Filling the gap

Answers in Practice

Louis Kuchnir, MD

Louis Kuchnir, MD, discusses his gap year program for prospective medical students

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Dermatology World: Tell me about your gap year program.

Dr. Kuchnir: About four years ago, I realized that many students planning to enter medical school are not going directly from their senior year in college to medical school. Instead, they are taking a gap year in between. However, there are very few clinical opportunities and many of the most qualified pre-medical students have extensive research and volunteerism experience already from their time in college. I determined that the college graduate who was not only intending, but clearly capable of being in medical school, could function very well as a temporary employee in a dermatology practice, so I developed a 14-month gap year program for these students in my practice. They get a fixed salary and benefits.

Dermatology World: What does the prospective medical student do on a day-to-day basis?

Dr. Kuchnir: In my office, they serve as patient care coordinators. They fulfill both traditional roles of medical assistant and medical receptionist. They answer phones, take copayments, bring patients to examination rooms, and write down why the patient is there. They help the dermatologist by serving as scribes for medical record keeping. They also make sure that the supplies are in order and sterilize the instruments. They can be taught to remove sutures, explain handouts or pamphlets to patients, and arrange follow-up appointments. In short, they do everything that happens in a dermatology office that does not require a medical license.

With this program, each employee works for 14 months and commits to helping with the recruitment, hiring, orientation, and training of their successor. The 14-month overlap happens in June and July, so that new coordinators can shadow the old ones before they leave for medical school. We also do some teaching and give lectures on subjects from biology to ethics.

Dermatology World: How do you find and select your candidates?

Dr. Kuchnir: We do a national search for candidates through college campuses. From that group of resumes, we recruit and interview prospective hires in January and February, and hire them in March. The students we interview already have their medical school letters of reference. We also check their MCAT scores and GPA. In the beginning of April, I do my best to give away the resumes for the folks I won’t hire to my colleagues who wish to start or continue a similar program.

Dermatology World: How many of these care coordinators do you hire for each 14-month program?

Dr. Kuchnir: For the 2014-2015 year cycle we had 10 in my practice, and eight others worked in practices elsewhere mostly in Massachusetts. Last year we had nine in my practice and seven in other practices. In the 2012-2013 year, there were three in my practice, and the year before we had one. For the 2015-2016 gap year cycle, I will probably hire a total of 11. I don’t know how many of the others will get hired by my other dermatology colleagues.

Dermatology World: How many applicants do you usually receive?

Dr. Kuchnir: This year, we interviewed 102 applicants on seven college campuses. Over the years, the number of applicants has increased because gap years have become popular both with students and medical schools. Business schools have always wanted more experience before their students matriculate, and while medical schools historically have shunned it, they are now open to it, if not supportive. When these prospective students are interviewed, medical schools are impressed that they’re using their time well. It’s understandable that people who want to be clinicians would choose a job where they’re directly working with patients.[pagebreak]

Dermatology World: What value does this program offer the practice?

Dr. Kuchnir: The main thing is that the work they do is excellent. We are getting a higher-quality employee who is answering our phones and greeting and serving our patients than we had in the past. It’s also improved the spirit of the office. We benefit from having an enthusiastic, dedicated entry-level staff. Also, we get to enjoy planned turnover. I get a lot of advance notice not just two weeks and a commitment from the employee to help with recruiting, hiring, orienting, and training their successor.

Dermatology World: Have you received any feedback from some of the “graduates” of this program?

Dr. Kuchnir: We’re starting to get feedback from the alumni of this program who are now in their first, second, and third years of medical school who say they are better able to take advantage of learning opportunities in medical school after having had this experience. When they leave, they are grateful that they experienced what they did and they are looking forward to building on to what they learned.

Dermatology World: What value does this provide for patients and the specialty as a whole?

Dr. Kuchnir: We don’t expect many to become dermatologists, but through this program they begin to develop bedside manner and a high level of compassion and service toward actual patients in a clinical setting. We have 12 years of post-high school education to make board-certified specialists out of them. Every year they have to learn something, and they really mustn’t waste any time in their 20s.

Also, these future physicians will see the important work that we do as dermatologists, and have a good understanding of the significance of the diseases that dermatologists are best equipped to manage. Dermatologists invest enormous amounts of time and energy educating our assistants about the medical thought-processes of our work. This education is truly appreciated by the students in their role as coordinators because they get a first-hand view of how we do our work in the office setting.

Dermatology World: Is this program something you would recommend other physicians to undertake? If so, how would they go about getting started?

Dr. Kuchnir: Yes. Start by posting a position like this at local, high-quality colleges. Plan to start the students after graduation and release them in time to move to medical school. Post the job in January and start doing interviews in March or April and then go from there. Also, if a physician were to contact me on April 1, I have amazing resumes to give away.

Dr. Louis Kuchnir is in private practice at Kuchnir Dermatology & Dermatologic Surgery in Marlborough, Massachusetts.