The Inteflex Program

 

All the Wrong Reasons – The incentive problem in Medicine

I’d like to elaborate and explain my inflammatory, accusatory statement  “Your Doctor is Killing You” by focusing on the subtitle “and he doesn’t even know it.”  I truly think that most of my peers would NOT agree with me that we are killing people; unfortunately the statistics are gruesome.  It’s accidental mostly: a combination of greed, ignorance and persuasion by other, not so goodly types with alternative incentives.  It usually didn’t start out that way.

When asked why they went into medicine, many doctors will answer “to help people.”   Most patients would believe that and so would many doctors.  In fact, I think most of them are telling the truth; at least in the beginning.  The question is, what happens over time to change them into “the system” that orders all the unnecessary and often damaging tests and procedures?

There is no one thing that does it.  The change begins gradually,  starting even before medical school.  To get into medical school in the USA you have to be at the top of your class and score well on an entrance exam called the MCAT (Ehm Cat). Most classes in the “pre-med” curriculum are graded “on a curve.”  That means that even if everyone does really well on the test, only a certain percentage can get an “A.”   Now that’s understandable, someone has to be average, right?  Well unfortunately it leads to a system of intense competition, known colloquially as the “Cut Throat” or “Gunner” mentality.  It is certainly not an environment of cooperation that you, as a patient, would like to see in your doctor. Especially when you need services from other types of doctors in the future (more later about “turf” battles).    Competition is so intense that it leads to some seriously crazy behavior.  Cheating, psycho-battles of titanic proportions, you name it.  I’ll give you a little personal history about my education that will show you my point.

I was a good student in high school and scored well on the SAT test.  At that time I was living in Michigan.  I had no idea what I wanted to do, but was pretty good at math and science so I was looking at engineering.  I thought I might like to fly jet planes and even applied to the Naval Academy.  Unfortunately I wear glasses and at that time only 10% of the “Plebes” (1st year Naval Academy Students) could have an “eye waiver.”  (I.e. wear glasses).  Worse yet, those 10% would never get to fly the plane, they could only be navigators. I didn’t like the idea of being in the back seat all the time so I started looking at other options.  I went to see my high school counselor and she asked me “have you ever considered medicine?”  Of course I had had my Marcus Welby dreams but I was familiar with the system and thought that it didn’t matter so much which classes I took in the first few years of college, I could always become “pre-med.” later.  She surprised me with “Do you know about the Inteflex Program at the University of Michigan?”

The “Inteflex” program was one of a handful of “baby-doc” programs in the United States.  Although fairly common in other countries, it was unusual in the U.S.A. in the way it trained doctors.  Instead of going through the competitive hazing of the usual pre-med classes, students were accepted to medical school right out of high school.  The official name was the exhausting “Integrated pre-medical/medical Program at the University of Michigan.”  The idea was sound:  get students involved early and train them in a way that didn’t foster the intense competitive nature but instead would lead to cooperative physicians who care.  It was the 13th year of the program and one tempting advantage of it was that it took only 6 years (instead of the usual 8 (4 yrs of college + 4 years of medical school).  At that time they also had a stated goal of producing “compassionate primary care physicians.”

Well that sounded pretty good to me.  Especially since I couldn’t fly the jet and Harvard had offered me a paltry $1,300 in financial aid (tuition alone at that time was about 13K).  I filled out the application, got an interview, drove my 1973 orange Ford Pinto over to Ann Arbor and interviewed with a wild haired professor named James Kenworthy.  I had run cross-country (3 mile races) in high school and he interestingly started grilling me on why I would do that when soccer was such a better sport.  Needless to say I felt a bit weird arguing that off-topic with the esteemed professor and didn’t have particularly high hopes of getting accepted into the elite program.  Surprisingly, a few months later, I got an acceptance letter.  I really wanted to frame it, but after the first paragraph telling me I had been accepted, it went on to chastise me to send in my $250 deposit immediately or they wouldn’t hold my place.  Kind of a bad tenor to discuss money on your first day as a medical student don’t you think? By that point I had collected a few other small scholarships and the University of Michigan was looking like a pretty good deal. I sent in my $250 and prepared to become a doctor.

The year I entered the program they had had some budget cuts.  Michigan was in the middle of a serious recession, the results of the Arab Oil Embargo and making too many enormo-vehicles for too long while the Japanese were getting there big jump on efficient compacts.  Sound like a familiar story?  Anyway the program up till that year had had 50 students but my year they cut back to 46.  (Supposedly the first half of a 25% cutback).  They also increased the length of the program by one year, from 6 years to 7.  It was never quite clear why they did that but I wasn’t too upset.  The kids in the years ahead of me really ended up racing through school and, except for Doogie Howser, many of them were socially immature.  The net result for me was that I had the opportunity to take a FEW electives.  Unfortunately it also gave the people in the program an opportunity to throw in a few more mandatory classes trying to make this new “7 year class” less problematic with the maturity issues.  My favorite was ‘Techniques of Social Interaction.”  Apparently there was a need to teach us geeks how to interact with the normal population in some semblance of a normal fashion.

Cutting the class size also increased the competition for the remaining 46 slots.  When we finally did get on campus there were lots of students who had NOT gotten into the program and still ended up at the University of Michigan.  Needless to say some of them were a bit irritated.  Especially since many of them had scores just as good as ours.  With only 46 slots (and 8 of those were granted to “out of staters”)  the program obviously had to make some tough choices with regards to who got in and who didn’t.  How did they do it?  Practically every valedictorian of every high school in Michigan had been encouraged to apply.  Well I never got an answer to that question from anybody of authority but after looking at my class and looking at previous (and later subsequent) classes I noticed the following characteristics:

1)  Half male half female

2) Always at least one person from Michigan’s isolated (and VERY COLD) upper peninsula.  [1]

3) One set of identical twins.  One year male, the next female.

4) No more than half of the in-state class from Michgan’s “tri-county” area around Detroit.

5) Always one black female (occasionally more but always one).

So it looked like I’d gotten myself unwittingly involved in some sort of sociology experiment.  This was way before institutional review boards had any control over scientific experiments and “informed consent” was not really too important either.  Just to further convince me I had become a guinea pig of sorts I recall having to take half a day each year to fill out long questionnaires with probing demands such as “True or False,  “All babies look like monkeys to me.”  I’m sure I could find some attorney to sue the University for me, but since I’m still happy that I did actually become a doctor I think I’ll leave that for a more disgruntled soul.

Of the 46 of us that started many didn’t end up finishing.  One became an archeologist, one a lawyer, one went into business, another became an English major and two (including, unfortunately, the one black female in our class) flunked out.  Of the rest of us, we were given an incredible opportunity:  get into medical school and NOT have to participate in the cut throat pre-med business that occupied all the other students wishing to get into medical school.  I decided to take that gift and run with it.  I started by taking a bunch of classes I wasn’t particularly good at but found interesting:  Art History, Architecture, Italian Literature and Language.  I still had to take all the chemistry, biology etc. but I also had the luxury of taking a class I might get (aghast) a “B” in!  I reveled in that freedom and thought I would find many like-minded individuals in my cohort, but, unfortunately, I did not.  In fact, after I excluded the ones that went on to other fields eventually, I’m hard pressed to find more than one other.  In fact exactly the opposite of what I thought would happen occurred; The Inteflex students were BIGGER gunners than even the regular pre-med students.

In hindsight it shouldn’t surprise me.  You take the most successful high school students in the land, put them all together and expect them to relax?  I don’t think so.  Unfortunately some of them carried it way too far.  At least one got caught cheating on a chemistry test and later got expelled for a semester for plagiarizing an English paper.  The guy was a good friend of mine but I could never figure that part out; here he was ALREADY ACCEPTED to med school and he was cheating on a chemistry test.  All he had to do was PASS the class and he was worried about getting an A on the thing.  I couldn’t sort it out.  25 years later, I’m still bewildered.  I can tell you that he did become a high paid sub-specialist making big bucks and not a primary care doctor making (what he would consider) chump change like me.

I think, in the end, the experiment (the Inteflex Program) was a failure.  The original stated goal was to produce compassionate primary care physicians.  When it became obvious to the powers that be that that was not happening that stated goal was dropped.  I think it was also obvious that the kids going through in 6 years were way too immature and that is why they modified the program beginning with my year to be 7 years.  Later, they changed it to 8 years, which is ostensibly the same amount of time that a “regular” path through medical school would take.  I asked my wife recently what she thought, 26 years after the whole experiment and I was surprised at her response.  I guess I forgot to mention that she was also a student in the class of 46 “Flexies.”  3 pairs of us (6/46 =  13%) ended up marrying.  One marriage ended early and one of the other two dropped out of the program so I’m not sure they count and I just heard rumor that they got divorced so I guess that leaves us the last couple standing.  Anyway my wife’s response was that the program had done a disservice to many of the students and not helped but a few.

Her explanation was, as usual, eloquent.  The experiment had some unintended consequences.  Some the originators must have seen things (such as the immaturity of the students in the 6 year program) and tried to make changes.  The most important, however, is probably that a 16 or 17 yr old high school student is likely not equipped to make a final commitment to a profession at that time.  Especially given that the group that was recruited was of the top talent pool and could have probably done whatever they wanted.  In thinking back on our class of 46 we could think of probably only one other student besides me who had benefited significantly from the program.  And I’m not even sure about him as I haven’t kept in touch but he was a guy who I suspect was gay and is probably now an excellent physician but “might” not have gotten in to medical school back in the 80’s when the “typical” successful student didn’t much look like him.  Of the other 46 the 7 that dropped out might have been better off doing something else and the 2 that flunked out who knows?  I can tell you the one African American female who was probably the quota our year was woefully under-prepared for the intensity of the competition that popped up. She had done well at a small, mostly white, suburban Catholic parish school but I suspect her Detroit proper mailing address added to her attractiveness to the program administrators.  For her, however, it was a disaster.  She lasted only one year.

Of the others, I suspect all of them “could” have gotten in the regular way but that a few ended up becoming doctors even though they probably didn’t really want to be in the end.  It was pretty difficult to bail out (emotionally and otherwise).  The program surely didn’t want you to as it made them look bad.  Certainly after the first 2½  years of undergraduate college work had been done and the bona fide medical school classes (like gross anatomy) had started one had already received his junior union card.

Carolyn suggested I should file a freedom of information act request or something like that and try to obtain the raw data from the “experiment” that was the Inteflex Program.  I suspect she is right in her analysis but once again, since I’m still glad I’m a doctor and I think the program allowed me to relax enough during college to become a bit more “well rounded,” I think I’ll let that dog lie for now.  It is distressing, however, to see that even with good intentions, some things just don’t work.  The Inteflex program, as far as I can tell, did not produce an abundance of compassionate primary care physicians.  If they exist at all they have come to that point through force of personality only and have really succeeded despite the system in which they were raised.

I’ve thought about how I would change the system if I was the “Medical Education Czar” but haven’t come up with any fits of genius that would have much of a chance.  Since this endeavor is dedicated to the individual patient seeking how to protect him or herself from the system my only advice is to try to find those rare birds out there who have had the ego to bypass the system and act humanely despite the pressures to do otherwise.

There does seem to be one type of scenario that breeds kind, wise, compassionate physician: it is becoming more popular at medical schools so you may find more people out there who fit this description.  They consist of people who have gone to college, then gone on to do some “real” work or at least had some sort of “real” life experienc before starting medical school .   Woman who start families are a good example.  They then return to medical school as “older” or, as the administrators like to call them, “non-traditional” students.  In general, and I can say this after training medical students for the last decade and seeing many versions come through my office: the older ones are more realistic, have better interpersonal skills, and usually have great study skills.   They may not be the types that are going to win Nobel prizes but I think as far as doctors go most of them turn out for the better for having done something else besides medicine before they became doctors.

This brings us to one of the biggest issues of American doctors – Ego.  Now I would prefer it if doctors had BIGGER egos.  Sounds strange but usually the ones you think of as having these huge egos are actually the opposite;  they’re still trying to prove they are the best or that they are in control.  Maybe they are just trying to give a patient his money’s worth by sounding confident.  To me, the best doctor you can find is the one who will tell you “I don’t know.”  Or, even more importantly, “WE don’t know,”  and then take the time to explain to you why any other doctor who tells you otherwise is full of himself, miss-informed, insincere or financially motivated.  The ego issues are especially problematic between specialties.  Surgeons call Internal Medicine doctors “fleas” and many sub-specialists consider primary care a lower life form.  Pediatricians get a bit of a bye because adult medicine doctors don’t understand children very well but they still don’t get paid but a 1/4th of what many of the specialists bring in.  Why does it have to be like that among the doctors?  Well the answer comes at many levels.

Firstly there is just the simple matter of the competitive personality types that are recruited into medicine in the first place.   You really can’t change people`s personalities, even if you put M.D. after their name.  You can, however, as a patient and “consumer,” seek out those doctors who seem able to check their egos at the door and fess up when we just don’t know the absolute answer to your questions.

There are a few out there.  If you have one who doesn’t fit the bill keep looking till you find one.

Addendum:  To further investigate our supposition that the Inteflex program was a big sociology experiment, Carolyn and I traveled back to Ann Arbor as part of our 25th anniversary celebrations.  We went to the Bentley Library and dug up “7 linear feet” of old documents.  There were great e-mail chains that pretty much documented what we supposed.  It was especially interesting because all this occurred at the beginning of the e-mail era so I suspect many of the writers had no idea that the stuff would subsequently get printed out in hard-copy and land in a box in the Bentley Library!  Special thanks to the super-secretary of the program, Ann Zinn, who I got to know quite well and documented everything.  One of the directors, Donald Brown, PhD, (who interestingly was always listed as “co-director” even though the other, Alphonse Burdi, PhD., was listed as “director,” made an entire academic career publishing papers about medical education based on results gleaned from watching us poor rats!  It was fun to see pics of ourselves 25 years ago and realize just how young and impressionable we were.

Addendum 2:  This is the general info from the records at the Bentley Library.  The boxes that we went through were VERY interesting but even more interesting was what was missing.  Some of the info is apparently unavailable for 50 years and I doubt I will live long enough to care but if there are any old “Flexies” reading this, check it out next time you are in Ann Arbor.

University Archives and Records Program

Bentley Historical Library

University of Michigan

Finding aid for

Integrated Premedical-Medical Program

(University of Michigan)

records, 1972-2002

Finding aid created by

Michelle R. Bennett, 1996;

Leigh Jasmer, 2002

Summary Information

Title: Integrated Premedical-Medical Program (University of Michigan) records

Creator: University of Michigan. Integrated Premedical-Medical Program.

Inclusive dates: 1972-2002

Extent: 7 linear feet and 7 outsize folders

Abstract:

The Integrated Premedical-Medical Program, commonly called Inteflex, combined undergraduate and medical school education into one specialized curriculum program at the University of Michigan. Inteflex was conceived to allow an integrated, flexible program through a liberal arts education offered by the College of Literature, Science, and the Arts while also obtaining a medical degree through the MedicalSchool. Inteflex began as a six-year program in 1971, expanded to seven years in 1982, and again to eight years in 1994. The Inteflex program accepted its last entering group of students in 1998.

Call number: 9620 Bimu C26 2

Language: The material is in English

Repository: Bentley Historical Library, University of Michigan

1150 Beal Ave.

Ann Arbor, MI48109-2113

Phone: 734-764-3482

Fax: 734-936-1333

e-mail: bentley.ref@umich.edu

Home Page: http://www.bentley.umich.edu/

Access and Use

Acquisition Information:

The record group (donor no. 8377) was initially received from the unit in 1995. Additional accessions were added between 2000 and 2002

Access Restrictions:

The Integrated Premedical-Medical Program records are open for research except for certain records restricted by statute or university policy.

The Integrated Premedical-Medical Program record group includes restricted material in the following categories:

Student Academic Records — removed to vault

Access Restrictions for University of Michigan Records

University records are public records and once fully processed are generally open to research use. Records that contain personally identifiable information will be restricted in order to protect individual privacy. Certain administrative records are restricted in accordance with university policy as outlined below. The restriction of university records is subject to compliance with applicable laws, including the Freedom of Information Act.

Categories of Restricted Records:

Personnel related files , including search, review, promotion, and tenure files, are restricted for thirty years from date of creation.

Student educational records are restricted for seventy-five years from date of creation.

Patient/client records are restricted for one-hundred years from date of creation.

Executive Officers, Deans and Directors files . By university records policy in effect as of January 1, 2001, University records generated by the university’s Executive Officers, Deans, Directors and their support offices are restricted for a period of twenty years from their date of accession by the Bentley Historical Library. The restriction is subject to applicable law, most notably the Freedom of Information Act (FOIA).

Files restricted for 10 years — records added to a record group in this category prior to January 1, 2001 are restricted for a period of ten years from the date of creation

Files restricted for 20 years — records added to a record group in this category after January 1, 2001 are restricted for a period of 20 years from the date they were added to the record group.

Restricted files are indicated in the contents list with a restriction note indicating the restriction type and the date of expiration.

CR (Client/Patient records, 100 years from date of creation)

PR (Personnel related records, 30 years from date of creation)

R (Student educational records, 75 years from date of creation)

ER (Executive Officers, Deans and Directors records, 20 years from the date the material added to the record group)

For further information on the restriction policy and placing FOIA requests for restricted material, consult the reference archivist at the Bentley Historical Library or the University of Michigan Freedom of Information Office website at: http://www.umich.edu/~urel/foia.html

Copyright:

Copyright is held by the Regents of the University of Michigan.

Preferred Citation:

[item], folder, box, Integrated Premedical-Medical Program (University of Michigan) records, Bentley Historical Library, University of Michigan

History

Inteflex, or the Integrated Premedical-Medical Program, began as an alternative to the traditional path of obtaining a medical degree: four years of premedical education focusing on the sciences and matriculation to medical school. Inteflex combined and accelerated these into one program. Inteflex aimed to produce a more caring and humane, rather than what was seen as a disease-oriented, physician. One of the original pushes to start the program was a national concern over a shortage of doctors. There was also a widely held perception that doctors were not overly compassionate. Due to these reasons, there was ample funding to start a program that would focus on creating humane doctors at an accelerated rate. It was decided to test the theory that an education based on the arts, social sciences, and ethics would produce a more caring doctor.

Inteflex distinguished itself by becoming an exclusive program offering openings for a limited number of LS&A students, 50 or fewer per year. Although acceptance to the program and the course-load was intense, “flexies” had a supportive atmosphere. Many of the students lived together in East Quad, a move that staff hoped would foster cooperation rather than competition. Inteflex also had specialized premedical counselors to help with academic or personal issues. Students also did not have to compete for entrance into medical school since they were guaranteed entrance with their Inteflex status.

Classes in the Inteflex program included a combination of standard LS&A courses and smaller classes only for Inteflex students. The program attempted to reduce the redundancy between premedical preparation and medical school while offering an introduction to the arts and social sciences. The original six-year program contained 24 months of concentrated undergraduate education, two years of basic medical sciences in small Inteflex classes, and two years of clinical clerkship with standard medical students.

One of the key Inteflex courses was Introduction to Patient Care, or the “preceptorship.” This was a summer course that featured one-on-one work in a medical setting. The student was placed with a mentor doctor and worked along with him or her for two months. This took place the first summer at the university, exposing the students to patient care early in their medical training.

Since the program began as an experiment, the program was constantly being evaluated. Students were questioned, tested, and evaluated with regularity. The curriculum changed with the results of the studies. Inteflex was also continually making adjustments to conform to curriculum changes and standards set by the MedicalSchool and LS&A. Inteflex leader made several adjustments to courses, requirements, length of study, and admissions over the years.

The program became a total of seven years in 1982. The undergraduate portion lengthened to three years. Inteflex students studied basic sciences with standard medical students, however they used different schedules. Yearly class size also decreased from fifty incoming students to forty. These adjustments were made due to a number of factors. The intense six year program made it difficult for students to finish their requirements within the required time span. LS&A required foreign language proficiency. It was often difficult for “flexies” to meet this requirement without previous instruction or advanced placement in high school. The initial national fervor to educate more doctors also declined. Funding for Inteflex also lessened at this time.

Inteflex expanded program length again in 1994 following massive curriculum changes within the MedicalSchool the previous year. The new medical curriculum was too different to accommodate the former Inteflex structure and as a result, it became an eight year program. The undergraduate portion became four years long. Admissions were lowered again, from 40 to 35 incoming students per year. Also, Inteflex students were now required to pass the MCAT medical school examination and have a combined MCAT/GPA score of a certain level before entrance into the MedicalSchool. This was a first for the program since previously students, once admitted into Inteflex, moved right into MedicalSchool without separate applications, assessment, or testing. This move was initiated by the MedicalSchool after finding that Inteflex students generally had more difficulty in MedicalSchool than students taking the standard path. At this time, Inteflex changed focus slightly to accommodate and support more minorities and students from rural areas. Attention was given to producing primary care physicians, a continuation of the hope for more compassionate doctors. The program now also allowed students a non-M.D. degree option.

The program underwent close scrutiny in 1997. Reviewers included the MedicalSchool, LS&A, and Inteflex faculty as well as Inteflex students, counselors, alumni, and staff. After much consideration, it was determined that Inteflex was no longer making an enduring contribution to either LS&A or the MedicalSchool. The review committee decided that the curriculum was no longer innovative, the community was too stifling for the “real world” of medical school, and that Inteflex students were generally not academically better than regular medical students. Even though it was studied thoroughly, there was no final way of determining if the Inteflex program, with its small classes, individualized attention and focus on humanities, created a more compassionate doctor than students going through a traditional path. If they were using the family practice doctor as a resulting factor, then this did not prove to be the case. Most doctors who were “flexies” specialized in a particular branch as did most traditional students. The program accepted the last entering class in 1998, and Inteflex offices closed in 2002. The last group of “flexies” was scheduled to graduate MedicalSchool in 2006.

Collection Scope and Content Note

The Integrated Premedical-Medical Program (Inteflex) Records are divided into six series: Administrative, Committees, Curricula, Reports, Students, and Visual Materials. An earlier two linear foot collection came to the library in 1996. Due to the size of the accessions following the program’s discontinuance, the older records were absorbed to make one holistic record group. Yearly classes are known by several names throughout the papers. The two most commonly used classifications are by the year the class entered Inteflex and also by the year of graduation from the MedicalSchool. Classes may also be known by their status in the program, such as I4 meaning the student is in the fourth year of Inteflex. To create the least confusion possible, classes within the finding aid are filed under the MedicalSchool graduation year.

Subject Terms

This collection is indexed under the following headings in the finding aid database and catalog of The Bentley Historical Library/University of Michigan. Researchers desiring additional information about related topics should search the catalog using these headings.

Subjects:

University of Michigan. Integrated Premedical-Medical Program.

Medicine–Study and teaching–Michigan.

Premedical education.

University of Michigan. MedicalSchool.

Genre Terms:

Photographs.

Contents List

Container / Location            Title

Administrative, 1972-2000 [series]:

The Administrative series, 1972-2000 (1.0 linear feet), comprises materials used to manage and operate the Inteflex program. Included is a large volume of chronological correspondence sent out by the Inteflex administrative office including letters to prospective, current, and former students, other units, and people outside of the university. These files show the history and yearly activities of the staff. The series also contains collected data, director correspondence, office procedure manuals, and faculty retreat records.

Box   1

Academic Calendars, 1984-1995

Box   1

Admissions Data, 1975-1993

Box   1

Donald R. Brown Vita, 1993

Box   1

Budget, 1992-1998

Correspondence

Box   1

Administrative, 1973-1993

Box   1

Course Related, 1973-1992

Box   1

Director, 1980-1998

Box   1

General to Students, 1972-1990

Memos

Box   1

1975-1978

Box   1

1985-1988

Office

Box   1

1988

Box   1

1994

Box   1

1995-1996

Box   1

1996-1997

Box   1

1997-1998

Box   1

1998-1999

Box   1

1999-2000

Box   1

Counseling, 1973-1999

Box   1

Dean, 1993

Box   1

Inteflex Governance, 1972-1994

Box   1

Inteflex Research, 1977-1995

Box   1

Inteflex/LS&A Procedural/General Materials, 1973-1992

Box   1

Office Instruction Manual (The Lifesaver), undated

Box   1

Office Schedules, 1975-1997

Box   1

Outreach, 1993-1994

Box   1

Organizational Chart, 1993

Relocation

Box   1

Alice Lloyd, 1993-1994

Box   1

East Quad, 1994-1995

Retreat

Box   1

1973

Box   1

1984

Box   1

1994

Box   1

Shipman Weekend, 1997

Box   1

Staff Meeting Minutes, 1993-1994

Box   1

Student Attrition/Withdrawl, 1977-1986

Box   1

Student Tracking Statistics, ca. 1980-1992

Committees, 1973-2000 [series]:

The series Committees, 1973-2000 (1.1 linear feet), documents the interdisciplinary nature of the Inteflex Program and its evolution. The Admissions Committee records the changing student demographics over time. The Inteflex Review Committee, formed of Inteflex, MedicalSchool, and LS&A faculty, examined the structure and progress of the Inteflex Program in 1993 and 1997. The progress is shown through correspondence, questionnaires, and reports. The Participating Faculty minutes report faculty and student solutions to internal Inteflex problems. The Policy Committee minutes contain high-level administration discussions about Inteflex policy. This subseries seems to continue under the name Steering Committee beginning in the 1990s. It is a particularly rich source of information on the Inteflex program evaluation containing detailed minutes, reports, and some correspondence.

Vault

Academic Review Board, 1995 [SR RESTRICTED until July 1, 2070)

Admissions Committee

Box   1

Admissions Forms, 1982-1995

Box   1

Manual, 1993

Minutes

Box   1

1973-1987

Box   1

1988-1993

Box   1

1994-1999

Box   2

Conference on Ethics, Humanism, and Medicine, 1979-1994

Inteflex Review Committee

Box   2

1993 Review, 1992-1993

1997 Review

Box   2

Correspondence, 1996-1997

Box   2

Review Committee Questions, 1997

Box   2

Report, 1997

Survey Questionnaires

Box   2

Alumni, 1997

Box   2

Counselors, 1997

Box   2

Faculty, 1997

Box   2

Steering Committee, 1997

Box   2

Students, 1997

Participating Faculty Committee Minutes

Box   2

1974-1976

Box   2

1977-1981

Box   2

1994

Box   2

1995

Box   2

1996

Box   2

1997

Policy Committee Minutes

Box   2

1973-1974

Box   2

1975-1980

Box   2

1982-1992

Steering Committee Minutes

Box   2

1993

Box   2

1994

Box   2

1995

Box   2

1996

Box   2

1997

Vault

1997 [SR RESTRICTED until July 1, 2072]

Box   3

1998

Box   3

1999

Vault

1999 [SR RESTRICTED until July 1, 2074]

Vault

2000 [SR RESTRICTED until July 1, 2075]

Curricula, 1972-1999 [series]:

The Curricula series, 1972-1999 (2.2 linear feet), includes information regarding the numerous learning opportunities of the Inteflex student. The largest subseries is Courses. This includes syllabi and descriptions of Inteflex classes as well as courses offered through LS&A. A large amount of records are devoted to the Inteflex course “Introduction to Patient Care” and include student/doctor assignments, schedules, and course materials. The curricula series also includes class evaluations by students, requirements for the Inteflex program and concentrations, and grading policies.

Concentrations/Dual Programs

Box   3

Business Program, 1996-1997

Box   3

Concentration Proposal, 1995

Box   3

School of Public Health Program, 1996-1997

Courses

Box   3

Approvals, 1973-1987

Box   3

Changes, 1976-1993

Box   3

Course Proposals, 1989-1996

Inteflex

Freshmen Seminar

Box   3

Correspondence, 1972-1991

Box   3

Course Rosters, 1979-1989

Descriptions

IFX 100

Box   3

1977-1989

Box   3

1990-1998

Box   3

IFX 101, 1978-1998

Box   3

IFX 102/103, 1995

Box   3

IFX 201/PSY 380: Nature of Illness, 1975-1995

IFX 210: Introduction to Patient Care

Box   3

Calendar/Schedule

Box   3

Course Handouts, 1975-1994

Box   3

Cumulative Match List of Preceptor Doctors, 1983-1994

Box   3

Preceptorship Materials, 1975-1986

Box   3

Recruitment, 1983-1995

Box   3

Tri-University Participation (University of Michigan, MichiganStateUniversity, WayneStateUniversity), 1991

Box   3

Yearly Course Information and Rosters, 1973-1997 (23 folders)

Box   4

IFX 211: Introduction to Health Care, 1995-1999

Box   4

IFX 212: Introduction to Health Care: The Social Sciences, 1995-1996

Box   4

IFX 301: The Changing Political Economy of Health and Disease, 1990-1993

Box   4

IFX 401: Human Sexuality, 1985-1998

Box   4

IFX 500: Introduction to Clinical Sciences, 1982

Box   4

IFX 505: Human Genetics, 1981

Box   4

IFX 506/507: Anatomy, 1981-1992

Box   4

IFX 560/561: Physiology, 1981

Box   4

IFX 630/640/650: Human Illness, undated

Inter-Departmental Courses

Box   4

Anatomy, 1977

Box   4

Biology, 1997

Box   4

Chemistry, 1979-1997

Box   4

Clinical Studies, 1981-1991

Box   4

Philosophy, 1985-1996

Box   4

Physics, 1972-1988

Box   4

Psychology, 1979-1996

Box   4

Social Science, undated

Box   4

Statistics, 1993

Evaluations by Students

Box   4

IFX 210: Introduction to Patient Care, undated

Box   4

Phase I, Year I, 1972-1990

Box   4

Phase I, Year I and II, 1972-1977

Box   4

Phase I, Year II, 1973-1990

Box   4

Phase II, Year III, 1975-1989

Box   5

Phase II, Year IV, 1972-1988

Box   5

Review, 1974-1996

Box   5

Semester Schedules, 1980-1992

Curricula

Box   5

Schedules, 1973-1996

Changes

Box   5

1980-1985

Box   5

1987-1989

Box   5

1992-1994

Box   5

1997

Box   5

Grading Policy, 1981-1995

Box   5

Michigan Education Trust, 1997

Other Experiences

Box   5

Lancaster Program (Study Abroad), 1996-1997

Box   5

Off-Campus Experiences, 1996

Program Requirements

Box   5

English Composition Board, 1982-1995

Box   5

Honors Program, 1985-1994

Box   5

Prematriculation Program, 1996

Reports, 1972-1999 [series]:

The series Reports, 1972-1999 (1.0 linear feet) compiles the multitude of studies conducted by the Inteflex, LS&A, and MedicalSchool faculty and committees. Many of the reports are student interview results describing their experiences, achievements, and satisfaction of the program. Some classes were interviewed at several stages within their academic careers. The results are arranged by the students’ graduation year for clarity and consistency purposes. Many reports from the later years are in electronic format.

Box   5

1978 Postgraduate Year Six Questionnaire, 1978 MedicalSchool Graduating Class, 1986

1979

Box   5

1979 MedicalSchool Graduating Class, Postgraduate Year Six Questionnaire

Box   5

Academic and Career Development Within the LS&A Control Group (1972-1975)

Box   5

Attrition Patterns in the Inteflex Program

Box   5

Career Development in Inteflex Students

Box   5

Development of Inteflex Students (1972-1977) and a Comparison of Their Personal and Professional Attitudes to Those of Standard Medical Students

Box   5

Faculty Members’ Assessments of the Inteflex Program

Box   5

Inteflex Admissions Report: Descriptive Data for Qualified Applicants 1972-1977

Box   5

Inteflex Funding

Box   5

Liberal Arts in the Inteflex Program

Box   5

Student Achievement Within the Inteflex Program During the First Six Years of the Program (1972-1978)

Box   5

Student Satisfaction with the Inteflex Program: Issues and Perceptions

1980

Box   5

[Class of 1980 Tenth-Year Postgraduate Study], 1991

Box   5

Report of Evaluative Data Regarding the Inteflex Program

1981

Box   5

Report of Evaluative Data Regarding the Inteflex Program

1982

Box   5

Class of 1982 Report to Participants [Sixth-Year Postgraduate Study]

Box   5

Inteflex Evaluation and Future Options of the Program

1983

Box   5

1983 MedicalSchool Graduating Class: Postgraduate Year Two Questionnaire, 1986

Box   5

[Class of 1983 Sixth-Year Postgraduate Study] Report to Participants, 1990

Box   5

Combined Premedical-Medical Programs: Program Structures and Student Outcomes at Four Universities

Box   5

Integrating and Accelerating Medical Education: The Combined Baccalaureate-M.D. Programs at Boston University, the City College of New York, the University of Michigan, and the University of Missouri-Kansas City (2 folders)

1984

Box   5

1984 MedicalSchool Graduating Class: Postgraduate Year Two Questionnaire, 1989

Box   5

Task Force on Medical Education

1985

Box   6

[Class of 1985]: Integrated Premedical-Medical Program Sixth-Year Interview Summary, 1979 Entering Class

Box   6

[Class of 1985]: StandardMedicalSchool Program Fourth-Year Interview Summary, 1981 Entering Class

Box   6

Program Evaluation by Standard Medical Students, 1976-1980 Entering Class

Box   6

Workshop on the Liberal Arts

1986

Box   6

[Class of 1986]: Integrated Premedical-Medical Six-Year Interview Summary, 1980 Entering Class

Box   6

[Class of 1986 Second-Year Postgraduate Study] Report to Participants, 1989

Box   6

[Class of 1986]: StandardMedicalSchool Program Fourth-Year Interview Summary, 1982 Entering Class

1987

Box   6

[Class of 1987 Second-Year Postgraduate Study] Report to Participants, 1991

Box   6

[Class of 1987]: StandardMedicalSchool Program Fourth-Year Interview Summary, 1983 Entering Class

Box   6

1988 [Class of 1988]: 1984 Standard Medical Students Interview Summary (electronic file on disc 1 located at the end of the series)

1989

Box   6

[Class of 1989]: 1985 Standard Medical Students Interview Summary (electronic file on disc 5 located at the end of the series)

Box   6

[Class of 1989]: Seventh Year Inteflex Interview Summary Report, 1982-A Entering Class (electronic file on disc 3 located at the end of the series)

1990

Box   6

[Class of 1990]: Inteflex Fifth Year Interview Summary, 1983 Entering Class (electronic file on disc 1 located at the end of the series)

Box   6

[Class of 1990]: Integrated Pre-Medical and Medical Seventh-Year Interview Summary, 1983 Entering Class (electronic file on disc 5 located at the end of the series)

Box   6

[Class of 1990]: Standard Medical Students Interview Summary (electronic file on disc 2 located at the end of the series)

1991

Box   6

[Class of 1991]: Fourth-Year Standard Medical Students, 1987 Entering Class (electronic file on disc 4 located at the end of the series)

Box   6

[Class of 1991]: Nineties in 1984 Entering Inteflex Class Interviews (electronic file on disc 5 located at the end of the series)

Box   6

[Class of 1991]: Nineties in the M/4 Interview, [Entering] Class of 1987 (electronic file on disc 2 located at the end of the series)

Box   6

[Class of 1991]: Seventh Year Inteflex Interview Summary Report, 1984 Entering Class (electronic file on disc 4 located at the end of the series)

1992

Box   6

New Responses, 1988 [EnteringMedicalSchool] Class (electronic file on disc 2 located at the end of the series)

Box   6

[Class of 1992]: Nineties in the Fifth Year Inteflex Interviews, Entering Class 1985 (electronic file on disc 1 located at the end of the series)

Box   6

[Class of 1992]: Nineties in the M/4 Interview, [Entering] Class of 1988 (electronic file on disc 3 located at the end of the series)

Box   6

[Class of 1992]: Nineties in the 7th Year Interview, 1985 Entering Class (electronic file on disc 3 located at the end of the series)

Box   6

[Class of 1992]: Third-Year Inteflex Interview Summary, 1985 Entering Class (electronic file on disc 1 located at the end of the series)

Box   6

Evaluative Reports on the Inteflex Program

1993

Box   6

[Class of 1993]: Fifth Year Inteflex Interview Summary Report, 1986 Entering Class (electronic file on disc 4 located at the end of the series)

Box   6

[Class of 1993]: Nineties in the 7th Year Interview, 1986 Entering Class (electronic file on disc 4 located at the end of the series)

Box   6

Final Report to the Dean of LS&A from the Committee to Review the LS&A Component of the Inteflex Program

Box   6

1994/1995 Building Undergraduate Academic Communities and Delivering Student Support Services

1995

Box   6

Academic Performance Analyses: Inteflex Students I4/M1 Year, 1988-1995

Box   6

[Class of 1995]: I-5 New Responses, 1988 [Entering] Class (electronic file on disc 2 located at the end of the series

1996

Box   6

Summary Report on the LS&A Component of Inteflex

Box   6

Self-Study: LS&A Component — Inteflex Program

1997

Box   6

Academic Performance Analysis: Inteflex Students (With Comparative Data from Standard Classes)

Box   6

Final Report: Inteflex Internal Review Committee

Box   6

1999 Report of the Committee to Review Undergraduate Premedical Education

Box   6

Electronic Files Stored on Discs

Student Life, 1972-2000 [series]:

The Student Life series, 1972-2000 (0.6 linear feet) reveals some aspects of life as an Inteflex student as well as life as a medical student. The series includes class rosters and alumni lists, activities, and relevant topical files such as housing and tutoring. The award subseries describes special achievements by students and includes correspondence and award background information. The Student Representatives subseries documents involvement with Inteflex committees and community service. The Student Council Agendas and Minutes are particularly dense with student involvement.

Box   6

Activities, 1998

Box   6

Alumni Lists, 1982-1995

Awards

Vault

Michael Archibald Award, 1986-2000 SR Restricted until July 1, 2075

Box   6

Colton Scholarship, 1994-1999

Box   6

Miscellaneous Awards and Letters, 1986-1998

Vault

Phi Beta Kappa, 1982-1997 SR Restricted until July 1, 20725

Box   6

Frank E. Robbins Award, 1984-1998 (6 folders)

Box   6

Shipman Scholarship, 1995-1999

Box   6

Dr. Jane Skillen Memorial Award, 1988-1999

Box   6

Class Lists, 1978-2003

Box   6

Commencement Brunch, 1989-1992

Box   6

Convocation, 1988-1998

Box   6

Director Announcements, 1998

Box   6

Disabled Students, 1984

Box   6

Housing, 1972-1986

Box   6

Orientation, 1982-1997

Student Representatives

Box   6

Committee Rosters, 1977-1999

Community Service

Box   6

General Activities, 1997-1998

Charity Week

Box   6

1988-1996

Box   6

1997

Box   6

1998

Box   6

1999

Box   6

I-Ball Tickets and Invitations, 1988-2000

Inteflex Student Council Agendas and Minutes

Box   6

Constitution, 1991

Box   6

1977-1988

Box   6

1990-1992

Box   6

1992-1996

Box   6

1996-1997

Box   6

1997-1998

Box   6

1998-1999

Box   6

1999

Box   6          Tutoring, 1978-1993

Box   6

Weekly Announcements, 1997-1999

Visual Materials, 1973-2000 [series]

The Visual Materials series, 1973-2002 (1.1 linear feet) contains scrapbook materials, photographs, and videotapes. One Inteflex scrapbook was created by Inteflex office staff. The rest of the clippings are loose materials collected with the intention of creating another scrapbook. Photographs are separated into faculty and staff, student life, and photograph albums. While there are few images of the administration, there are many photographs of students. There are formal and informal collages of class members under class photos. Snapshots of student activities are filed under yearly activities. There are also two photograph albums, one showing student life and the other containing images from students’ internships (or preceptorships) with Michigan doctors. There are also three VHS videotapes in the records. Two videotapes are of special events: The annual charity I-Ball from 1997, and the 1998 Convocation. The third was created by students during the 1998 charity week. It follows students through dorms and classroom buildings for “Jail & Bail” activities and also documents a charity auction aimed at Inteflex students.

Photographs

Faculty and Staff

Box   6

General, undated

Box   6

Picnic, 1987

Box   6

Robert Johnson’s Retirement, 1987

Student Life

Box   6

General, undated

Class Photos

Box   6

1978-1979     ((photocopies only, copy negative for 1979)

Box   6

1980-1982 (roll negatives)

Box   6

[1983] Entering Class of 1977-[1986/1987] Entering Class of 1980 (copy negatives)

Box   6

[1987/1988] Entering Class of 1981-[1990] Entering Class of 1983     (see also oversized folder UBImul C26)

Box   6

1991-1994     (see also oversized folder UBImul C26)

Box   6

1995-1996     (see also oversized folder UBImul C26)

Box   6

1997-1999     (see also oversized folder UBImul C26)

Box   6

2000-2003     (copy negative for 2000 and 2003)   (see also oversized folder UBImul C26)

Box   6

2004-2006     (see also oversized folder UBImul C26)

Yearly Activities

Box   7

1978

Box   7

1979

1980

Box   7

General

Box   7

Alumni Reunion

Box   7

1981

Box   7

1982

1983

Box   7

General

Box   7

Alumni Reunion

Box   7

1985

Box   7

1986

1987

Box   7

General

Box   7

Graduation

Box   7

I-Ball

Box   7

1988

1989

Box   7

General

Box   7

Picnic

Box   7

Preceptorships

Box   7

1990

Box   7

1991

Box   7

1992

Box   7

1993

1994

Box   7

General (includes slides)

Box   7

Inteflex Planning Meeting

1995

Box   7

General (includes slides)

Box   7

I-Ball

Box   7

Picnic

Box   7

1996 (includes slides)

1997

Box   7

General (includes slides)

Box   7

Graduation Luncheon

Box   7

Pie-in-the-Face Challenge

Box   7

1998

Photograph Albums

Box   7

Inteflex Activities, 1984-1986

Box   7

Preceptor Photo Book, 1983-1989

Scrapbook Items

Box   7

Inteflex Scrapbook, 1981-1987

Box   7

Loose Clippings, 1973-199

Video TapesBox   7

Charity Week Activities (Auction, Jail & Bail), January 1998 (VHS)

Box   7                      I-Ball “Vision” (includes faculty and student speakers, guest speech by Dr. Ryler, and a student skit), 1997 (VHS)

Box   7          Inteflex Convocation, September 3, 1998 (VHS)

Box   7         Roll NegativesTo comment or inquire about content, contact Bentley Historical Library   University of Michigan Digital Library


[1]             (Michigan is divided into the “upper” peninsula – which looks like it ought to be part of Wisconsin but is part of Michigan after they traded it for Toledo- and the “lower” peninsula (the one that looks like a mitten).  The upper peninsula is usually called “the U.P.” (the YOU PEE) and the people from there are called U.P’ers (YOOPERS).  The people in the L.P. Are called trolls because they live “under da bridge.” (MackinacBridge – longest suspension bridge in the world.  divides Lake Michigan and Lake Huron and connects Michigan’s two peninsulas.)

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24 thoughts on “The Inteflex Program

  1. Dr. Nick,
    Quick question on Interplex. Did you guys graduate as part of the regular medical school class as it would pertain to class rank and graduation honors?

    Just following up on an earlier Interplex grad graduating as “THE summa cum laude of a 250 student class.”

    Like

  2. Brick,
    Once we got to the 3rd and 4th years of medical school all the classes and grades were the same. Although calling oneself “THE summa cum laude” is a bit crass, I suppose he might be telling the truth.

    The Inteflex Program suffered from “Simpson’s Paradox.” On first look, the average grades of the students in the program were slightly lower than the “regular” medical students. At the time there were many more women in the inteflex program (almost 50%) than the “regular” medical school class. Male Inteflex students did better then regular male medical students and female Inteflex students did better than female regular students. Because, in general (at that time) male students did better than female students, the “excess” females in the Inteflex program brought the “average” score down. Lot’s of arguments about affirmative action, feminism, etc. ensued.
    Suffice it to say some of my classmates were pretty dang smart. At least one had a 1,600 on the SAT (at the time a perfect score).

    Thanks for your question. Keep them coming.

    Dr. Nick

    Like

  3. Hi, Dr. Nick! Interesting thoughts and stuff you dug up about our Flexie years. During my l-6 and I-7 years in the program, I was a member of the Inteflex admissions committee. I remember interviewing a number of applicants and giving numerical scores to applicant files. I don’t recall any specific quotas for the various gender/geographic/racial breakdowns that you mention (except for the in-state/out-state slots), but those final decisions may have been made on the Burdi/Brown level after the committee members had submitted their evaluations of the applications.
    I originally had some thoughts about going into primary care, but between my I-3 and I-4 years I did a summer research job in a Physiology lab and found my niche in Endocrinology. Like you, I loved the freedom of taking liberal arts electives and not worrying about any impact on my future journey through Med School. For my residency, I decided to go to Sacramento for the UC-Davis Int Med program, and I have stayed in California since then.
    I have been an Endocrinologist at Kaiser Permanente in West Los Angeles since 1997. Living in LA, I have taken the opportunity when possible to parlay (if I may coin an oxymoronic phrase) my “well-rounded geekdom” into a nice hobby as a game show contestant. I have been on seven different game shows so far.
    Here are the two that are available on YouTube
    https://www.youtube.com/watch?v=o720SRSrIhI (starting at the 22 min mark)
    https://www.youtube.com/watch?v=kxmfwWoMQSU (part 1)
    https://www.youtube.com/watch?v=xbD1djSg4ms (part 2)

    I’m glad to hear that you and Carolyn are still together. (Hi Carolyn!)
    I met my wife here in LA (she grew up in New Jersey), and we are trying to raise our daughter and son here with some “heartland” sensibilities, but it can be challenging when the elementary school has 3(!) drama teachers. When I hear about the recent weather afflicting Michigan, I’ll take the bad with the good about living in So Cal.

    Feel free to reply to my e-mail or this comment if you want to carry on more discussion about our shared history

    Tim Hsieh

    Like

    • Well what a great guy to hear from! Tim was one of the amazingly smart people that got drawn to Ann Arbor for the Inteflex program. Even though he was from Kalamazoo (“Yes, Virginia there really is a Kalamazoo), I’m sure he could have gone to Harvard, Yale etc. I had no idea he’d become a famous game show contestant. Thanks for your comments Tim.

      One thing I didn’t mention was I suspect I got into this program, to certain extent, by a serendipitous move by my parents. I had the grades and scores to get in but I also lived in the Detroit Metropolitan area which is the most competitive part of Michigan. In addition, one of my former high school classmates at Detroit Jesuit High School, Rob Waldvogel (who was wicked smart and unfortunately died at young age), would have been my direct competitor. I doubt that 2 kids from the same school would have gotten into Inteflex. I switched schools and became a bigger fish in a smaller pond. In addition, my parents then moved to rural Jackson County MI. I actually lived with my good friend in Dearborn, MI to finish up my senior year and never lived in Jackson BUT my mailing address was Jackson, MI. I suspect that I conveniently fell into a nice quota for the “rural” portion of the program. I did NOT, however, confirm this with my research through the library but will continue to look and would love to hear from anyone else who might have more info.

      Dr.Nick

      Like

  4. Dr. Nick, honey, on what basis do you keep saying that the six year students were “way too immature”? There are still six year programs, at Northwestern, Penn, Missouri and RPI. If that were the case, they wouldn’t exist. How “mature” do you think you have to be to be a drone? Or a data entry clerk, which is what I now do for a living since the EMR was mandated.

    I think if you were to look at what those of us who finished in six years went on to do, you would see what caused them to stop the program was they couldn’t control what we do–and we sure didn’t go in to primary care, no matter how small the town was we came from.
    In my class, we have a neurosurgeon, a cardiac surgeon, a few psychiatrist, two opthamologists, three orthopedic surgeons, two anesthesiologists, a dermatologist, and an interventional neuroradiologist, among other non-primary care doctors. We may have been young, but we weren’t stupid.

    Two kids from the same high school did get in my year, btw–Howell High.

    Inteflex was THE BEST THING EVER to happen to me–I was able to go to med school for $1600 a year, marry a classmate, do my residency and fellowship and join a private practice before starting my even more important life as a mother.

    As a matter of fact, now that I think about it, it’s probably some kind of Title IX violation to have closed it…

    I would love to get my hands on all the psych testing they did on those of us in the early classes. We weren’t smart enough as 18 year olds to tell them to go take a long walk off a short dock when they made us take the tests.
    Though I well remember when they “offered” to let us take “MCATs for free” three years later, if we wished, they had zero takers.

    Like

    • Lee,
      I appreciate your caustic reply! From your email address I’m guessing you were born in 55 which puts you 11-12 years ahead of me which means you must have been one of the first few Inteflex classes. The information you provide is really confirmation of my conclusions and I agree with you on almost all of it. Inteflex was definitely the best thing that happened to me as well for some of the same reasons – namely I also married my classmate (radiation oncologist). You are the second early flexie to point out that 2 kids from the same school could get in. I suspect it shows that the counselor at those schools in the early years was familiar with the program and encouraged application. Was there a set of identical twins in your year? One Yooper? One AA Female?
      I was able to see some of the data they collected. Would be happy to share. Thanks for commenting.

      Nick

      P.S. If you’re from Howell how do you end up calling me “honey?” Did you move south? Take the interesting language test when you’re bored at http://nyti.ms/1hubLXb It nailed me to Detroit, even though I haven’t lived there in 20 years.

      Like

      • Nick, honey, you nailed it, bless your heart. Though NC does not consider itself The South, and it’s not, but parts of Virginia are. I live just ten miles from the SC border though, and SC is most definitely The South–or was. Now populated from beach to mountains with northerners like us who came for work and discovered life is very very good.
        When we finished training in Boston, there were ZERO jobs in private practice in Michigan, the south was beginning to take off, so here we are. Another really great break. Family has a lake house up north and I do not practice full time, so I spend a few months a year in Michigan still. My youngest so loves his summers that he tells people he’s “from Michigan, but I grew up in NC.”

        I have taken that test test a couple of times–I still speak true to my Flint/Jackson roots. I think it’s POP that nails it, though I do know how the civilized Easterners request a non-alcoholic carbonated flavored beverage after my time there. Howell was but a blip in my time.

        You must be from suburban Detroit to think counselors had a thing to do with which colleges kids end up at. I don’t think Howell High even had counselors, or they were busy arranging bail for all the weed smokers–teachers and students. In my case, it was all due to the great generosity of one of my classmates, who pointed out the little box to check that was one EVERY UM application in 1972-73 to apply to the Inteflex program.

        Like

  5. Hi Nick
    I was in the first Inteflex class starting in 1972. I am originally from Port Huron, MI. My best friend from high school (Robert Grambau) was also admitted. I graduated on time in 1978 and he finished a year later in 1979. I subsequently became a radiologist and then later subspecialized in interventional radiology. Rob became a child psychiatrist. My experience with Inteflex was generally excellent and I very much appreciated not running the premed gauntlet. I agree, however, that that type of program is clearly not for everyone. For me, it was the best thing that could have happened.

    Regards to you.

    Mark Fielding Yost, MD

    Like

    • Mark,
      Thanks for your comments. Are you descended from THE Fielding Yost? I also appreciated not running the pre-med gauntlet as it gave me freedom to pursue other ventures such as Italian and Art History that would have fallen by the wayside. Part of that ability was the change to the 7 year program in 1983. I recently learned that 1982 was a transitional year and that those students chose either a 6 or 7 year plan. In any case I have no regrets personally as I came out smelling like a rose. Lee’s comments (see previous comments by a female former flexie) that some programs still exist are true but the general pattern has been to close them down.
      Sorry it took me so long to moderate your comment. Been traveling in Italy and now need to watch MICHIGAN teach sparty some lessons on the gridiron!
      Nick

      Like

  6. Nick: I was admitted in 81 as a 6 year, did 7, spending one year in Israel. one of my classmates did 9, and was a poet as I remember. We had FIVE admitted from my high school in suburban Detroit: FIVE!!! and one went to Yale. Two of us, myself and one other, are gynecologists, the others I don’t know. The ability to extend was crucial for me, and I think gave one the freedom to gun or explore as one wished. The extension to 7 years came up very early in my tenure, and raised a row as we sensed it was a transition away from the core value of the program, which in a way was validated by the outcome 10 plus years later. My understanding was that the initial impetus for the program was the somewhat skewed data predicting a physician shortage form the mid sixties, plus the federal money that became available in response. The “produce compassionate primary care physicians” mission was the rationale to get the money. when the money was no longer there, the writing was on the wall.In the final analysis for me, medicine has suited me just fine, but I am not certain I would have ended up here by a traditional track of stellar grades, which I never earned, and high test scores, ditto, and the need to take an MCAT. After all the weed I probably would have ended up a roadie for the Allman Brothers.

    Like

    • David,
      Thanks for your comments. I should think I would have remembered you but I confess no recollection. I received clarification from a few friends in the entering class of ’82 that they got to choose 6 or 7 years up front and it was approx 50/50. So you were the last official 6 year class. Like you I took longer (actually 9 years!) to complete the course. I did a study abroad in Italy, got a dual major in microbiology along with the concocted “Biomedical Sciences” degree (Choose BA or BS, your preference!), then took another year to do “research” in Switzerland. I “researched” quite a few ski hills!
      I am surprised at the number of kids accepted from one school. Going to have to guess it was Grosse Pointe or Birmingham/Bloomfield Hills. I feel I became a “compassionate primary care physician” and it sounds like you did too, so maybe they were successful on at least a few of the test subjects.

      Nick

      Like

      • Hi Nick, and pls say hello to Carolyn for me also! – Dan Stulberg Inteflex ’81-87
        Fun to find your blog RE us Flexies! 6 yrs was great for me. As you mentioned having to get the Language requirement was tough for some as it took away your only elective slot for 2 semesters. I had enough language to pass out as well as AP credits so got to take classical Greek archeology with the wonderful Professor Pedley and spent as much time in the ceramics studio as in the anatomy lab (college art is not a cake walk.)

        I’m a Family Doc having worked with great Mentors in FM at U of M and now Professor at the University of New Mexico. You are right most of the Flexies were stellar students coming out of their high schools with top scores and grades Not surprisingly a lot went on to excellence in many fields. Some of the innovations were our taking medical stats, ethics and sex health with the PMR husband and wife docs – forget their names. As I recall the standard students were jealous of our course offerings. I hear some of those things were incorporated into standard track based on the results of us test tube babies. I don’t recall immaturity being a problem for any in my class and some added an extra year.
        Hope you Carolyn and the rest of the Flexies are all doing well!
        Dan Stulberg,

        Like

      • Great to hear from you Dan. I saw your brother Tom at a Rugby event last year and he told me you were out in NM. Hope you’re getting some great skiing in. The sex ed teacher was Sandra Cole. Husband was Ted. It’s interesting that you remember it so differently than me. Sandra Cole, as I recall, didn’t have a Ph.D. at the time and was teaching graduate level courses to medical students. Not that that is a dis-qualifier (and I may be wrong – her later bios did title her Ph.D). I thought her presentations were TERRIBLE. She was a notorious name dropper and I couldn’t count the number of times she would say “A colleague of mine at the University of Minnesota…” I’m not sure she did much original research or really had many credentials other than her husband was a PM&R chair and she was willing to teach the course and show the pornos.
        Now on the other hand I CAN completely agree that the material itself should be mandatory for medical students; especially those in an expedited program who may have fewer life experiences to use in their workplace.
        So you must have been the 10th entering class. Would have been 50 students. What percent went into primary care? (FP/OB/Peds/IM?)
        Thanks for responding. I keep meaning to buff this up a bit but it’s a bit esoteric and a lot of what I’ve been preaching for the last decade (avoid overtreatement, the oversell of many of our wares) is becoming more mainstream.

        Thanks again for posting.

        Nick

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  7. Dan,
    Your FP mentors would have been my wonderful classmate John O’Brien and perhaps Scott Frank was still there as well.
    We need to be grateful to the taxpayers of Michigan and the Feds for financing such an incredible education for us. I had Harvard Medical School students on my services as an intern and resident, and could not believe how poorly trained they were. Really, truly abysmal as a group.

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    • Nick,

      In my experience, I did not recall any programmatic encouragement or push towards primary care spelled out to us. I don’t have a formal tab on what fields my classmates went into. It was a huge spread, ophthalmology, anesthesiology, around the G radiology pediatric infectious disease is, general pediatrics, and primary care fields all represented.

      For the other responder who I did not see your name, John Obrien was our residency director as I went onto family medicine residency there at the university of Michigan. Jim Peggs and Kent Sheets were my medical school mentors Dan

      Sent from my iPhone

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  8. No overt push for us either (73-79) re: primary care, though as freshman we did do the month with a PCP outstate. We had next to no contact with any Inteflex administrators once we started our ward rotations.
    I wasn’t aware til years later that it was funded from tax moneys made available to increase primary care physicians.

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  9. Hi Nick,
    I entered the first class of Inteflex in 1972 and it was a life changer. I came from California, had wanted to go into medicine my entire life and was interested in shortening the usual 8 years of premed-medical studies. I took a year off after my first 2 years to pursue personal interests and finished in 1979. I returned to California, trained in Internal Medicine and went into hospital medicine before the the field even existed. I have spent my entire career working in the inner city serving predominantly a poor minority population and at the same time enjoying a healthy balance of work and leisure. In fact, because of very fortunate financial circumstances I could have retired years ago but choose to continue working as a hospitalist as long as I am physically and mentally able to do so because of my passion for medicine. I’m not sure that any of this would have happened without Inteflex because it assured me a spot in medical school right out of high school, spared me the entire premed competitive grind and allowed me to focus on my medical studies and achievement of my goals while sparing me much unnecessary stress, which I believe was in a large part responsible for my satisfaction with medicine and eventually led to a much longer career. When I read blogs of current medical students I realize how fortunate we were. I think that the idea upon which the program was created was a sound one and am saddened that the program was terminated. It had much to recommend it.

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    • Thanks for the comment Andy. Appears you would have graduated with Lee (also 1979). I entered in 1983 and agree with you completely that the absence of the pressure cooker “pre-med” experience opened up many other options for us. Do you recall filling out lots of questionnaires? I would love to read some of the final reports from Don Brown’s work.
      Nick

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  10. Hi Nick, just stumbled across this blog. I started in Inteflex in 1979, graduated in 1985. A lot of what you wrote resonates with me. I remember well the “babies look like monkeys to me” or however it was phrased–we used to joke about it. it seems I had a vague awareness it was all some sort of social psychology experiment, but I was too young to care too much about that I guess. A lot of good memories; all part of an interesting life journey for me. Would love to hear from other “flexies” as we called ourselves……

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    • Thanks for the comment Karl. I did dig up a lot of information awhile back when Carolyn and I went back to Ann Arbor to celebrate our 25th anniversary. In 1982 the program went to an “optional” 7 years and when we came along in 1983 it was all 7 years. I’m not sure what additional classes we had that you didn’t but I do recall “Techniques of Social Interaction” being one particularly humorous one! I guess we required instruction in how to interact! Our year the class size was pared (lost funding) so we were slightly smaller (46 students). Do you recall a specific mission to create “compassionate primary care physicians?” I suspect that was something that was used to garner grant money at the time. I suspect flexies were even less likely to go into primary care than “regular” med students. As I see from a quick google, you also progressed to one of the ROAD specialties (Radiology, Orthopedic Surgery, Anesthesiology and Dermatology). I’m sure to a happy rewarding career! Thanks for commenting. I will try to update this blog a bit more and see if we can make it a reservoir of old time flexie stories since now that the program is defunct we will soon be extinct!

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      • Definitely recall the “goal” was to produce “compassionate primary care physicians”….not quite sure what parts of the program specifically were supposed to result in that, maybe that came from some leftover 60’s idealism which was palpable when I came on campus in 1979…..

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  11. The program was specifically instituted to form primary care doctors–that’s where the funding came from for the first expansion of medical schools in decades. The moneys used to set up Inteflex were from Federal funds legislated during the Nixon administration for that express purpose. And Techniques of Social Interaction (TSI) was seen as a cornerstone of the program! I can’t believe they endured the eye rolling and laughing through your time there. I think the Liberal Arts libs thought that it was simply a matter of ignorance that all doctors didn’t want to live in towns of 10,000 and tell people to eat better/less and exercise more, and quit smoking, oh, and don’t drink so much either, so TSI clearly would have us all heading for the hills once we were properly educated—at least, the UP. In my class, many of us came from small towns–and it still “didn’t work.”

    I love to see the reaction from people when I tell them about Inteflex being ultimately judged a failure and being shut down, in part because of mates from my class training at Johns Hopkins and becoming the world’s leading mitral valve surgeon, now on staff at UM; at MGH training in neurosurgery, interventional neuroradiology, and cardiac anesthesia; another surgeon for UM who headed their transplant team for years; producing three opthamologists, a couple psychiatrists, as well as FIVE orthopedic surgeons–one of whom is now Secretary of Health and Human Services. (Tom Price dropped back and graduated with my class. He started in Inteflex’s first year,)

    Yes, what a horrible, disastrous “failure!” Inteflex turned out to be. My class didn’t produce but four or five family practioners–whose job is now done in my community by nurse practioners, who are petitioning states all over the country to practice unsupervised, and likely are going to be replaced by AI in my lifetime.

    I’m sticking by my Best.Thing.Ever. for me.

    And God Bless every single primary care physician and psychiatrist out there.
    Heroes, each and every one.

    I write my legislators whenever a bill comes up explaining (basically, as nicely as I can) the difference in SAT scores between a physician and a nurse, not to mention the five to eight years of additional training.

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    • Hi Lee,

      thanks for providing the Tom Price info….based on his bio, I thought he was a flexie but had never seen that confirmed anywhere.

      I guess TSI didn’t work on me either…..

      Like

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