SLIM: Systems, Leadership, Integration, and Management

Recent estimates of healthcare performance put accidental deaths in hospitals at a minimum of 200,000 per year and waste at a trillion dollars per year. Not surprisingly, societal trust in healthcare is at an all-time low. Students in the Columbia-Bassett track receive special training to enable them to lead transformative change in a healthcare system fraught with challenges. The Systems, Leadership, Integration and Management (SLIM) curriculum empowers students to not only understand the forces that drive healthcare delivery towards these negative extremes, but to take action in response to them. 

Our mission is to train doctors who can apply the science of performance improvement to healthcare delivery problems at any level, from a malfunctioning system in a clinic to a malfunctioning component of Medicare. To this end, they receive robust training and education in the intersection of health policy, health economics, health systems improvement, and leadership. As a keystone project, the students lead a health systems effort with real stakes during their clinical year. This unique experience prepares students – in a way no other experience can – to understand and negotiate the problems healthcare leaders face in putting policy into practice, which is often a clumsy and imperfect process. 

Students are immersed in the following: 

  • Overview of healthcare policy and delivery, overtreatment, waste, and harm 
  • Training in the advanced performance improvement techniques of Lean and Six Sigma 
  • A year-long SLIM project during the Major Clinical Year, supervised by Lean Six Sigma Master Black Belts 
  • Presentations of the SLIM project to senior Bassett physicians and management during the year 
  • Research in performance improvement effectiveness and efficiency 

The curriculum is spread out over the students’ entire experience in Columbia-Bassett, spanning the pre-clinical, major clinical, and post-clinical years. 

Fundamentals Curriculum

  • Orientation: Students experience a multi-day immersive training in the basics of health systems improvement led by experts in the field. 
  • Didactics: During the 1.5-year pre-clinical training in NYC, students meet periodically to discuss SLIM concepts with expert faculty. 
  • First Year Summer: Interested students may elect to participate in research projects focused on health systems improvement or on a systems improvement project. 

Major Clinical Year

  • SLIM training: Students are immersed in training to become experts in the Lean/Six Sigma method for performance improvement. Very few physicians at large possess the knowledge and skills acquired in such a curriculum. 
  • SLIM Projects: The keystone of the SLIM curriculum is the MCY SLIM project, in which medical students lead a project at Bassett Hospital with a real team of performance improvement engineers, guided by an expert in systems improvement. They dive deep into a real health systems problem of intrinsic institutional importance to the hospital’s leadership, organize and implement a solution, and present their progress to C-suite stakeholders. This experience uniquely prepares the Columbia-Bassett students to be future practitioners and ambassadors of health systems science. 
  • SLIM Workshops: Students meet with faculty monthly for one-hour workshops on the complex problems that plague healthcare delivery including reimbursement systems, waste, harm, overtreatment, and variability. 

Differentiation & Integration

Scholarly Project: Columbia-Bassett students may elect any of the majors available in New York City (e.g., basic sciences or world health) or may perform a scholarly project within the SLIM construct or emotional trauma/physical disease platform (Columbia-Bassett's other distinct focus). These projects culminate in a thesis during the final year of medical school. Columbia-Bassett faculty and alumni are available for mentorship and guidance.