Gwen McIntosh, MD.

Interview by Alissa Siegenthaler, AHEC intern

MADISON — UW medical students will have greater continuity from one rotation to the next, under new leadership in the curriculum office. “One of the reasons my position was created was to better integrate curriculum across the clerkships, instead of each clerkship existing in isolation,”explains Dr. Gwen McIntosh, MD, who became the Director of Clinical Curriculum at the UW School of Medicine and Public Health in January 2012. In this new position, Dr. McIntosh is responsible for coordination among all third-year clerkships and fourth-year courses for the medical students, during the time they are placed in communities across the state. She also continues to practice as a general pediatrician at the UW-Health East Clinic in Madison.

One of the core-required clerkships for third-year students, the Primary Care Clerkship, is being enhanced through an ongoing partnership with AHEC. “We are trying to create more intention in terms of what the students are learning,” Dr. McIntosh adds, “so when redundancy occurs, it’s planned and benefits the student’s education.” Another focus is looking at “how we can weave common threads throughout the clerkships.” For example, Dr. McIntosh says patient safety concepts will be covered in most of the clerkships to help the students see what patient safety might look like throughout all of their rotations during the third year, including Pediatrics, Surgery, the Primary Care Clerkship, and others. Dr. McIntosh explains that this integrated approach will help the clerkships to communicate with each other more. “People have been willing to work with each other, which has been nice.”

Dr. McIntosh also oversees the Year-End Professional Skills Assessment (YEPSA), an exam that all third-year medical students have to pass as a graduation requirement. This clinical scenario exam takes students through 12 clinical stations. It allows the students to demonstrate the clinical skills they have been learning in the last year. “It’s a way for us to look at the students in a snapshot at the end of the year to be really sure that the students have attained mastery of the skills that we want them to have developed over the course of the third year and make sure they’re ready to move onto the fourth year,” says Dr. McIntosh. The second purpose YEPSA serves is practice for the national licensing exam, “Step 2 Clinical Skills.” Dr. McIntosh says YEPSA’s exam format is very similar to the national licensing exam in terms of clinical scenarios that the students have to walk through.

Overseeing YEPSA is a natural component of Dr. McIntosh’s new leadership position because all of the clerkships contribute to the content of YEPSA. Each clerkship develops one or two YEPSA stations and determines the critical content that a student must cover to pass. Coordination from Dr. McIntosh and an advisory committee will help ensure that there isn’t too much emphasis on one particular skill or one particular clinical disease, and to allow for integrated content among the stations. In the past, if a student entered a YEPSA station and saw a surgeon there as the evaluator, it was obvious to think “surgery” and respond with that in mind. Yet in real situations with patients it is often not so obvious what approach to take. Integrated stations will offer fewer faculty clues to the students about what is being tested, and ultimately, it is hoped, better assess students’ knowledge base and ability to handle scenarios they will encounter

In reference to the statewide placements of medical students, Dr. McIntosh says she really enjoys seeing the unique bonds the students are able to develop with the local community preceptors. “I just want to say how grateful and thankful we are for a really strong network of community preceptors and all the opportunities that they offer our students and the unique experiences that the students have with them.”

Dr. McIntosh grew up in Mequon. After completing her undergraduate degree at Wesleyan University in Connecticut, Dr. McIntosh went to medical school at the UW and finished her residency and pediatrics at the University of Massachusetts. She says she had always planned on coming back to Wisconsin after school. “My husband is a New England native, so that was a bit of a change for him, but once we started having kids, Wisconsin was where I wanted to raise my family.”

Wisconsin Rapids is where Dr. McIntosh enjoys spending time during the summers. She enthusiastically described a time when her family received exceptional care from Riverview Hospital in Wisconsin Rapids. “We were there vacationing and my daughter had to get stitches. We had such a great experience! You know, I didn’t identify myself as a medical doctor, and we got great service from the moment we walked into the door to the moment we were discharged,” Dr. McIntosh says. That first-hand familiarity with the statewide medical resources has reinforced her appreciation for the structure of the third and fourth year rotations. “The opportunity it gives our students to see care in a variety of settings, to go out into smaller communities and see the broad range of clinical practices,” she adds, “is wonderful.”

Overall, Dr. McIntosh hopes the newly integrated curriculum will help students think about their role as physicians in a much broader sense – “not just at the bedside, but in a community as well”- in order to create a strong primary care workforce. “The great feature about AHEC is how you are tied into public health, which is one thing we really want our students to experience,” she says. When students go out into communities, “they get to see what it’s really like on the front lines and what it looks like for most practicing physicians in the country.”