot camp curriculum consisting of two 2½-hour knowledge-based and procedural skills (SimMan) didactic sessions per week and completion of 25 core intensive introductory American College of Surgeons Fundamentals of Surgery web-based self-study modules, followed by a standardized patient clinical skills assessment.

At Baystate Medical Center in Massachusetts new trainees are taught essential skills in patient care and procedures. Over the 4 year period during which interns experienced the boot camp, “Individual simulation-based Boot Camp performance scores for cognitive and procedural skills assessments in PGY-1 residents [interns] correlate with subjective and objective clinical performance evaluations.”

The Department of Surgery at the University of Pennsylvania holds a boot camp for senior students interested in surgical career. The introduction to the abstract describing the program says, “Medical school does not specifically prepare students for surgical internship.”

There is talk of shortening medical school to 3 years. Does it sound like graduating students would be ready for residency after 3 years?

I have one more question. Why can’t we just teach “boot camp” skills during medical school?

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last three years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog averages over 1000 page views per day, and he has over 7000 followers on Twitter.

3 Comments

  1. Maranon: “See one, do one, teach one” was a different era. While some of those interns were dense as stone, most were pretty quick on the uptake. I wonder if the equation has shifted? What is being taught in medical school? Has the entitlement plague invaded the halls of medicine too?

    This week has been a real grind, so funny story: It was the open heart unit at a large university medical center on the west coast. Young intern is draped over the top of an intra-aortic balloon pump (a noisy device at best). He looked at me intently and said “did you know this man is on a balloon pump?!”. I said, “well, yes, I do”. He asked where it was. I said “you’re leaning on it”. He jumped a foot in the air and three backwards. Never saw him again…

    • I agree that see one, do one, teach one is long gone. Good story about the pump.
      ***
      I’m not sure how anyone can make money running an intern boot camp. In fact, it’s likely a money loser. The interns have to be paid. The interns and the faculty are not taking care of patients while the camp is ongoing. Other staff must be paid to cover the patients.
      ***
      That’s an interesting situation with the privatization of the law school. I wonder who is enrolling there at twice the cost and with less than 50% of law school grads unable to find jobs as lawyers.

  2. These new academies and boot camps are a money making venue for somebody, as there is more interest in privatizing all education to rake in even bigger bills for those students and more $$ for the “private” academy.
    Arizona State University, recently privatized their Law School.
    It is operated in the same location, the teachers are the same, the secretaries are the same, but the cost has doubled and the benefits to the workers cut, and some of the professors made part time, so they will never have benefits nor tenure. Same is coming for the rest of professional training. What happened to the “see one, do one teach one?

[ HIDE/SHOW ]