How can you keep the population of a country as healthy as possible, and inequities in care as small as possible? What effect does climate change have on our health? How do you ensure that healthcare is and remains accessible to all? These are big social issues that require people with vision. But who educates these people? That is Dr. Ed van Beeck, physician of society and health and head of the education section of the Department of Social Health at the School of Medicine. As a teacher, he has dedicated his entire career to socially engaged project education and, as the crowning glory of his work, he reached the finals of the national election for Teacher of the Year 2023. Reasons enough to talk to him about education, ErasmusArts2030 and socially engaged students.
To properly tell Van Beeck's story, we have to travel back in time. It all began in 1979 when, as a student assistant, he was already involved in the development and supervision of project education for the medical school. This project education became the blueprint for the education he worked hard for throughout his career. Van Beeck is a great supporter of socially engaged students and over the years has become, in his own words, a "kind of a one-stop shop" for the student whose ambition extends beyond the lecture rooms.
Looking at education from a new perspective
Nowadays everyone talks about making a positive societal impact, but that was quite different 20 years ago. About fifteen years ago, Van Beeck himself led the way in introducing society-focused project education in medical school. 'At that time, I introduced community projects into medical education where students could work with real-world issues. Questions that truly live and to which students can contribute. A small piece of knowledge gained and therefore also a contribution to the health situation of people.'
This was not always easy. Looking at education from a new perspective at a faculty that was still quite traditional could be met with resistance. 'I look especially at the students in the first years. Project education was quite difficult for them, but gradually we saw that there was always a group of students who were incredibly enthusiastic about it. In the beginning it was quite small, but that group grew in time. This is a very nice development and I think also a very necessary development given the big problems in society and certainly when it comes to health issues.' Van Beeck then talks about inequality, the health gap between rich and poor, climate change and health, and the accessibility of healthcare. 'These are truly issues that require people with vision.'
A physician is more than medical knowledge alone
Currently, societal involvement is woven into EMC's medical education in two places: during third-year community projects and in the social medicine residency in the master's phase. 'That's when students do an internship at, for example, a Centrum voor Jeugd en Gezin, an Occupational Health and Safety Service or at an addiction facility. But we also entered a collaboration five years ago with the municipality of Rotterdam to position those internships partly in the social domain as well. The interns can then join the social neighborhood teams or the street doctor project of the municipality.'
In its vision of the future, Erasmus MC has stated that the ErasmusArts2030 curriculum will have three focuses, including a focus on societal involvement. 'In the new bachelor program there will be room for project education in all years and in the master there will also be a period of ten weeks of project education.' Van Beeck explains the importance of this: 'As a doctor-to-be, you not only have to have your medical knowledge and skills in good order, but [you must] also be able to develop well in other competencies. I am talking about communication, cooperation, leadership and social action. These are not typically things that you learn well in a lecture hall and through textbooks, but that you can only master by dealing with real issues. And preferably in groups.' 'How do I report? You've learned how to write a scientific paper, but how do you report scientific results to the general public? Or how do I do a presentation in a Huis van de Wijk in Rotterdam, where people still suffer from language deficiencies or perhaps even illiteracy?' Valuable lessons that students can only learn through project education.
Students’ civic engagement
As for the students, things have really changed over time. Whereas twenty years ago students had to be convinced to engage in socially oriented education, now students themselves ask for it. 'Students are very concerned about the impact of climate change, including when it comes to health. We are still very much behind on this in the curricula. But two years ago, a group of students came to me and said: we want to do something with this. Then we immediately implemented it in my teaching block. I freed up a lecture for that topic and two students gave it. From the perspective: they have delved so deeply into this; they are now the teachers. Whereas we as teachers have a lot of catching up to do there. These students then also developed a game. The so-called Climate and Health Challenge. This is a two-hour session with a card game where students delve into: what effects does climate have on health? And yes, what is my role as a doctor in that to reflect on?
These are questions that Van Beeck wants his students to consider. 'You can limit yourself to doing nothing, but you can also properly educate your patients to make them switch to plant-based food. Other students are very into activism: they are going to block the A12 [highway]. So, you can take different roles, but you must think about it. That's what this education is about. We don't want to turn everyone into an activist, but we do want them to think about their own role. And in doing so, I do hope that some students also end up on that activist step of the ladder.'
Fortunately, Van Beeck no longer stands alone within Erasmus MC when it comes to societal commitment. For example, sustainability in healthcare is an important theme and a lifestyle counter is also being set up. In fact, Van Beeck himself has become a kind of ‘one stop-shop’. If you need help in developing an idea to make a societal impact or just want to bounce ideas, Van Beeck is always willing to talk to you. Such was the case five years ago, when a group of students from the Querido Honors College of Medicine expressed the ambition to further implement socially oriented education into the curriculum. Together with Prof. Charles Boucher and Prof. Walter van den Broek, Van Beeck supported them at the time in setting up an organization through which they could achieve this.
The crowning glory of his work
That Van Beeck is good at his job and appreciated by his students also spoke from his nomination for Teacher of the Year 2023 of the Netherlands. 'That was of course, because the nomination really came from the student side, a crowning glory for me. I have been active at Erasmus MC for a long time. In medical education and research. I've had to row against some currents for a long time. Nowadays everyone talks about societal impact, but that was quite different twenty years ago. I am proud of the fact that we ourselves were at the forefront of this kind of education so long ago.' And he's not done yet: Van Beeck is still filled with ambition for medical education. 'We now also have a project in which we are trying to embed the subject of sustainability and climate, i.e. planetary health, throughout the curriculum. That's an ambition I still hope to fulfill. Another big dream is interprofessional education where students from different programs are working on societal urgencies together. That we can really roll this out in a large-scale way one day. We dream together, but we still have to make it happen.’ Hopefully, this doesn’t have to take twenty years.
Text: Manon Langeveld