The Art of Listening
At the foundation of the LIC is the gift of time. The program, which launched at the Hudson Headwaters site in 2017, gives students the opportunity to stay in one location for the entirety of their third year. They complete
all of the same core clerkships as medical students across the country, but they do it over 12 months, as opposed to rotating through a different specialty every few weeks. The College launched a second LIC location at Central Vermont Medical Center in
the spring of 2019, bringing the current total number of students in the LIC to eight. UVM Clinical Assistant Professor of Family Medicine Christine Payne, M.D., site director for the Central Vermont LIC, says even in the first year of the program students
are contributing to the work of the UVM Health Network location.
“They really form a bridge between different providers,” she says, adding that as students get to know patients and their families, they also play an important role
in helping to navigate the healthcare system.
Students—in their short white coats emblazoned with the UVM Larner College of Medicine name—become a familiar presence over the course of the LIC. At both Hudson Headwaters and Central
Vermont, they are assigned two family medicine or outpatient medicine preceptors and a pediatric preceptor for the duration of the year. They spend at least half a day per week with each of these providers. They work with a neurologist and psychiatric
nurse practitioner two times every month. For obstetrics/gynecology and surgery, they spend half the year focused on each specialty. Students complete “Burst Weeks” for inpatient medicine and psychiatry, where they focus solely on each of
these specialties. Rounding out these requirements is “white space,” or the unstructured time in the schedule when students take the lead. The opportunities here are many: Students explore specialties they’re interested in; they use
the time to study for upcoming exams; they see patients they’ve been adding to their panel over the course of the year.
This panel—consisting of anywhere from 25 to 50 people—gives LIC students opportunities to dig deep into
the patient experience. Whether it’s witnessing a birth and then following mother and baby to post-natal check-ups, or accompanying a patient with diabetes through check-ups and consultations, students are there with patients through it all, often
becoming trusted advisors.
Catherine Westbom ’21, a student in the Central Vermont LIC, says she’s able to help patients get their questions answered, improving their care in the process. “One of the benefits of being a medical
student is I can spend 20 minutes with any one patient and chit chat,” she says. “And through the chit chat sometimes they’ll say: ‘Oh yeah, I’ve been wondering about this and keep forgetting to ask.’”
At the Hudson Headwaters site, Cassie Nowicki ’21 says this role—liaison between patients and providers—dovetails nicely with their work learning the basics of patient care.
“Across different specialties, physicians
are asking questions about what’s relevant,” she says. “You’re actually able to contribute and they’re trusting you to contribute.”
Students in both locations have patients on their panels who live in nursing
homes; they go on home visits; they spend time in the emergency department and with palliative care teams. Depending on their interests, some students fill their white space by spending time with cardiologists, pathologists, or neurologists. Others have
accompanied patients to social services appointments, seeing first-hand how issues like homelessness and lack of access to reliable transportation can influence health.
Central Vermont LIC student Alexa Golden ’21 has patients on her
panel who have been diagnosed with terminal illnesses. Witnessing how these patients face the end of life with dignity and grace is shaping how she plans to practice medicine.
“There are people in really tough situations who are at the
hospital all the time or in the doctor’s office all the time,” she says. “Some of these patients are never going to get better, but they’re really optimistic. They carry on knowing that they’re going to do the best with what
they have left.”
For Jessica Lyon ’21, following up with a physician who hosted a continuing medical education talk she attended led to an opportunity to spend time at a UVM Medical Center clinic for patients who identify as transgender
or LGBTQ. She learned more about this interest area and has connected with some patients.
Kalle Fjeld ’21 is building a foundation for life-long wellness through her LIC experience at Hudson Headwaters.
to know some people really well, which has been a delight,” says Fjeld. “Some of the most sustaining and fulfilling things that keep people from burning out are those long-term positive relationships. I think it’s good to be able to
start that now rather than in five years when I’m done with residency.”
Through these experiences, students begin to recognize their talents and skillsets, says Quinn, which helps them to chart a course for the future.
“As they go through the program, they learn a lot about themselves,”
she says. “It’s an amazing thing to watch as they gain confidence.”