AAMC Reporter: January 2008

Student Affairs Plans "Fuzzy" as Schools Expand

Scott & White Memorial Hospital is the primary clinical campus for The Texas A&M Health Science Center College of Medicine campus in Temple, Texas.

As the medical school community undergoes its largest expansion in 40 years, many institutions are seeking answers. Where does the money come from? Can we recruit enough faculty? What should the new curriculum look like? Should growth occur in existing facilities, or are new buildings—or even a new campus—in order?

According to the authors of a new AAMC study, there is one area of expansion-related planning and policymaking that may take longer to coalesce than others. While literally not as visible as a new building, a new donation check, or a new department chair, proper consideration of student affairs plays a crucial role in a successful expansion plan.

"Planning for the bricks and mortar of an expansion is sometimes very straightforward—you know how many seats you need to have in the lecture hall, for example," said Sarah Bunton, Ph.D., lead author of the study, titled "Medical School Expansion: Challenges and Strategies," due for release this month.

"But planning for student affairs and student services can be a little fuzzier because there is no formula for how best to tackle these issues. Finances and facilities are usually addressed very early in the process, but implementing student services is not always the first issue to receive focus, and that can lead to uncertainty."

The study explores the challenges and strategies of existing medical schools as they expand medical student class size, including specific expansion planning and the tactics school officials employ to overcome obstacles.

According to the study, in 2006, 93 schools reported an existing or expected increase in first-year enrollment over 2002 levels. Of these schools, seven already have or are formally proposing four-year branch campuses as their means of expansion, with dozens more creating two-year branch campuses or considering the branch or regional campus model. Overall, medical student enrollment is projected to increase by at least 20 percent from 2002 to 2013, with most of that increase coming from school expansion plans. As schools admit more students, they must also build in the necessary staff and services to assist them.

"[There is] anxiety and unease that front-line faculty and administrators feel in the aftermath of a policy decision to expand class size," the report states. "How will they accommodate more students in the admissions process? Will additional financial aid resources be available? Will the school commit more staff to counseling and support services? How will increasing class size affect efforts to improve the diversity of the medical student body?"

Within the student affairs area, administrators and faculty from all six of the expanding medical schools included in the study—Boston University School of Medicine, Michigan State University College of Human Medicine, Oregon Health & Science University School of Medicine, Texas A&M Health Science Center College of Medicine, University of Arkansas for Medical Sciences College of Medicine, and the University of Texas Medical School at Houston— cited admissions policies as a particularly challenging area.

"The admissions aspect was probably the most difficult part of our expansion from a student services perspective," said Kathleen Fallon, M.D., associate dean of student affairs and admissions at Texas A&M's college of medicine, which is expanding its flagship and regional campuses in College Station and Temple, respectively.

Admissions officers in the study noted that, in most cases, administrators were asking the same pool of admissions officers to take on more students and assignments. Admissions officers at institutions with branch campuses face uncertainty over how and when to assign incoming students to the remote or flagship locations. According to a 2003 AAMC study, two-thirds of regional campuses let students decide if they wanted to attend the branch site—most with the caveat that an assignment or lottery system could be used if too few or too many students volunteered. This is one area where branch or regional campuses can present unique challenges during expansion efforts.

"When you are planning regional campuses, you do really have to make changes," Fallon said. "You have to have student affairs particularly at the forefront or else students can get lost in the shuffle. A lot of these small groups can feel disconnected from the mother ship. The institution has to be nimble enough to respond to them so that they do not feel like stepchildren."

At Texas A&M, Fallon said students at the Temple campus get the same opportunities to participate in student governance and other organizations as their College Station counterparts. According to the AAMC study, some schools encourage staff to travel between campuses whenever possible, while others periodically bring students to the home campus for services. Others blend the two, or hire full- or part-time professionals for the branch locations. Fallon said videoconferencing helps connect the two Texas A&M campuses, although eventually the school will probably hire full-time employees for the Temple site.

Institutions reexamine student affairs policies during these growth periods not only to accommodate more students, but to make advancements in areas such as racial and ethnic diversity. Efforts by medical schools to expand diversity as they expand their campuses could bear fruit, although it is too early to know for sure. The expanding University of California, Irvine, College of Medicine and University of New Mexico School of Medicine established admission programs geared toward producing doctors for underserved communities. However, there is no guarantee of efficacy, and the numbers are not overwhelming. According to two separate studies published in the December 2007 issue of the journal Academic Medicine, the New Mexico program will enroll 16 students per year, the first of whom will not enter clinical practice until 2016, and the Irvine program will lead to 12 additional students per class per year.

Fallon said that paying close attention to student services and policies—and, by extension, to the students themselves—during expansion will pay institution-wide dividends.

"Students want to feel as if they were accounted for in the process," Fallon said. "If your students are happy, they are the best sellers for your program. If they feel the school answers their questions and concerns, that feeling multiplies."

At the end of January, the report will be available at www.aamc.org/publications.

—By Scott Harris

Contact Us    © 1995-2008 AAMC    Terms and Conditions    Privacy Statement