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Family Centered Experience

How U-M Diabetes Patients Are Helping the Physicians of Tomorrow

Since 1848, the University of Michigan Medical School has taken great pride in their innovative medical education, research, and clinical care. Awarding over 20,000 medical degrees over the past 159 years, Michigan has consistently ranked among the nation’s top-tiered instructional institutions. To stay at the forefront of medical care, the medical school is teaching the next generation of physicians the art of communication — through a program instructed by real-life patients.

The program entitled the Family Centered Experience (FCE) was created in 2003 by Casey White, Ph.D., assistant dean for medical education, and founded by White, along with Arno Kumagai, M.D., who is now director of the program and associate professor of internal medicine, and Rachel Perlman, M.D., who is associate director of the FCE and assistant professor of internal medicine.

The FCE, a leading program of its kind, pairs first-year medical students with volunteer patients and their family members. The volunteers, diagnosed with chronic illnesses such as diabetes, rheumatoid arthritis, multiple sclerosis, and cancer, meet with the students over a two-year period. The students gain real-world experience and see firsthand how chronic illnesses affect the volunteers and those close to them. Additionally, students gain insight into the important connection between health care and the patient’s culture, health beliefs, and family influences. While the students do not provide medical care, they are encouraged to accompany the volunteers to their doctor appointments to observe the interaction and communication with their physicians.

The patient volunteers serve as the "professors" for the students, and among the volunteers are many individuals with type 1 or type 2 diabetes who teach beginning medical students about the challenges and triumphs of living with the disease. "The one thing that I’ve learned from my patients over the years is that diabetes isn’t just about ‘the numbers," says the FCE Director, Dr. Kumagai, who is also director of the Intensive Insulin Therapy Clinic at the UM Diabetes Center. "Diabetes isn’t just a disease but an entire way of life. For medical students to learn this lesson from people with diabetes is, I believe, essential to the development of doctors who are capable of providing compassionate, patient-centered diabetes care."

First-year medical students Caitlin Enright and Ashwin Vasan feel the course is extremely valuable and just another reason why Michigan is a top medical school. They had been paired with John Kulka, who suffers from type 1 diabetes.

"I think the primary goal of the Family Centered Experience is to teach physicians the importance of understanding their patients’ perspectives. For me, I came into medical school with a certain assumption about how it would be to interact with patients – what they might be experiencing, etc. However, the fact remains that I have never suffered from a chronic illness where I needed to see a physician on a regular basis. If I had a bad experience, I could just avoid the doctor for a while. However, patients like Mr. Kulka cannot do that. Therefore physicians need to remember the importance of building relationships and to customize treatment plans according to their patient’s individual needs," says Enright.

John, the patient volunteer paired with Enright and Vasan, was diagnosed with diabetes in 1968 at the age of four. He has a vast amount of experience in living with type 1 diabetes and as a patient knows firsthand that good rapport with his physician positively influences how he deals with his disease. "The students see firsthand what it is actually like living with a chronic condition like diabetes and how important it is for physicians to get to know their patients. It is a great program and I will continue to take part as long as I can."

"The FCE program allows medical students, from the very beginning of their pre-clinical training, to begin thinking critically about the social, psychological, and economic effects of dealing with chronic illness on patients and their families. In addition, as we follow the patients throughout our two years of pre-clinical work, we are exposed to longitudinal, continuous care, which is often lacking in the hospital setting, and which focuses mainly on acute, periodic management of illness," says Vasan.

Students also share their personal experiences in small groups with faculty instructors. Each experience is unique and the students discuss what they have learned and how different social contexts like health beliefs, support systems and financial status can affect someone’s ability to manage their disease and how these circumstances vary greatly from person to person.

"I think the FCE program will be invaluable to us as students. It will better prepare us to think of our patients not only as people who are sick and in need of our help, but as complete people with many other life considerations that impact their ability to effectively manage their disease," Vasan says.

The Family Centered Experience is currently recruiting volunteers who live within 30 miles of the medical center with chronic medical conditions that have a significant impact on their lives and perspectives and who are willing to teach students to be better doctors. For more information on the Family Centered Experience, click on the logo below or visit