Johan Stienstra, medical doctor in training for hospital doctor

Becoming the first hospital doctor in Leiden and, in addition, one of the first hundred in the Netherlands, seems like a surreal dream. But this is exactly what Johan Stienstra is aiming for with his training at the LUMC. And because he is to become the first in Leiden, his training is very unique; Johan is the ideal testcase for the future of the education program.

The training to become a hospital doctor or ‘general’ physician is a new profile and has been created to improve the continuity and quality of healthcare in all departments. It is expected there will be a decrease in doctors trained as specialists in the future, which in turn will increase the demand for other kinds of doctors in hospitals: “Specialists mostly tend to look at their patients from their speciality’s point of view. Hospital doctors are trained more broadly and, thus, are an ideal addition to these specialists in healthcare”, says Johan. So, a pulmonologist is an expert in lung-related conditions, but has less expertise in other issues that might occur in a patient during an intake, for instance disrupted diabetes. A hospital doctor is specifically trained to provide this common, non-specific clinical healthcare. He or she can resolve often occurring issues his- or herself and ask for a specialists’ assistance if necessary. 

The value of hospital doctors
Core values in the role as a hospital doctor are quality and patient safety: “We are able to work in any department and are therefore able to sum up and combine all the best practices from each department to improve healthcare across the board.” Furthermore, by introducing hospital doctors in the LUMC, the quality of healthcare in the work place is increased: “By introducing hospital doctors, we ensure that patients always have a point of contact, even when specialists are occupied with other tasks. This means that there is always a doctor available to the patient, even when specialists are busy helping other patients with specific conditions. This enables us to improve patient safety.”

The education program
So how does the LUMC ensure a hospital doctor gets trained well enough to have above average knowledge of each and every discipline that can be used in practice? “Through a three-year program I get trained to be a hospital doctor. The first year is focused on teaching you the ins & outs of internal medicine. The second year consists of in-depth training in anaesthesia, surgery, neurology and neurosurgery. And now, in my final year of the program, I focus on geriatric medicine, general medicine practice and a six-month internship.” In relation to quality, the internship has to be finished with a quality improvement project. 

And this training is only the start of the many possibilities for the education program and the position itself; since Johan is to be the first to become a hospital doctor in Leiden: “For this exact reason, my experiences and those of the students in the first few upcoming years are so important. Being the first adds an extra layer to my profession. I get to make suggestions about the contents of the program and how we can take important steps to make hospital doctors, like me, as complete and competent as possible.” 

Thus, the program to become a hospital doctor is for everyone who wants to stand on the forefront of a ground breaking innovation in healthcare; a crucial shift that will realize an important boost in quality in patientcare. Because that is what it is all about: “The patient has to be the determining factor in the health care process. We have to look beyond the main problem of a patient. We also need to take his or her personal needs, not related to their main concern, into account and see to those health care needs accordingly. We need to look at the patient as a whole.”

In addition, the program is for everyone who has an interest in multiple disciplines and wants to be educated in a broader sense, for those who want to be pioneers in the medical profession and want to contribute to the future of hospital doctors, and for those who want to make important quality improvements in healthcare based on evidence-based working methods.