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New York City
July 2001

Downstate’s Dean Eugene Feigelson: Professionalism in a New Curriculum
by Joan Baum, Ph.D.

As the Dean of the College of Medicine, one of the five major divisions of The State University of New York Health Science Center at Brooklyn, known simply as Downstate, Dr. Eugene B. Feigelson holds an understandably responsible position: Downstate is the borough’s only academic medical center. Older than the Brooklyn Bridge, and serving over 2.3 million people, Downstate educates and trains one of the nation’s most diverse group of graduate students. More than any other medical center in the country, it provides the City of New York with its largest number of physicians, many of whom return to their local neighborhoods to practice.

Incisively, and with a focused and reflective manner that suggests both his own specialty, psychiatry, and an authentic devotion to the mission of a large urban teaching complex, Feigelson notes that Downstate ranks seventh in the number of graduates engaged in academic medicine. He has created an innovative new curriculum, aiming for medical education “on a human scale,” he says. This has meant a significant reduction in the large lecture classes that dominated the old system because “the kids weren’t going to them,” as well as an expansion of case and problem-based, interactive learning, including focusing on basic science, and early exposure to clinical practice, involving students directly with patients in their first year. The old way, the Dean says, was the “gastro-intestinal form of medical education—stuff it down, regurgitate.”

Before he became Dean, Feigelson had been chair of the Psychiatry Department, and later on, of Family Practice, and then Vice Dean. Soft-spoken, a slight drawl betraying his early days growing up in a coal-mining village in Alabama (“the only Jewish family in town”), he speaks of how he psyched out the battle of revamping the curriculum—in effect taking it on in the spirit of psychotherapy. He read surveys about performance and attitude. Students, he knew, had been complaining about their first two years at Downstate. They needed a closer connection between basic science and clinical practice, each infusing the other, continually. They also needed mentoring, early on.

So did the new curriculum work? “Who knows?” he says with a kind of laconic playfulness. Did the old system turn out bad doctors? No. Does the new one turn out better ones? “Society will have to decide.” What he does know is that the new curriculum has “considerably improved [student] morale.” And for those with their eyes on the boards, he notes that the new exams now contain more clinical questions. Feigelson meets with every student in the senior class in groups of six, and he has created an Office of Education in the Associate Dean’s Office, where he meets with representative faculty.

Fifty-five percent of graduates go into Primary Care, and many others go into Internal Medicine and Academic Medicine. Most come from New York State and remain here to practice medicine. Feigelson is especially proud of Downstate’s success in graduating large numbers of students from diverse and minority backgrounds. “Kids are hungry to become part of the American dream,” he says. “It’s heartwarming to listen to the names called out at graduation—Asian, Russian, African-American, so many. We’ve probably got one of the highest Yarmulke counts of any medical school.”

Downstate is competitive, with an acceptance rate of 180 out of the 370 who make it through an application process that cuts off at 2,800. Feigelson confess he misses the ‘good old (pre-’60’s) days’ when money was never a topic of conversation and when students felt that going to medical school was a privilege, not an entitlement. And when there was a less permissive attitude about cheating, a topic recently brought to the attention of the 14-member New York Association of Medical School Deans of which Feigelson has just recently been made President. His concern expresses his personal views as much as his professional ones: Dr. Eugene Feigelson still believes that medicine is a noble profession. Downstate’s new curriculum, he says, does not take the concept of professionalism for granted. #


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