By Cheryl Chun, MS, MA, Health Policy Scholar, Robert Wood Johnson Foundation (RWJF) Center for Health Policy at Meharry Medical College

Before I was a medical student, I was a teacher. I taught high school mathematics for two years in the District of Columbia.

Being a public school teacher was one of the most challenging and rewarding experiences of my life. I spent my days trying to not only excite my students about mathematics, but also to help change their life trajectory by encouraging them to go to college.

Neither of these tasks was easy. Many of my students cited math as their least favorite subject in school. And despite the college atmosphere my colleagues and I worked diligently to create, many of my students struggled to accomplish the necessary coursework and SAT scores they needed for college.

I realized that teaching high-needs students was more complicated than having a good lesson plan. While I will always believe in the importance of having a good teacher in the classroom and up-to-date resources for them to use, my time in the classroom has showed me that often good students fall behind in school because of obstacles they face outside school. My students had to deal with guns and gang violence, not enough money for basic needs, and inadequate access to medical care. Many had no medical insurance and would miss class to spend all day waiting in line at free clinics to translate for their sick parent; or be too exhausted to come to class after spending all night with their sick child in the Emergency Room. I also saw how inadequate nutrition could affect students’ behaviors and their ability to learn.

Witnessing these needs in my classroom inspired me to go back to school and become a physician.

While I hope that I made an impact on my students while I was their teacher, I know they made an impact on me and changed my life trajectory. I hope to one day practice in a medically underserved area and help provide care to those who need it most.

The Association of American Medical Colleges (AAMC) last week announced forthcoming changes to the Medical College Admission Test (MCAT). Mindful of the changing skillset that practitioners need to meet the demands of the job, the AAMC said that, beginning in 2015, the MCAT will test students’ reasoning and social science skills.

“Being a good doctor isn't just about understanding science: it's about understanding people,” Darrell G. Kirch, MD, president and chief executive officer of AAMC, said at a news conference announcing the changes.

Two new sections will be added to the test: Psychological, Sociological and Biological Foundations of Behavior; and Critical Analysis and Reasoning Skills. These sections will assess applicants’ perceptions and reactions to the world, understanding of population health and cross-cultural studies, and ethical and scientific reasoning skills.

Officials hope the expanded scope of the test will encourage students from a wide range of disciplines to consider medical school, the Los Angeles Times Booster Shots blog reports, and will lead to a more diverse medical workforce that is better prepared to deal with a changing patient population.

What do you think? Does the new MCAT test align with skills physicians will need in the future? Are there other subjects that also should be tested? Register below to leave a comment.

The University of Kansas last month opened a new medical school campus in the rural town of Salina, to teach students the complexities of rural health care and, university leaders hope, to encourage physicians to practice in small, underserved communities after graduation.

The new school, three hours from the University’s main campus in Kansas City, plans to accept only eight students a year, and has offered it first class free tuition and monthly stipends to study there and start their careers in rural communities. Students will attend virtual classes, with video and podcasts streamed from the school’s other campuses, and will receive training in local doctors’ offices and at the hospital in Salina.

“It just makes sense, and it’s great that it’s been put into practice,” Alan Morgan, the president of the National Rural Health Association, told the New York Times. “From a rural policy perspective, this is big news.”

What do you think? Will going to medical school in a rural setting help encourage physicians to practice there? What other options should medical schools and policy-makers consider to recruit and retain health care providers in rural and underserved communities? Register for a Disqus account below to leave a comment and let us know what you think.

Read more about the Salina medical campus. Read about nursing solutions to advancing health care in rural America.

Aaron Kesselheim, M.D., J.D., M.P.H., is an assistant professor of medicine at Harvard Medical School and a primary care physician based in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital. He is a 2009 recipient of the Robert Wood Johnson Foundation Investigator Award in Health Policy Research.

As a physician who studies trends in drug prescribing and seeks to promote evidence-based medicine, I have always been intrigued by the paradox related to the impact of pharmaceutical marketing on physicians’ behavior. Physicians are highly educated, and that preparation is intended to impart special insight when it comes to the medical literature and evaluating the data underlying potential treatment decisions. It is perhaps not surprising, therefore, that when physicians are surveyed, most report that pharmaceutical marketing does not sway their individual prescribing choices. Yet most objective studies show that marketing does indeed drive prescribing in non-evidence-based ways. And physicians, when polled, will generally not deny this effect, although they usually point fingers at their colleagues, believing them to be influenced by marketing, while claiming that they personally are not.

What’s going on? In numerous cases, pharmaceutical industry marketing has been shown to rely on distorted presentations of the medical literature, and many advertising campaigns improperly favor use of the particular drug being promoted in order to sell more product. Yet most physicians take seriously their professional ethical requirements, and I don’t doubt that all physicians try to apply their years of training to offer the best care they can to their patients. If so, why are physicians as susceptible to marketing messages from the pharmaceutical industry as ordinary consumers are susceptible to marketing messages they see on television?

One possible contributing factor is the perspectives and practices formed early in physicians’ careers. The socialization effect of professional schooling can be strong, exerting a powerful influence on how students behave after graduation. It is well known that medical students are frequently exposed to pharmaceutical marketing, even in their preclinical years. Some policymakers dismiss the relevance of these interactions; after all, medical students cannot prescribe drugs, so the potential for direct harm is limited. And medical students are often deeply in debt, and thus many sorely need the free supplies and books that might be distributed to them by pharmaceutical manufacturers.