I recently concluded a trip down to Nashville, TN where I gave my talk on the health care-social media intersection at Vanderbilt University School of Medicine.

My audience normally consists of physicians and hospital staff, so talking to students was a refreshing change.

I had the opportunity to have dinner the night before, and breakfast and lunch the day of, with several groups of Vanderbilt medical students.  It’s been 12 years since I graduated medical school, so I was looking forward to hear what students today had to say.

Here are some of the issues we discussed.

1. Cost of education. There have been several posts recently on the cost of medical education, and how it weighs heavily on the mind of prospective doctors.  These students were no exception.  When I asked them, “Will the your medical school debt influence your choice of medical career?”, almost all answered in the affirmative.  That’s consistent with recent data showing that money is indeed a factor when a student considers a career.

Some students brought up the point that the interest accumulated during residency, which can be significant.  They asked me if there are any solutions, on a medical education level, that can entice more students to primary care.  Well, there are a couple.  One, some schools are experimenting with a 3-year MD program for students who go into primary care; and two, other schools are fully subsidizing the entire cost of education, in the hopes that the lack of debt will sway students into more generalist or research-based fields.

2. Health reform. The popular belief is that medical students are rather apathetic to health reform and health policy.  Not here, or rather, not with the students I interacted with.  All were actively engaged with the health reform conversation, and asked me insightful questions.  Although my talk was sponsored by the American Medical Student Association, which has a known progressive tilt, I found that the political tone among the students was moderate.  The students seemed to understand that tackling our health care issues requires ideas from both sides of the political spectrum.  We need to combine progressive and conservative ideas, which includes both raising taxes and encouraging more consumer responsibility for their health costs.

3. Twitter. The students’ Twitter use was, for the most part, limited.  Some social media evangelists in the class used Twitter as a way to filter and curate information, which, arguably, is one of its most powerful applications.  But most of the students, while on Facebook, only saw limited utility in Twitter.  Hopefully I swayed some students to try it.

4. Treating the underserved. I talked to several first and second year students who had their hearts set on rural medicine, and treating the underserved.  It was admirable to witness their passion for primary care, and in one case, general surgery.  Some were inspired by Atul Gawande’s recent New Yorker piece, The Hot Spotters, which illustrated how health care costs could be cut by targeting the neediest patients. Vanderbilt also runs the Shade Tree Family Clinic, where faculty members mentor first and second years in a student-run clinic treating the underserved. That experience clearly impacted the students I talked to.

5. Involving physicians. While most of my time was spent with students, I had a chance to talk to Shana Bresnahan, Vanderbilt’s Interactive Marketing Program Manager.  As with most hospitals, engaging physicians remains a challenge.  Including physicians in social media leadership positions, similar to what the Mayo Clinic has done with their medical adviser to their Center for Social Media, is a necessity.  But the biggest impact would necessitate including social media as part of a physician’s job, and give doctors the protected time they need to engage online.  It cannot be framed as “one more thing” for doctors to do, in addition to their clinical responsibilities.

Thanks to Vanderbilt School of Medicine for hosting me, and giving me the opportunity to speak to, and learn from, their students.  It was nice to go back to school again.

Kevin Pho is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on Facebook, Twitter, and LinkedIn.