I experienced a stark transition coming to medical school. I not only felt I lacked the time to explore personal interests outside of medicine but also felt as though I had no ownership of my educational path (besides my academic performance). The flexibility of undergraduate education was quickly replaced by a predictable weekly schedule to be followed uniformly by all 130 students in my class. I found myself constantly stuck in a one-track mindset, unable to let myself explore anything deemed irrelevant to the current organ system block. I spent much of my first year feeling as though something was missing, something beyond mastering the role of antidiuretic hormone or the adverse effects of amiodarone. With so much structure inherently present in my education, I wanted to explore a topic beyond our traditional curriculum while connecting with both my peers and potential mentors.
At my institution, elective courses are a required part of our first- and second-year curriculum. In theory, these courses offer a reprieve from our highly structured core curriculum and a chance to explore topics that interest us. My experience with elective courses, however, was that they lacked student input and were rarely updated to suit the changing interests and passions of the student body. In response to this lack of student-driven course offerings, I decided to create my own.
By writing this, I do not mean to imply that creating an elective is groundbreaking or an incredible feat of academic prowess. It was actually a lot easier than I expected due to the outpouring of support from my peers and the faculty who worked with me to make it successful. I want to share my experience as a way to illuminate an opportunity present at almost every medical school that may only rarely be taken advantage of. When I began thinking of establishing an elective, I wished there had been a roadmap to follow to understand where to start and how to invest my time. Hopefully, by detailing my own process, which I’ve broken down into three phases, other students may feel that they too can take ownership of their education by developing something rooted in their passions for others to enjoy and learn from.
Phase 1: Finding a core group of faculty.
At my institution, to develop an elective you need a schedule, syllabus, list of core readings, and faculty sponsor, all of which I did not have. All I had was a topic. I wanted to try to build an elective around the topic of leadership development. I wanted to be able to hear from leaders representing academic institutions, community hospitals, private practices, and local government about how they got to where they are today and what lessons they felt they could pass down to the next generation. I did not personally know any of those leaders or have a list of potential speakers prepared when this all began. In fact, the closest thing I had done to designing a curriculum was creating an Anki deck. I started small by bringing this idea to my academic community director who oversees around 20 students per class and who is our point of contact for personal advice. Just by bringing the idea to her, a plan began to take shape through connections. She connected me to our Dean of Student Affairs who then connected me to our Dean of Graduate Medical Education, and just like that, I had found the faculty nucleus that the elective would evolve around. It was through this first step in the process that I learned I did not need to have all the answers, but, rather, I needed to tap into the wealth of resources already around me.
Phase 2: Developing a curriculum and recruiting speakers.
This step is where the most variability will exist as every elective focuses on different topics and, subsequently, is structured differently. I definitely felt intimidated by developing a curriculum from scratch with no previous experience, but looking back I can absolutely attest to it being doable for anyone motivated. In developing the bones of the curriculum, I polled my fellow students on leadership topics they would be interested in. This is known as a “needs assessment” in the world of education. We then compiled the identified topics into eight classroom sessions over ten weeks, beginning with broad topics like “developing your personal leadership identity” and then transitioning to the more granular topics like “effectively giving and receiving constructive feedback in your career.”
With each topic, we needed a speaker. As a student, I had few connections to lean on besides past mentors. Once again, it was the strength of having a core group of faculty who also felt passionate about this topic that made the process easy. The success of the curriculum coming together in its early stages hinged on being connected to resources and not being afraid to ask for help. Support came from fellow students, residents, and even administrators who wanted to contribute their thoughts on how to craft a successful curriculum. For other students developing electives, finding speakers or generating topics may not be their biggest challenge like it was for me. Still, there will undoubtedly be questions along the way about how best to engage students and how to create something that makes a lasting impact. I found success by prioritizing the student experience based on interests identified through surveying my classmates; I then built a curriculum out with that as the established centerpiece. Effectively communicating my intentions to class participants, whether students or presenting physicians, then attracted others looking to take part in building something meaningful together.
Phase 3: Active course delivery and gathering student feedback.
I assumed that more experienced educators do such a great job planning their curriculum that they can sit back when the course actually arrives. What I found instead was that the delivery of the new course was pretty much a weekly experiment identifying what worked and what didn’t. Coordinating the daily reality of a course actually required my constant engagement — everything from helping speakers find parking to breaking awkward silences when no other students wanted to answer an open-ended question. It was in those moments, though, that I fully felt a sense of ownership in having created a space where those awkward open-ended questions were being asked in the first place. Gathering student feedback was also extremely important to me: we had intentionally left some flexibility in the structure of class topics throughout the elective to allow for redirecting if necessary. Students filled out surveys every two weeks about what was going well, what wasn’t, and what they wanted to gain from the remainder of the course. Each week we would then relay that information to our next speaker so they could adjust and add to their presentation when possible. A big reason I feel this experience is something worthwhile for others to pursue is that both the speakers who presented and the students who were enrolled put so much thought into trying to improve it week by week.
Hopefully, sharing my experience illuminates how no prior knowledge of curricular development is needed to make an impact and develop an elective as a student — just an idea, some motivation, and a supportive network. Hopefully, other students feel empowered to try to express themselves and connect with like-minded peers through building something together. Not only did I gain friendships with students I may not have interacted with otherwise, but I was also able to connect with faculty members who may be key stakeholders in my future while showing them what I am passionate about. I firmly believe that student-driven courses can help medical education continually evolve and can show our faculty and administrators what we want to learn and how we want to be educated.
I am the first to admit that at times I have felt lost and insignificant in my medical education. Building an elective flipped those feelings and fostered a sense of connection. It created an opportunity where I could own a piece of my education and allow my passions to become evident to others.
Image credit: Lecture Hall (CC BY 2.0) by Accretion Disc