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Trauma Education in a State of Emergency: An Audit of the Curriculum at a Northeastern Medical School

Avi Lebenthal, MD, Stephen D. Waterford, MS, Jonathan D. Gates, MD
Brigham and Women’s Hospital- Division of Trauma and Burns; Boston, MA


PURPOSE OF STUDY
Trauma is the leading cause of death among persons aged 1-44 in the United States and is the 4th leading cause of death overall. It accounts for more lost years of life than atherosclerosis and cancer combined. In the United States over 100 billion dollars are spent annually in the care of trauma. Very little is known about the quantity of trauma education in American medical school curriculums. We sought to determine if trauma as a disease receives appropriate attention in the medical curriculum by examining the pre-clinical curriculum of a northeastern medical school.

METHODS USED:
A quantitative review of the pre-clinical curriculum at a northeastern medical school was performed. The total number of hours devoted to trauma education was compared to the total number of hours devoted to the other top 10 causes of mortality in the United States.

SUMMARY OF RESULTS:
A total of 6.33 hours were devoted to trauma in the first two pre-clinical years of curriculum. 0.33 hours of lecture time was spent on trauma; this was a lecture on describing fractures on plain films. 6 hours of small group time, where students meet to discuss a case, was spent on a single trauma case, involving one patient who fell from a height. There were no lectures on resuscitation or management of trauma patients. By contrast, the number of hours devoted to the other top 10 causes of death far exceeded that devoted to trauma (Table 1).

CONCLUSIONS:
Compared to the morbidity and mortality of trauma, little time was spent on trauma education at this northeastern medical school. The question is whether this is an isolated problem or indicative of a much larger problem in medical education. Future data will examine trauma education during the clinical years and at other institutions in the United States to further characterize the disparity in trauma education. Based on these priliminary data, future physicians at this northeastern medical school are receiving almost no education in trauma.

TABLES AND CHARTS:
Top 10 Causes of Death in the US, all age groups Curricular time (hours)
Heart Disease128
Malignant Neoplasm76
Cerebrovascular13
Chronic Respiratory80
Unintentional injury (trauma)6.33
Diabetes mellitus15
Alzheimer’s disease1
Influenza/Pneumonia16
Nephritis16.5
Septicemia2.5

 

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