New Hyde Park, N.Y.-based Northwell Health is rethinking how to train the next generation of physicians in the age of AI, David Battinelli, MD, executive vice president and physician-in-chief at Northwell, and dean of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, said in a session of the Northwell Cardiovascular Summit on Oct. 1.
The school, which was created in 2008, is a 50-50 partnership between Hofstra University and Northwell. Students begin medical school by training as EMTs and working on ambulances. From the first day, each student also has a one-to-one relationship with a practicing physician in internal medicine, surgery, obstetrics, pediatrics or psychiatry. The school has no lectures or multiple-choice tests. Instead all assessments are orals exams, essays and practicals, Dr. Battinelli said.
The curriculum was designed for physicians who would be practicing in 2020. When a proposed update came back a few years ago, Dr. Battinelli said it looked like “rearranging the furniture,” so he paused it — in part because of AI. The school is now planning for how physicians will practice in 2035 to 2040.
“You must understand how young doctors learn, rather than how old doctors teach,” Dr. Battinelli said.
Here are three ways the school is rethinking physician training for the AI era.
1. The school’s curriculum is built around five drivers: continuum of care, decision-making under uncertainty, quality and effectiveness, social context and responsibility, and scientific discovery. Dr. Battinelli said those drivers remain the right ones for 2035 to 2040, and that AI could help the school finally deliver on them — for example, by tracking patient outcomes over time and giving every patient an AI assistant to coordinate their care.
“AI doesn’t tell you what to do,” he said. “AI needs to be harnessed to figure out how do you solve the problems you always had.”
2. The school also wants to prepare students to shift from physician-centered care to what Dr. Battinelli calls “connected care,” in which patients are connected to the health system and their own care beyond a scheduled appointment.
“I call it connected care because what you’re really trying to do is connect to what it is they actually want,” he said.
He compared it to banking. Decades ago, customers could access their banks only during specific hours. Banks solved that not by extending hours or opening more banks, but by changing how customers connect.
In cardiology, he said only about 20% to 25% of patients diagnosed with hypertension and on medication have it under control. The blood pressure cuff measures blood pressure, he said, but it gives patients no practical way to monitor their own. Dr. Battinelli said, validated wearable blood pressure monitors — enabled by advances in AI and other technology — could do for hypertension what continuous glucose monitoring did for diabetes.
3. The school wants to move from a time-fixed training model to a time-variable one and let students differentiate earlier.
“We are in a time-fixed structure. Everything is fixed. It’s not the right way to educate,” Dr. Battinelli said. He said students headed into ophthalmology, orthopedics and obstetrics are in a good position for time-variable learning.
On concerns that earlier specialization could hurt students in the residency match, he said: “Just forget about the what-ifs. Just do the right thing, and things are going to work out.”
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