Interdisciplinary care from the medical student perspective

Both medicine and dentistry are aimed at preventing deleterious health conditions, addressing and tackling health disparities, educating communities and patients about taking charge of their health, and diagnosing and treating malformations and diseases. Yet how often do doctors and dentists — better yet, medical students and dental students — work together? How can we learn from each other and, ultimately, work as a cohesive team?

It starts with what’s learned in the lecture hall. At my school, we’re taught one lecture on dental anatomy and one on oral cavity nerves. We’re not taught to ask patients about their dental history — at least not from the adult perspective. (With children, during their annual well-child exams, we ask how often they brush their teeth, the type of toothpaste they use and how often they see their dentist.) We’re not taught important differential diagnoses in relation to oral pathology. What’s more, when a hospital or clinic patient presents with new onset dental pain/pathology, we have no clue where to start. What questions am I supposed to ask the patient? How should I inspect the oral cavity, aside from shining my pen light and looking for ulcers, lesions and xerostomia? If I do see something, how do I describe it?

No matter how great the field of medicine is, there is a divide. There are doctors who are specialized in every organ of the human body, yet there aren’t many who have a working knowledge of oral anatomy and pathology. There is much medical students can learn from our peers at neighboring dental schools, and I believe dental students share the same sentiment.

For us to work together effectively, we must first get to know each other and find common ground. Why not have quarterly medical center-wide social gatherings that bring students from all schools together? Some schools are starting once-a-year interdisciplinary sessions where students from neighboring universities work together for a day to discuss two or three patient cases, covering topics such as formulating differential diagnoses, creating management plans and counseling patients.

There should be more than this one session, though. Why not have a series of lectures throughout the school year that covers topics that both medical and dental students learn about? For instance, hypertension, diabetes, heart and lung disease, and obesity are universal risk factors for most health problems; medical and dental students could learn about these in one space. What about oral anatomy and common pathology seen in both fields? What about insurance? Many don’t speak freely about PPOs, HMOs, Medicare and Medicaid, and how these impact patients.

There could also be standardized patient exams that require both a medical and dental student to see a patient together, create an assessment and plan, and meet with him or her to discuss findings and next steps. In addition, dental students should have the opportunity to rotate through hospitals and outpatient clinics and work alongside their medical school peers.

One of the biggest ways we can make an immediate impact is at health fairs. If someone visiting a health fair hears the same message from each health care provider, then the individual will be more likely to take positive action. This is our opportunity to take what we have learned in the classroom and share it with our community.

Much effort and planning need to take place in order for interdisciplinary learning to become a reality. We can keep the conversation going, though, by sharing our knowledge and ideas on how we all can be on the same team.

~Ton (T.J.) La Jr., Baylor College of Medicine and the University of Houston Law Center

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About Ton La Jr.

Ton (T.J.) La Jr. is a third-year MD/JD student at Baylor College of Medicine and the University of Houston Law Center. He serves on the American Medical Student Association Board of Trustees as student editor of The New Physician. T.J. is an aspiring pediatric surgeon with an interest in health policy, medical malpractice and medical ethics.

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