TOPMEd: Team-Oriented Patient-centered Medical Education

topmednewlogo200x200The TOPMEd program seeks to inspire and prepare future Family Physicians to provide patient-centered and team-oriented medical care in rural and underserved communities. TOPMEd is an innovative program which enhances the Vermont Integrated Curriculum through inter-departmental collaboration, and is designed to ensure that medical students have the knowledge, skills and attitudes necessary to provide patient care in a changing healthcare landscape.

What is TOPMEd?

TOPMEd is an innovative, longitudinal training curriculum developed by faculty in the Department of Family Medicine. Led by Martha Seagrave, PA-C, Associate Professor and Director of Medical Student Education, it is supported by a five-year grant from the federal Health Resources and Services Administration. The TOPMEd project team is ensuring that principles related to team-oriented and patient-centered care are integral parts of the existing curriculum. According to the VIC competencies, "students must demonstrate an awareness and responsiveness to the larger context of systems of health care and use of system resources." Our healthcare system in the 21st century requires that students be able to rely on team members and collaborate with the patient throughout the course of care, and the TOPMEd program is helping UVM educate students with that goal in mind.

Why TOPMEd, Why Now?

Healthcare in the United States is being redesigned to ensure that all Americans have access to affordable and quality medical care. Primary Care is a crucial part of this effort. With an aging primary care workforce, we need to recruit and train more primary care physicians. It has been shown that areas with greater proportion of primary care physicians have better health outcomes, decreased health costs and greater patient satisfaction. Family Physicians are ideally suited as leaders in primary care because they provide preventive, acute, chronic and psychosocial health care as well as perform a wide range of procedures for all members of their community regardless of age and gender. To better serve patients, many family physicians are moving to a more systematic team based approach to healthcare. This approach relies on a team of physicians, allied health professionals and healthcare staff that recognize and address the unique needs of individual patients, their families and communities. The family physician coordinates care for the patient whether they are at home, in the office, or in the care of a subspecialist. TOPMEd seeks to highlight the systematic, team-based, and essential role of family physicians in medicine and further the government's mission to increase the Primary Care workforce.

What is TOPMEd doing?

Enhancing the Curriculum:
The TOPMEd curriculum is being integrated into the existing UVM curriculum. It progressively introduces medical students to the concepts, language, and integration of knowledge, skills and attitudes central to the Patient-Centered Medical Home (PCMH) concept. Key components are enhanced by the expansion of the Family Medicine Clerkship to six weeks in length. This expansion allows students more opportunities to apply what they have learned into practice, and promotes students' career interest in primary care for the underserved. Education and training are integrated into the three levels of the curriculum: Foundations, Clerkship and Advanced Integration. Learn more.

Promoting Community Health Projects:
Students have multiple opportunities to engage in population health projects as part of all three VIC phases. Working with community members, students identify and strategically address local health issues. Their work usually culminates in a presentation and contribution to their practice. TOPMEd is working to support those community health projects by focusing student efforts on underserved communities. Learn more.

Expanding Experiential Opportunities:
The Family Medicine clerkship was increased by 50% to six weeks. Additional opportunities to work with disadvantaged populations and in Patient-Centered Medical Homes have been identified. A full week of active learning/skill building programming has been implemented. New advanced level courses in healthcare reform and curriculum development were created. Learn more.

Creating Student Resources:
The TOPMEd team is helping medical students understand healthcare and the opportunities associated with a career in Family Medicine. Learn more.

Martha Seagrave, PA-C
Associate Professor
Director of Medical Student Programs 
TOPMEd Principal Investigator

“Family physicians provide essential patient advocacy and coordination in an increasingly complex medical system. I am excited about this opportunity to link our innovative educational program to the Vermont Blueprint for Health, and ensure our graduates possess the tools and skills they will need to work confidently, effectively and competently in the emerging Patient Centered Medical Home.”