A new program at the School of Medicine is betting that matching students with chronically ill patients, who they then follow throughout their four-year curriculum, will help them to become better doctors.

Was it Christian Street or Catharine Street? The two medical students weren’t sure as they navigated the densely populated blocks of the Gray’s Ferry section of Philadelphia looking for the home of the kidney-transplant patient they had met in clinic a few weeks before. Ericka Gibson, a graduate of Spelman College in Atlanta, was new to Philadelphia and still getting to know the city as she neared the end of her first year of medical school at the University of Pennsylvania. Her classmate, Casey Halpern, had grown up in the Philadelphia suburb of Radnor, Pennsylvania, and had spent four years at Penn as an undergraduate. Still, he wasn’t that familiar with the working-class neighborhood just across the South Street bridge from Penn’s sprawling medical complex on the west side of the Schuylkill River.

Once a lower-middle class stronghold, Gray’s Ferry is now being gentrified, with renovated rowhouses and new condos sprouting on nearly every block. While this new wealth has brought opportunity, it has also posed challenges, including the prospect of higher property taxes for the elderly residents on fixed incomes, many of whom have lived in the neighborhood for generations. Mary Bullock, a 67-year-old widow who has lived in Gray’s Ferry for more than 50 years, vows to hang onto her three-story rowhouse in the 2400 block of Christian Street. “They buyin’ out here like hotcakes,” she says. “But not me. Not now, anyway.”

As they criss-crossed the neighborhood trying to find Bullock’s home one sunny afternoon in June 2004, Gibson and Halpern were among 150 entering students at Penn’s School of Medicine who were embarking on a bold new experiment in medical education. Beginning with their class—the Class of 2008—Penn started requiring all entering medical students to be matched with a chronically ill person in the community, whom they are to follow for four years. The patients, recruited from among the practices of Penn-affiliated doctors, range in age from three to 96. Their illnesses run the gamut—from renal disease, as in Bullock’s case, to HIV, heart disease, diabetes, asthma, rheumatoid arthritis, and many other conditions that medicine can treat but not cure.

The students are grouped into pairs. Each pair is asked to get to know their patient during an initial home visit or a visit someplace on the patient’s home turf such as a community center or a church. The students then follow the patient during clinic visits and come to the patient’s bedside if they are hospitalized. The students are also encouraged to call their patient at least once a month and to keep a personal journal about their experiences. The goal, say school officials, is to help medical students see the world from the patient’s perspective—and thereby become better doctors.

“How do you get to know a patient as a person first, not as a container for a disease?” asks Dr. Paul N. Lanken, a critical-care pulmonary doctor who heads the medical school’s new program, known as LEAPP, for Longitudinal Experience to Appreciate Patient Perspectives. “The disease is the disease. But the illness is what the patient, as a person, experiences. You can study diseases in textbooks, but you can only understand illness by talking to patients.”

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©2005 The Pennsylvania Gazette
Last modified 07/02/05

Leapp of Faith
By Huntly Collins

Photography by
Candace diCarlo

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