‘When you hear hooves, think zebras’: further integrating the biopsychosocial model in medical education to help rare disease patients

Abstract

Diagnostic delay in individuals with a rare disease is, on average, 4.8 years. Their journey to diagnosis, often referred to as a diagnostic odyssey, is plagued by countless investigations and unsuccessful referrals. How can we ensure that healthcare professionals will consider rare diseases when first meeting a patient? The answer may lie in tackling the issue early on when clinicians begin their journey at medical school. 

The current medical school curriculum approach in the United Kingdom, which is largely based on the ‘biomedical’ model, causes a hindrance in improving rare disease diagnosis. Bypassing the cultural, social and psychological considerations that a doctor has to address when treating a patient, may contribute to the diagnostic odyssey patients have to go through. Further integration of the ‘biopsychosocial’ model into medical teaching can improve the diagnostic journey for patients as well as the patient-doctor relationship. The latter could lead to a shorter diagnostic delay by increasing compliance and engagement. Additionally, approaching a patient with the biopsychosocial model could help their wellbeing and mental health during their journey to diagnosis. Integrating rare disease teaching pre-clinically and clinically via student selected units (SSU), paediatrics and primary care placements, will equip future clinicians with an understanding of rare diseases to ultimately reduced diagnostic delay and improve the experience of those living with one.