Clinical and Health Affairs
The Minneapolis Heart Institute Foundation Summer Research Internship Program
The Benefits of Preprofessional Experience for Prospective Physicians
By Benjamin D. Willenbring, Katherine C. McKee, Betsy V. Wilson, R.N., M.L.S., and Timothy D. Henry, M.D.
Abstract
There is a distinct shortage of preprofessional opportunities for undergraduate premedical students. During the last 7 summers, the Minneapolis Heart Institute Foundation Summer Research Internship Program has exposed interested students to cardiology and clinical research. The goals of the internship program are threefold: to bring students in contact with the medical profession, to offer experiences in the various disciplines of cardiology, and to introduce students to clinical research. The success of the program can be measured by its influence on participants’ academic pursuits and scholarly contributions. Of the 65 internship alumni, 52 are studying to become physicians and most of the others are in health-related fields. Interns have also contributed abstracts and manuscripts to peer-reviewed journals and presented their research at major conferences.
Direct clinical exposure is important for students considering a career in medicine.1 High school students, undergraduates, and medical students benefit from involvement in a health care environment where they are active participants rather than passive observers. However, there are few programs that provide this type of experience and almost no studies that evaluate the design and effectiveness of those programs.2 This suggests a shortage of relevant preprofessional experiences for students interested in medicine.
Existing programs such as the Stewart F. Alexander Premedical Program at Pascack Valley Hospital in Westwood, New Jersey; the Dartmouth Health Experience Learning Program; St. Jude’s Pediatric Oncology Education (POE) Program in Memphis, Tennessee; and the Patient Perspectives Program of the Charlotte Institute of Rehabilitation in North Carolina have demonstrated the effectiveness of exposing undergraduates to careers in medicine.3-6 For example, the organizers of the Stewart F. Alexander Premedical Program found that of the 58 students who completed it, 43 (74%) were in medical school, doing postgraduate training, or in clinical practice.3 The 598 students who have taken part in St. Jude’s POE Program have coauthored 121 peer-reviewed articles that have appeared in leading journals such as Blood, Cancer, Cancer Research, the Journal of Clinical Oncology, Leukemia, and Science. Of the 461 participants in the POE Program who have finished their academic work, 405 (87.9%) have a doctorate.5
Although cardiovascular disease continues to be the leading cause of death in the United States, there are few opportunities for students interested in studying and researching it.7 The Minnesota Chapter of the American Heart Association (AHA) currently awards several scholarships each year to Minnesota high school and college students who spend a summer at one of several cardiovascular research institutes in the state. Participation in the AHA program led the Minneapolis Heart Institute Foundation (MHIF) to develop its own internship program so undergraduate students could experience the clinical and research sides of cardiology.
The MHIF Program
The MHIF Summer Research Internship Program has 3 goals: 1) to provide students with experiences that facilitate a better understanding of medicine as a career, 2) to expose students to the spectrum of work that clinical cardiology includes, and 3) to provide students with an introduction to clinical research.
This is the 7th year of the program. Eighteen students were selected from 44 applicants. Participants are chosen by a panel of MHIF research personnel who select candidates based on their background and experience, communication skills, professional interests, and enthusiasm. The duration of the internship is flexible, but most students participate for a minimum of 10 to 12 weeks. Students are expected to work 40 hours per week and receive an hourly wage. Funding for the program comes from a variety of sources including MHIF, AHA, the Abbott Northwestern Foundation, Piper Jaffray, industry, and, in some cases, the students’ undergraduate or medical schools.
The internship is structured around a 2-tiered mentoring system. The first connects students with an internal medicine resident, cardiovascular fellow, or research nurse coordinator. The second pairs them with a cardiologist mentor.
♦ Exposure to Medicine as a Career
Ultimately, the internship will help students decide whether they should pursue a career in medicine. For that reason, mentoring is central to the internship experience, as it provides students with the opportunity to shadow a physician and get valuable career advice. Working with medical students, residents, and cardiovascular fellows allows participants to get insider information about what medical school is like, what type of postmedical school training they need to become a cardiologist, and what the daily life of a physician is like.
♦ Experience in Clinical Cardiology
During the internship, students spend time in the cardiology clinic, the cardiac catheterization laboratory, and the cardiac intensive care unit, where they have a chance to observe and learn about various aspects of clinical cardiology including computed tomography angiography, magnetic resonance imaging, echocardiography, cardiovascular surgery, exercise treadmill testing, interventional cardiology, and nuclear medicine. The mentors can provide participants with more in-depth opportunities to learn about a specific area.
The students’ observational experiences are complemented by weekly lectures presented by MHIF research nurse coordinators, research scientists, and physicians. Lecture topics are diverse, ranging from acute coronary syndromes to clinical cardiac MRI. Following each lecture and observational experience, students are expected to reflect on what they learned and turn in a written assessment.
♦ Experience in Clinical Research
A unique aspect of the MHIF internship program is the introduction to clinical research. Each participant takes part in a preceptor-directed research project in areas such as cardiovascular imaging, electrophysiology, interventional cardiology, hypertrophic cardiomyopathy, acute coronary syndromes, peripheral artery disease, preventive cardiology, and women’s heart disease. Examples of projects completed by students are listed in Table 1.
The interns’ responsibilities range from basic data collection and entry to making follow-up calls to patients, reviewing literature to better understand study design and data analysis, and writing journal articles or abstracts. The nature of their participation depends on their level of interest and experience.
Outcomes
Of the 65 students who have completed the MHIF internship program, 23 are finishing premedical studies and 29 are completing medical school or residency programs (Table 2). The program affirmed these students’ desire to become a physician and helped others realize they should consider another career path. Many of the students not pursuing careers as a physician are now studying or working in other health-related fields including public health, pharmacy, clinical research, and molecular epidemiology.
These students’ occupational choices suggest that the MHIF internship program is valuable in that it allowed them to make a more informed career decision. The program also benefits the greater medical community, as it produces students who have a realistic view of the demands and challenges of a medical career.
In addition, participants have an opportunity to make scholarly contributions to the field. Interns have presented posters at AHA and American College of Cardiology conferences and co-authored abstracts or original manuscripts. Since 2002, participants have contributed to more than 50 abstracts and 25 original manuscripts that have been accepted for publication in a number of journals including Catheterization and Cardiovascular Interventions, Echocardiography, Heart Rhythm, the American Journal of Cardiology, and the Journal of the American Medical Association.8-12
Conclusion
The MHIF Summer Research Internship Program has demonstrated that a preprofessional development program benefits students considering medical careers and is advantageous to the medical community as a whole. It is our hope that other institutions will create similar programs in order to offer more opportunities to prospective physicians. MM
Benjamin Willenbring, lead intern with the MHIF Summer Research Internship Program in 2006, is starting medical school at the University of Minnesota; Katherine McKee, lead intern in 2005, is completing an administrative fellowship at Mayo Clinic; Betsy Wilson was the institute’s research nurse manager from 2005 to 2007; and Timothy Henry is the program’s research director and an interventional cardiologist at the Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital.
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