Adult placing stethoscope on the chest of a naked baby, the baby reaching for the adults hand and face, the adult smiling and looking at the baby's face
Medical student Varsha Pudi listens to a patient's heart during a Doctoring In Vermont session at Essex Pediatrics. (photo: David Seaver)

Hands-On Learning

Medical students work with patients early in curriculum.

August 19, 2024 by Janet Essman Franz

Baby Andrew coos contentedly while Varsha Pudi ’27 listens to his heart, feels his abdomen, and looks inside his ear with an otoscope.

This is Andrew’s six-month checkup, a time for the pediatrician to scan his growth and talk with his parents about his eating, sleeping, and development.

This is Pudi’s third session of Doctoring In Vermont, an eight-session course that spans the first and second year of the medical school curriculum.

Pudi listens and learns as Hannah Johnson, M.D. ’20, confers with Andrew’s parents. Johnson, a pediatrician at Essex Pediatrics in Essex Junction, Vt., serves as Pudi’s preceptor. “The experience has been fun and interesting,” Pudi says. “A physical exam on a newborn, infant, or toddler is very different than an adult because they move around a lot and are significantly smaller… Reassuring parents about their child’s health is very different than the practice of medicine with adult patients.”

Doctoring in Vermont (DIV) pairs first year medical students with physicians in the community. Students spend eight sessions observing and participating in direct patient care and practicing history-taking and examination skills. Martha Seagrave, PA-C, R.N., professor of family medicine, serves as course director and Judy Fingergut, M.D., assistant professor of family medicine, is associate course director.

At each DIV session, Pudi observes Johnson interviewing patients and families and asks her own questions to assess patients’ conditions. The student and preceptor work together to determine diagnoses, which helps Pudi realize she has skills and knowledge to contribute to the medical field.

“It was fun watching her make clinical connections to the content she's learned in pre-clinical courses,” says Johnson, who recalls her own Doctoring in Vermont experience during medical school at UVM. “I remember thinking the same thing as a medical student when she was surprised about how loud a baby's heart sounds through a stethoscope, and how fast it beats compared to an adult’s.” 

Two people standing in a corridor talking with each other, both wearing stethoscopes around their necks and holding laptop computersHannah Johnson, M.D., (left) a pediatrician at Essex Pediatrics and UVM medical school graduate, confers with medical student Varsha Pudi. (photo: David Seaver)

A person wearing a physician’s white coat and blue gloves examining the hand of another person while a third person wearing a “medical student” badge observes

Nick Jowkar '27 (left) observes as Kevin Lutsky, M.D., associate professor of orthopaedics and rehabilitation, examines a patient's hand and wrist at the UVM Medical Center Orthopedics Rehabilitation Center. (photo: David Seaver)

Community-defined learning opportunities 

In addition to Doctoring in Vermont, Larner medical students have multiple opportunities to participate in hands-on learning in the community during their first year of medical school. This includes visits to the medical center to shadow nurses and talk with patients, summer research projects, and community field work.

This summer, several Class of 2027 Larner Summer Research Fellows shadowed physicians at the UVM Medical Center Orthopedics and Rehabilitation outpatient clinic where they observed musculoskeletal assessments and interacted with patients in the examination rooms. And nine participated in a Global Health Elective, each contributing to the work of a medical team in Vietnam, Uganda, or the Dominican Republic.

Additionally, more than 60 Class of 2027 students participated in summer research projects funded by the Larner College of Medicine Fund, the Cardiovascular Research Institute and UVM Cancer Center. Some students conducted a needs assessment of local high schools for adaptive sports, while others investigated impacts of social determinants of health on access to non-FDA approved cancer therapies for pediatric patients, or scrutinized quality of care for older adults with cognitive impairment receiving treatment in the ophthalmology clinic.

Currently, ten medical students in the Class of 2027 are gaining hands-on health care experience through the Schweitzer Fellows program. This includes Claire Baptiste and Hamza Mirza, who lead blood pressure management conversation circles with Jamaican farmworkers in Vermont, and Greta Joos and Naomi Burhans, who host foot care clinics for unhoused people.

Claudia Tarrant '27 explains how the Doctoring In Vermont course nurtured a deeper understanding of the knowledge she gained through coursework:

“After almost a year of didactic material it was exciting to get into the clinical setting and see how much I knew and understood regarding indicated testing, differential diagnoses, and prescribed treatments,” says Tarrant, whose eight sessions took place in the UVM Medical Center emergency department. “The scope of practice of providers is vast and changeable on any given day. The system is imperfect and messy, but I was continually impressed with the work ethic, patience, and optimism in the providers I engaged with.”

A person wearing a colorful dress and head scarf, seated on a couch with her foot up in the lap of another person wearing a black t-shirt and black rubber gloves and seated on the floor with her hands on the other person's foot.

Naomi Burhans '27 provides foot care to a resident of a shelter for the unhoused. (photo: David Seaver)

Community based, experiential opportunities help cultivate skills and foster deeper understanding of knowledge gained through coursework.