An Inside Look into the UWSOM Colleges Program

 In this episode our guest, Molly Jackson, MD joins Kate Mulligan, PhD to discuss what the UWSOM Colleges program and how it brings a personalized approach to medical education and provides a deepening understanding of both fundamental clinical skills and professionalism.

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An Inside Look into the UW Colleges Program

Kate Mulligan, PhD, Teaching Professor, Neuroscience and Human Anatomy, Associate Director, Center for Learning and Innovation in Medical Education (CLIME)  

Molly Jackson, MD, Associate Professor, Division of General Internal Medicine, Department of Medicine, Assistant Dean for the Colleges

[Intro Music]

Amanda Garza: Welcome to CLIMEcast. I'm Amanda Garza, the CLIME Program Manager. In this episode, CLIME Associate Director Kate Mulligan talks with Dr. Molly Jackson about the college's system here at UW School of Medicine. Dr. Jackson is a General Internal Medicine Physician here at the University of Washington. She has been a college mentor since 2009, is a former Cascade College Head, and is currently the Assistant Dean for the colleges across WWAMI.

Kate Mulligan: Welcome, Molly. Thanks so much for joining us today. I'm dying to hear about the insiders view of the colleges from the outside for many, many years. I've been envious of the fact that we've got this program that facilitates and fosters strong relationships between faculty and students and sets up a learning environment that looks phenomenal from the outside. So thank you for joining me. 

Molly Jackson: It's a great honor to be here. Thank you for inviting me. 

Kate Mulligan: Great, so before we get started, Molly, maybe you could tell us a little bit about how you came into this position as head of the colleges. 

Molly Jackson: Yeah, happy to do it. So, I'm a general internal medicine physician, and I actually went to medical school in North Carolina, and I was doing my interviews around the country looking at where I wanted to go for residency.

This was in 2004 and. I interviewed here for the internal medicine residency program. And the person who interviewed me was Erica Goldstein. And in addition to Jenny Brody, who was one of the hematologist oncologists at Harborview and chief of medicine at the time. And so Dr. Goldstein is the person who initiated the college's program and in our interview, I was just a 4th year medical student, but I was like, wow, this sounds like an incredible program. I wish we had had something kind of like that where I went to medical school and I was just impressed by these 2 thoughtful women in medicine and also with the program.

And I remember thinking when I left that interview, like, wow, I want to come to residency here, but also, like, I want to work in that program. Wow. So, during successfully matched here, internal medicine, and had several years focused on my training. But during that time, I started doing a little bit of medical education research and and working a little bit with Dr Goldstein with Erica and with a couple of other folks who are doing essentially sort of outcomes research in medical education and with the colleges program.

It gave me an introduction, even during residency to what is, what are the components of a thoughtful learning communities program, which is what the colleges is and how do you do a great job of clinical skills training, which is really sort of the heart of the colleges program, and that introduction got me excited about working with the people in the colleges program.

And eventually I applied after I had worked as a hospitalist for a little while applied to the program and was lucky enough to have a job doing colleges work, starting at around 2009 and I've been in the colleges since and I sort of steadily thought about leadership opportunities and then kind of worked my way into a college head position.

Then started as the assistant dean for the colleges in 2019. 

Kate Mulligan: Excellent, thank you. I have very fond memories of Erica from way, way back. It doesn't seem that long ago that she's been retired, but I guess it's quite some time now. Time flies. 

Molly Jackson: Several years and we all miss her very much. 

Kate Mulligan: Yeah. Great legacy.

Molly Jackson: She left a great legacy as a person and, and also with a program that really is, I think, helps support students throughout their four plus years of medical school in a really important way. So I feel very lucky to be a part of it. 

Kate Mulligan: That sounds like a great segway. Maybe you can help explain to our listeners what the college program is.

I know It's maybe a bit of a hidden gem in some ways, the people who are involved in it and the students all know how great it is, but some of us in the regular foundations and beyond don't really have a clear sense of what it is. And I think adding to that, it has different forms across WWAMI. 

Molly Jackson: So yeah, the, the program was actually established in 2001 by Erica Goldstein, and it really came about in the context of a very thoughtful curriculum renewal that elucidated that we needed to spend a little bit of energy and investment in the space of strengthening clinical skills development for students as well as professionalism and also discovered that our students really needed longitudinal mentoring.

That was consistent. And so, Dr Goldstein's brainchild was, let's create a combined program that emphasizes a culture of professionalism, a culture of excellence in clinical skills development, and has the educators who are teaching those skills, also developing meaningful mentorship relationships with students and sticking with them for the longevity of their medical school journey. The program started small, our school was a lot smaller in 2001, five colleges at that time. And there were 30 faculty when the program launched all who are based in Seattle. Because our school at that time had first year students at their regional campuses for first year.

But then everybody came to Seattle for their second year for the whole year of second year. So our program was really centered on getting to know students in that 2nd year and doing a lot of intentional skill building around bedside clinical skills going to the bedside with real patients who volunteered to have students interview them physical exam with them and get to know them as people and the college faculty mentors would observe those interactions and provide real time coaching and feedback and direction for the students at the bedside and also provided a consistent faculty cohort to teach in what was then the introduction to clinical medicine course and is now the foundations of clinical medicine course.

Kate Mulligan: So it really has changed with the new curriculum, right, where we've changed foundations so that students are taking the first year and a half of their training at their regional sites. That must have been quite a huge undertaking to work out how to have the colleges function across the region in a sensible way for that clinical training at all the different sites.

Molly Jackson: Yeah, but that was a big change for our program in 2015, and that curriculum renewal changed everything for our program. Really, we now have college faculty who have the absolute privilege of getting to know their students starting at orientation. Very first day of medical school often. Those college faculty being at each of the regional sites, so they're connected to the home states for many of our students who are from, for example, Montana.

They get to have their college faculty who are there in Montana. And, um, and it really provides our program a really lovely opportunity to have a faculty cohort that is truly region wide and the ability to really learn from each other to have a diversity of strengths and perspectives. And we get to work with students for longer, because we work with them now for the 1st, 18 months of medical school, roughly in the foundations of clinical medicine course.

And and then we continue as we always have as longitudinal mentors for students. And, you know, I think the, the program differs a little bit from site to site inherently, because for 1 thing the cohort sizes are really quite different at some of our regional sites. There are 20 students at the campus.

So we have one college there and, you know, four to five faculty to be the mentors for those incoming students. Whereas in Seattle, we have a hundred students. And so we're actually launching a four colleges in Seattle. We've been at two colleges for some time, but we're headed towards four colleges in Seattle.

So there's a little bit of variation from site to site. What is consistent is that each student is matched with a cohort of peers in their class that is going to be their colleges group. It's usually 4 to 5 students per group. And that group remains consistent for the bedside teaching that occurs every other week throughout foundations for them at hospitals with a consistent faculty, a mentor. So, while there's some variations in size and how our program functions, and there's a little bit of variability about who those educators are from site to site, based on who the, who the docs are in the community who are available to be a longitudinal educators and mentors. The heart of our program is really the longitudinal relationships, the time for faculty to have dedicated observation time and coaching time and support time around clinical skills and professional skills development. And a real centeredness on connection and relationship. With that being sort of the heart of our program, of course, the, the clinical skills and the professional skills are part of how we develop that relationship or else I'm not sure the students would want to want to get to know us, but we have that across all of the regional sites. And I think that's sort of the magic that really makes it work. 

Kate Mulligan: So is it true that across the sites, the college faculty work in the FCM curriculum as well as doing the bedside teaching? 

Molly Jackson: So all of the bedside teaching we're doing is within the FCM course. And the FCM course contains many things. It contains workshops, which are sort of in the classroom, simulation sessions. Communication sessions, learning clinical reasoning, more in a classroom based environment. It contains hospital tutorials, which are those bedside with real patients. Half days where students are really develop some independent skills and doing their history and physical exam, and communication skills. It also contains the PCP experience, which students get matched with a local primary care provider, where they go out every other week and spend a half day with them in their community. The college faculty largely teach in the FCM workshops. And the hospital tutorials, there are some of our regional sites where the college faculty mentors do only 1 or the other.

They do only the bedside teaching or only the classroom based teaching. And that's largely because some of our regional sites, the physicians who are available to teach are the doctors for the community. They're spread pretty thin across the responsibilities that they have to their community. And it's challenging to carve out enough time to do all of those things.

And so we just sort of make it work and that provides some benefit too, actually. It shares the responsibility across a number of people, but also gives students a number of different people to interchange with, and to learn from, and to have as mentors that they can approach. 

Kate Mulligan: I think we've covered this, but let's, let's get explicit. And have you perhaps explain to us what the aims and responsibilities of the colleges are? And maybe we could also link that with the outcomes and how the outcomes are measured. I mean, it's like a beautiful program. I'm just wondering how you, how you metricize that. 

Molly Jackson: It's not always easy, right, to measure success.

Well, our current program's mission is focused on the training of compassionate, Expert physicians to practice patient centered care, and really what we are as a cohort of faculty who are doing that clinical and professional skills, teaching and training in the course, who are committed to sort of a culture of growth and lifelong learning and a culture of what it looks like to be excellent clinicians and excellent professionals. We have a responsibility to longitudinal mentorship, which is a big bucket, but might include some advising and some mentoring and some coaching. When we think about what our outcomes are we're actually going through this strategic planning process right now. So we're doing a lot of looking at data around our program, but for for years and really sort of currently too, we've thought about primary outcomes of our program including big things like the success of our students and clerkships, but they do, how do they feel like they are prepared?

How do the clerkship directors and preceptors feel that they are prepared when it comes to clinical and professional skills? How do they do and in making it through a match and to graduation? We also think a lot about student satisfaction with the teaching that they receive and the foundations of clinical medicine course, since we are their teachers, we think about student satisfaction with mentorship, and we have surveys both for individual mentorship for students to provide feedback about how that's going for them across and get those every year on their own mentor as well as feedback on the FCM course, you know, sort of course feedback and feedback on the educators in that space.

And then I would say, lastly, we're doing a lot of thinking about the other elements of our mission. That are not just focused on strict clinical skills or mentoring and, and those are things like, what does it really mean to be prepared as a professional, how are we doing in that domain for our students?

Also, how do our students feel that they were supported in the development of themselves as a person and a professional during medical school, there are questions. Those exact questions exist on some of the, um, AAMC questionnaires that the students receive and some of our internal UW surveys. So we look really critically at some of those domains that feel like they are part of our job.

And I would say some of those domains are the places that we have some work to do. How might we advance the student experience in that space, or how might we advance the support that we have for students and in some of those spaces. We also even look at the post graduate evaluations from residency program directors asking about level of preparation of UW students and think that we're a pretty significant part of their journey.

And that's part of our outcomes. And how do our students do in residency? So, a lot of different measures that sounds like a huge amount of data actually Molly. Joke a little bit. 1 of our new faculty who joined us over the past couple of years was learning about the FCM course and learning about the colleges program and learning about all the pieces of things that we do.

And there was a long pause after sort of, here's all of our job. And she was like, you know, this is, this is ambitious. Thinking about all of these things, we're like, uh huh. It is, but, you know, of course, it's a, it's not just us, it's a complete community of folks. Our block faculty are part of the preparation of our students as professionals and people.

Our clerkship faculty, all the staff that come around the students, our, our deans, our, our regional colleagues who are in leadership positions and teaching our students. It's really looking at some of these measures because we think we play a role. But of course, we're, we're just a part of the student's journey.

Kate Mulligan: Well, a very important part, obviously. So I'm curious about what it's like to be a college faculty, how you become one, what kind of training you get, what activities, what, I mean, I get the hospital time, I get the FCM workshops. What is it really like to be a college faculty? It's always seemed very prestigious thing for me, my perspective.

Molly Jackson: Well, it's a very fun job, and I think it's really a job that allows us to be sustained in our work as, as teaching physicians because it's really fun to work with people who are developing their skills, who are excited about, about learning clinical medicine. And it's it's life giving to walk along students and see their successes and also be beside them when they're going through ups and downs.

So what it really looks like to be a college faculty members. I'll tell you a little bit about the job and then I'll tell you how you have 1 becomes. Um, but. The role of a college faculty mentor varies a little bit from site to site, as I described, because some of our faculty do both clinical skills, teaching and workshops and in the bedside and some do only a portion of that.

But all of our faculty do some degree of clinical skills training. At several of our sites our faculty teach 1 full day per week during foundations for 1st and 2nd year students and that's a blend of teaching bedside tutorials with patients in local hospitals and in workshops doing a lot of facilitation of simulation sessions, like your patient comes in with chest pain and we have a small group of students who are standing around a standardized patient who is experiencing chest pain and the students have to work in teams to think through that problem to do a history and physical and then to make a plan together about what to do next.

And so we get to journey with them alongside in that space and facilitate and support. We spend a lot of energy thinking about how to have our students be at ease and connected with each other, have an environment that is growth oriented and safe enough for them to show up as their real selves to, um, to make mistakes and for that to be totally okay.

This is the time to do it during your foundations. I mean, to have a culture of this group of students and this faculty mentors here for the success of each student that are genuine investment is in their flourishing in medical school, and they're becoming superb, joyful physicians. So we spend a lot of time thinking about the environment of the teaching.

And then the other parts of the time that college faculty spend outside the classroom are in a mix of development sessions where we're doing some college faculty development on both teaching and mentoring and coaching, partnering with our colleagues in student affairs or our foundations deans to support students who are going through difficulty.

So, you know, medical school is hard a lot of times where students need some extra support and the college faculty are are part of that team doing a lot of 1 on 1 meetings and coaching and support for individual students, which we sort of fit in where we can students work days and hours. And in general, I would say, trying to be present at important moments in the students journeys.

I'm really prioritizing being around for the transition ceremonies for graduation and having them to our houses for soup nights and and having a barbecue at a ranch was my dear colleagues in Wyoming. Do they have a lot of fun with our students? And so trying to nurture relationships outside the classroom.

And the application process for college faculty varies from site to site. In Seattle, our process is we have an open hiring process every couple of years. We described the job and folks apply, and then we have a selection team that goes through the process of interviewing those who are who have look like that they're good candidates and have a selection process for that. And really what we're looking for is folks who care about students and want to grow themselves who are humble and interested in being better and who also have some joy in the practice of medicine and can share that with their students also who have some expertise in teaching and or coaching it varies from site to site we have some some sites who do a process of having only a Only taking students every other year so that they have a larger cohort of faculty.

 Some of our sites didn't so there's a little bit of variability, but for the most part, the students will receive 1 mentor who will be there consistent person. I'd say on average. Our faculty will stay in the program as educators roughly 8 to 10 years is the average number of years that books will give to the program.

Of course, people transition and move on in Seattle, we have term limits so that we make space for new teachers. And that varies from site to site, because some sites don't have very many faculty to draw from. So, having term limits is more challenging. 

Kate Mulligan: Right and then I can only imagine how thoughtful you manage the transition. Cause you know, if you take on some students the year before you're about to leave the program, you can imagine that there's a transition period there that you work carefully with the faculty, old and new, to manage well. 

Molly Jackson: Yeah, we do have a little bit of an off ramp where the first year we hire faculty, they actually get a lower FTE and they only have first years and there's an Carries on with their 2nd years and doesn't have 1st years and they work as partners.

So there's a bit of a transition there and I would say a lot of times our senior faculty across the region who've transitioned out of the program with formal funding will continue to be mentors to their senior students because, by then they know each other so well, then there's such a solid relationship that continuation of, of mentoring support, is positive for everybody.

Kate Mulligan: How will the students match to faculty? Is there a lot of social engineering that goes into it or is it happenstance? 

Molly Jackson: For years, it was mostly random with the exception of trying to balance out gender. We have over the past two years done a little bit more thoughtfulness in how matching works for our Student group and faculty as essentially a pilot at a couple of our sites with some specific intentionality towards having every single student who is in a group, not feel like they are isolated and in particular, for example, in Seattle, we've worked thoughtfully to try to make sure that any of our students or students of color are not the only student of color in a group, this is something we haven't done at every 1 of our regional sites, but it's really 1 of our areas of work right now is how do we create small groups that are diverse?

Because we know that that's helpful for learning. Yeah, I'm diverse in experience diverse and identity diverse and background and are inclusive and safe and supportive and there's a little bit of a balance there. I think even just in the peer group that we are working to create and then we, of course, are being thoughtful about the faculty match.

We also want our faculty to not be the only 1 who's a person of color and we have not. Done in the past matching with students who are interested, for example, in neurosurgery, trying to find somebody who's the right college mentor for them in that field. But I think as we grow and change, we may be do we may do a little bit more of thinking about what kind of a faculty mentor could be the best fit for each student and really spending a little bit more intentionality in that space. We're not there yet, but we're open to it and thinking about it and looking at how other programs across the country are doing this. Our school is part of a international organization called the learning communities Institute, which is basically, a bunch of colleges programs across the region and the leadership, the students involved in those programs, the staff and the faculty leaders of those programs and we have a collaborative where we have a lot of learning from each other on a very regular basis and a national meeting where we come to share ideas and that is a source of a lot of growth for us as a program, just learning with our colleagues across the region and thinking about what can we do to grow, to better serve students. 

Kate Mulligan: I can imagine it's a bit tricky trying to match students in their first year because yes, you might come in wanting to be a neurosurgeon and end up wanting to be an obstetrician or something.

And they're evolving through that whole time. So it's a bit of a balance trying to work out how you might match them. But I would guess, tell me, is it the case that there's much interaction in the cohorts from year to year, so, you know, I'm college mentor, doctor, so and so, and I have four or five students across four years.

Do they get all of those students together on a regular or semi regular basis? 

Molly Jackson: That's the goal, and I would say it's a little easier when you live in a place that students, the senior students rotate through regularly. We have that ability in Seattle. And so. Yes, we had a, we had a soup and stew night at my house with all of my students across 4 years, a couple months ago, and I made soup and they brought bread and dessert.

And we did a lot of vertical mentoring, allowing those 1st year students to get some questions out there to the senior students and for there to be some support across the years. I would say my colleagues who live in it Idaho or Montana may or may not have a lot of senior students around and they still manage, I would say, to do an amazing job of creating connectivity and support across years, but they have to do it a little bit differently and they, they are highly successful.

I think the students at those sites tend to be really happy, but that is 1 of the things we've heard from students across all sites is they would like more consistent opportunities to connect with students across years to learn from them and to feel like they're part of something bigger than their cohort, their class.

It's a challenge for our school because of the regional nature. But I think there's some opportunities and I hope that our program can be a part of some of those solutions for for our students. 

Kate Mulligan: Also imagine you've got this well, you've invested in diverse and well trained faculty for the colleges. Is there a lot of opportunity for one cohort and one faculty member to get together with another one?

Or build more webs with the other faculty as their students interests develop? Could you say I've got this student who's really interested in X and there's another mentor in the other group who has that expertise? 

Molly Jackson: Oh, it completely happens. We definitely, one of the things we See, as part of our job is to help our students network, particularly our students who may not come into medical school with a lot of knowledge about what networking and medicine might look like.

And so we do that all the time. I have 1 of my students who's a mentee who was interested in both internal medicine and neurology. And 1 of my dear colleagues, Dr Bree Taylor is a neurologist and in the colleges program. And so I said, okay, Dr Taylor, please, you know, can you check in with 1 of the students and provide some support and thank you. Dr. Taylor was able to provide an opportunity for shadowing and conversation and extra mentorship. So we definitely do that. And I think my colleagues who are in in Alaska, and who are in Montana and Idaho and Wyoming, they're doing that too in Spokane, doing that networking, not just within their own regional sites, but across our community.

And then even our larger sites where we have Seattle, we have 20 faculty, we, we're broken down into Well, cohorts of faculty. So, five faculty per each cohort that we have here, each college, and Our hope is that the 25 students in our cohort and the entering class can be connected with all 5 of us who are there.

Yep. They're college faculty and of course, they can approach any of the 20, but that they at least have 5 physicians who they get to know and feel like I could approach this person. It doesn't have to be just my primary mentor because sometimes the chemistry is better with somebody else or the other person is somebody who shares some life experience or identity with you or is somebody who practices in a way that you hope to see yourself practice.

So I think what we really try to have our students hear from us is that all of us are available to them, have many mentors in this community. 

Kate Mulligan: Oh, Molly, I just want to, I just want to like bottle all of that up and export it to all the other parts of the curriculum, right? I mean, if I had my cohort of faculty with 25 students to get through some biomedical science block or chunk of material, it's like, please, please sign me up.

Molly Jackson: Well, I mean, I think that speaks to one of the things that we're hoping to see evolve that we're exploring and thinking about in our program. I think everybody who works in the medical school from staff to block faculty to faculty and leaders and other spaces really desire relationship with students and the students desire that too.

And we needed as faculty to have a cohort of faculty who are in different fields who we see as folks that we can check in with, or debrief with, or learn from, or laugh with. I think that's part of the joy of our work. And so, as we are doing some strategic planning and thinking in our program about where we would like to go and grow, one of the questions that is, that we're thinking a lot about is, do we, do we add to what looks like our faculty community by having not just college faculty, for some of the community and service orientation soup nights, but also have block faculty that are assigned to some of those cohorts too. So that faculty have a smaller group that they can get to know and sort of a scaffolding for some of the ways to engage outside the academic time to get to know each other as people. We're also looking at other things that we can do as a program to better serve students and doing a little bit more interprofessional learning in our spaces with, including colleagues from the nursing school or the pharmacy school.

For example, we feel like we'll strengthen the community experience for students and also broaden their perspectives a little bit and be great for faculty too. Yeah, um, And we're also trying to think a little bit more, as I mentioned earlier about, you know, gosh, the foundations of clinical medicine course is superb. It really has highly rated by students prepares the students well, for their clerkships, particularly in the traditional clinical skills of doing a history and physical communication skills, clinical reasoning, we would like to spend a little bit of energy thinking about the other domains of professional skills, including things like, how do you journey through conflict?

How do you get to know yourself? Well, such that you can think more intentionally about where you need to grow and where you might really add value to teams. So, we're interested in this domain of professional skills as well as sort of professional identity formation and thinking a little bit about shifting the focus of our program from a mentorship focus to a coaching focus such that faculty engage with students sometimes, of course, as advisors or mentors where we're providing some expertise or advice or guidance that is more explicit, but sometimes engaging with our students as coaches where they are the expert on their own journey.

And we are increasingly good at asking questions to help them direct their own growth and development and making space. For those kinds of conversations and reflections and opportunities for growth, not only as individuals, but also, you know, in community with each other. So, we're looking for a little bit more of that.

How might we create opportunities in the school? For regular coaching support and for identity formation reflection. And then I will say the other thing we consistently hear from students in feedback is how much they value community. They how much they value meaningful connections with people, their colleagues with faculty mentors, not just in the colleges, but outside the colleges to and blocked experiences, how much they value community with the staff and thinking about what the role of our program is in that and how do we help prioritize community building and space for meaningful relationships to flourish in a school where things are are busy and in a profession where things are busy.

I think. Advancing a sense of community can be done effectively and it really without it. We're really missing something as a school and I think will be more sustainable and probably do our jobs better for students. If we have community and connection at the heart of all of our school. 

Kate Mulligan: Oh, that's beautiful, Molly. Thank you. Thank you for making that distinction between coaching and mentoring. That was that was helpful for me to think about. And I, I am totally behind you with the connection and community piece and trust building. I feel like for some reason that I can't define, it feels like there's some trust issues between various members of the community and pandemic didn't help with that at all. And I look forward to hearing some more about how colleges might help spread the magic, right? I mean, it's, I've often said, can't we just export the college program and build it throughout the rest of the curriculum, but it sounds like you're already on that path and thinking about that. So thank you for doing that. Is there anything else you'd like to add about the colleges? 

Molly Jackson: You know, I think part of the reason that we're successful is that we have carved out time. There are students, and 1 of the things that's written into our job description it's not just that we're there as teachers and evaluators, or, you know, somebody to give feedback to students, but that we are also part of the job is community is coaching and mentoring support and I think without that investment on the part of the leadership team, we wouldn't be as successful. It's an investment for our school to say it matters for our students to have faculty who have time that's focused on support for them as whole people.

I hope that we can build on that and and really have that investment be high yield for the student experience. I think it's such a crazy time in the world. You know, it's a crazy time in medicine. It's this like, you know, you feel sometimes like medicine is like this medical industrial complex where it's like, there's a risk of just becoming cogs in the wheel, right? In the machine. I think we're training up the doctors of the future. I hope we can help them be change agents. Such that what matters the most in doctoring is what they take away from medical school, you know, having a ability to prioritize what matters the most for them as people for them as young professionals to be able to connect with patients meaningfully about what matters most to them.

That is a lot of the stuff that we're trying to do. There's some things that we're trying to do in our program that are a little bit about slow medicine or about slowing down really listening to people, helping our students really listen to patients and helping ourselves as faculty really listen to our students. I think that kind of doctoring or that kind of coaching and mentoring ends up being more effective and more efficient. It's a better use of time. So I'm thinking a little bit about that a lot in the colleges program and and also sort of where else in our school do we need to do a little less in order to be a little more to our students? You know, gosh, I'm talking about all these new things. That I'd like to see us go and grow towards, but, you know, we can't take, we can't add without taking something away. And I think that's true for our students and it's true for our faculty too.

So, you know, critical thinking about what, what are we doing and teaching that is lower yield and some of this other work, I'm doing some discernment about that right now in the colleges, but I hope we can do some discernment. Yeah, about that as a school. And I don't know where that will take us, but it's something that we're thinking a lot about.

Kate Mulligan: Thanks, Molly! That's great thank you so much for joining us today. I can't wait to spread the word and keep the college's spirit alive throughout the region. So thank you very much for joining us today. Thank you for your positive energy and care and for all the time that you spent. It was fun to talk with you. Thanks Molly. 

Amanda Garza: Thank you to Dr. Jackson for taking the time to talk with us about the colleges and the benefits they bring to the UW School of Medicine. Don't forget to subscribe to Climecast on the streaming app of your choice to get updated when new episodes are released. Thanks!