Continuity of Care — The LIC Model in Action


David Skavdahl. Medical Student

St. Mary’s is one of the 5 health systems in Maine which is taking part in the Longitudinal Integrated Curriculum (LIC) being pioneered by Maine Medical Center and Tufts University. The LIC is an alternative method of clinical learning during the 3rd year of medical school which encompasses the 6 major disciplines of medicine at the same time. In contrast to the LIC model is the traditional “block” structure which divides the disciplines into blocks throughout the 3rd year. In this model, a student stays on family medicine service or surgery service for an 8-10 week block of time. In the LIC model, we have exposure to each discipline every week for a 9 month period. The two major goals of this model are to develop a continuity of patient care which allows the medical student to see the disease process and give the patient continuity in their care. 

Over the past two months I have been able to see these goals put into action. The first example is of a woman who was diagnosed with breast cancer about the same time Bob and I arrived at St. Mary’s. She was a patient with my internal medicine preceptor and was subsequently referred to the surgeon who is also my preceptor. In this case I was able to follow her medical visits as well as assist in her surgery. Following surgery I participated in her necessary oncology care. Currently, I will participate in her medical visits until I leave in January. This all encompassing perspective allows me to see everything involved in the care of the patient and gives the patient someone who can be an advocate for his or her care. 

The 2nd example is a woman who I followed in the OB clinic. I participated in her prenatal care and was able to go to Maine Medical Center (MMC) with her for further testing and evaluation of the pregnancy. When she was evaluated at MMC, the OBs wanted to admit her and proceed with her planned C-section at MMC. It was disappointing that she could not deliver at St. Mary’s, but I was able to scrub into the C-section and participate in the delivery of her adorable twins at MMC. It was a wonderful experience as I was the only person the patient was familiar with. I was able to tell the OBs information about the patient that would have been difficult to obtain without a thorough chart review. 

I share these examples because they set the LIC model apart from the block model in a significant way. I would not have been able to participate in the full care of either of these patients if I was in the block structure. The LIC model gives us the flexibility to do this and I believe both the patient and the learner are better for it. We’ll see in 9 months, but judging from the first 3 I think it is going exceptionally well. I commend St Mary’s for taking part in such an innovative program.

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One Response to “Continuity of Care — The LIC Model in Action”

  1. Anita Lalonde says:

    Having had personal interactions with both the students, I commend St. Marys for taking part in a new approach. These med students are not only professional in nature but kind and respectful.

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