Joey Wahler (Host): They play a vital role in healthcare. So we're understanding Carle Health as a teaching hospital. Our guest, Dr. James Kumar, a Hospital Medicine Specialist, Clinical Professor at Carle Illinois College of Medicine and also Medical Director and Designated Institutional Official for Carle Graduate Medical Education.

This is Expert Insights with the Carle Foundation Hospital. Thanks for joining us. I'm Joey Wahler. Hi, Dr. Kumar. Welcome.

James Kumar, MD, MS, FACP, FHM: Hi. Thanks for being here.

Joey Wahler (Host): Great to have you aboard. So first we've all heard the term, but what exactly in a nutshell is a teaching hospital for those that might not be as aware? How does it differ from a general hospital?

James Kumar, MD, MS, FACP, FHM: Teaching hospitals are generally hospitals that are affiliated with an educational institution, could be a medical school, could be a graduate medical education entity. They are committed to teaching and they're registered with the Center for Medicare and Medicaid Services as an academic medical center or a teaching hospital.

So from a patient's point of view, you get to be seen by resident physicians, fellows, clinical fellows, and of course at times, students, when you come to a teaching hospital.

Host: And so you're really serving a dual purpose, right? You're treating patients, but there's also education taking place.

James Kumar, MD, MS, FACP, FHM: Exactly. And this also goes along with the concept of lifelong learning, which is a very important core tenet of medical practice. Clinical practice is lifelong learning. We all learn on the job as we keep doing and keep getting better. So the clinicians, the staff physicians, the healthcare providers also learn. And then we also have physicians in training, students in training who learn alongside of us. So learning gets to be a priority. 

Host: And that learning when you're in healthcare never really ends, does it Doctor?

Yeah, it does not end. It is still the last breadth that we continue to improve. We continue to learn and we continue to improvise. So I think that is something that's important.

Absolutely. So can you discuss for us this diverse range of medical professionals, as you touched on, that are in training at the hospital and how their involvement constitutes great patient care?

James Kumar, MD, MS, FACP, FHM: So, I'm going to talk specifically about graduate medical education or postgraduate medical education, where you are generally talking about medical residents, clinical fellows and you also have trainees in terms of pharmacy residents. They also come under the residency domain. And this all started by Dr. William Osler in the late 19th century when residents essentially were invited to work in the hospital and stay in the hospital and care for the patients. And that's where the structured learning and education program began, the concept of residency training.

 And once that was established and set in place, there were national accreditation entities that came along. And they set standards on how these educational programs need to be set up. So as you have standards being set, hospitals have to maintain those standards, and of course, frequently exceed those standards in terms of scholarly activity, research, educational innovations, and quality improvement. So that's where patient care and medical education go hand in hand.

Host: Very well put. So that being said, what are the general benefits for patients being treated in a teaching hospital?

James Kumar, MD, MS, FACP, FHM: The benefits are you will be and essentially cared for by a team of physicians; some of whom are very senior, who have achieved higher levels of academic ranks. And then you'll have physicians in training and medical students as well. And since we all have to maintain that standard, we are practicing the latest cutting edge medical care, as we care for our patients. And that would mean rapid and timely diagnoses of medical conditions, treatments that are evidence-based and based on the latest guidelines and also the experience of the seasoned clinician who is usually the physician that is directing the care. So you get a combination in terms of things that are very modern and cutting edge and evidence-based in terms of the latest technology; but you also get the experience and the seasoned approach to patient care.

Host: And so it seems like the term teaching hospital, which I'm sure goes way back, you were alluding to history a moment ago, that can be misleading in a way for patients, right? Because you're talking about many experienced staff and cutting edge research, which maybe some wouldn't expect at a quote unquote teaching hospital. Right?

James Kumar, MD, MS, FACP, FHM: Yes. So in a sense you have to take teaching as the tip of the iceberg, because there's a lot of stuff that's happening below the sea level and below the tip. Especially when you, one thing that you talk about teaching hospital is residents clinic, continuity clinic, practice that is essentially run by the residents.

And the common misconception is that, oh, these are just residents, resident physicians, physicians in training who are going to be seeing us. But the key point is behind every physician in the clinic, there will be senior physicians, professors, associate professors of medicine who are there to guide and teach the residents as they care for the patients.

So it's a very important thing that people need to understand that there's a lot more to teaching than just teaching.

Host: Very well put again. So when you talk about this cutting edge research that takes place from you and yours, how significant is the role of clinical trials at the hospital?

James Kumar, MD, MS, FACP, FHM: As you know, as medicine has progressed and diagnostics have improved; we are able to detect diseases, cancers, and chronic diseases way early. And we are also able to identify unique subcategories. Right? Previously we just thought it was lymphoma. Now we have so many different kinds of lymphoma.

And as a teaching hospital, it is our job to say how can we treat these unique patient populations better? And that's where the participation in clinical center, Carle Cancer Institute does a great job in partnering with nationwide studies and doing clinical trials to find out the latest and the best treatment for that subgroup of patients. So along the lines of what we like to call as precision medicine, where medicine is catered to the needs and the uniqueness of the patient that is in your clinic.

Host: A couple of other things. One being how about the teaching hospital's outreach programs and other initiatives? They're really aimed at improving the health of the local community overall.

James Kumar, MD, MS, FACP, FHM: Exactly, and so that's a big strength for a community system based teaching entity like we are as opposed to a highly academic university based system, which sometimes tends to remain in an academic bubble. We on the other hand, are focused on our community because we have roots deep into the community.

And then our accreditation entities come up with requirements on how as a educational program, we need to address healthcare disparities. We need to teach our residents about social determinants of health and automatically, one of the biggest facts in terms of medical education is the importance of experiential learning.

You experience, you give the residents and the students the experience and then they will learn. So, we develop these outreach programs. We collaborate with the health system, and we set up mobile clinics, satellite clinics, high risk, low risk ob patient clinics, right? All those outreach programs that reach out into the community to care for the patients, the people of the community.

Host: Well, it's certainly great to hear. And in closing here, to summarize, Doctor, how rewarding is it for you and yours to be having such a big hand in developing this next generation of healthcare professionals?

James Kumar, MD, MS, FACP, FHM: I've had the privilege of being involved in teaching for several years. I, myself was a resident from the program here in Champaign Urbana, Internal Medicine Residency, and I've been practicing here for more than 15 years. I'm an international physician. I trained, outside the country and I came here and I loved the welcoming nature of our community here.

And then I have the opportunity of guiding and mentoring several physicians and students through the academic journey and helping them find their niche in clinical medicine. And that is a reward that is priceless. You cannot put value on that, and you cannot even look back and imagine the impact that you and the system has enabled you to do that. And this is where Carle is important because it supports people like us. And there are several of us, who do this day in and day out in training the future physicians for our region.

Host: And clearly Carle is a richer place because of your worldliness and experience. Folks, we trust you are now more familiar with Carle Health as a teaching hospital. Dr. James Kumar, keep up all your great work and a pleasure. Thanks so much again.

James Kumar, MD, MS, FACP, FHM: Thanks for having me.

Host: And for more information as well as to get connected with a provider, please do visit carle.org, C-A-R-L-E.org, or for a listing of Carle providers and to view Carle sponsored educational activities, you can also visit carleconnect.com. If you found this podcast helpful, please share it on your social media. I'm Joey Wahler. And thanks again for being part of Expert Insights with the Carle Foundation Hospital.