AAMC Reporter: March 2005

Opening New Medical School Requires Patience, Persistence

By Anne Blank, Special to the Reporter

The new campus at Florida State University College of Medicine

Last month, Sachin Parikh received notice that he had matched with the residency program in otolaryngology at Louisiana State University in New Orleans, his first choice. Before he starts the program Mr. Parikh, a fourth-year medical school student, plans to attend his graduation ceremony in Tallahassee this spring, where he will receive his diploma from the nation's first new medical school in more than two decades.

Parikh is a member of the inaugural class at Florida State University (FSU) College of Medicine.

"As a class we took a lot of responsibility upon ourselves to do well," he said. "But I know that my unique experience at a new medical school helped me attain the residency of my choice and set me apart as a candidate."

Florida State is the newest of the 125 accredited medical schools in the United States. It is the first medical school to open its doors since the mid-1980s when Mercer University School of Medicine and Morehouse School of Medicine were established in Georgia, according to the Liaison Committee on Medical Education (LCME). Oral Roberts University also established a medical school at that time, but it has since closed.

Today, however, with concerns about a looming physician shortage, a number of universities are seeking to establish their own medical schools. Contributing to this new trend is the prevailing belief that a locally trained physician is one who will practice locally. Lacking enough medical schools of their own, some communities with large medically underserved populations are now supporting local universities in an attempt to establish programs to train, and hopefully retain their own medical school graduates.

Branching Out

J. Ocie Harris, M.D., Dean, Florida State College of Medicine

Establishing a new school, however, is a costly and challenging process. In the case of FSU College of Medicine, one of its biggest hurdles involved developing a regional campus since the college does not have its own teaching hospital like most older schools, according to J. Ocie Harris, M.D., the school's dean. The FSU administration had to recruit faculty from among practicing physicians at the college's three clinical sites, which are located in Tallahassee, Pensacola and Orlando. Plans are already in place to add a fourth site in Sarasota in July.

"Rather than develop our own program in our own facility, which is what most traditional medical schools have done, we had to go to different communities and establish relationships, identify partners and really create a situation where we could develop what we call a regional medical campus," said Dr. Harris, who became dean in 2003. "If that's not put in place in a way that the relationships can grow and develop and be sustained, then that's going to be a huge impediment to your clinical program."

The college's administration also faced the daunting task of planning, developing and implementing its medical-training program at the same time. While it succeeded, Dr. Harris advises his peers who are opening a new medical school to allow an additional year or two to plan and to recruit faculty.

"We basically started the medical school and admitted students from day one," Harris said.

FSU College of Medicine recently received full accreditation from the LCME. David Steele, FSU College of Medicine's assistant dean for curriculum and evaluation, says he relied on the LCME's publications, especially Functions and Structure of a Medical School, throughout the process.

"My advice would be to put the LCME on your speed dial and if you have questions don't be hesitant at all about contacting the people there because they have been very, very helpful," Steele said.

Florida Frontiers

Because of Florida's rapidly growing and elderly population, other schools in the state are working toward establishing new schools as well. Officials at the University of Central Florida (UCF) are investi-gating the possibility of building a medical school in Orlando while at Florida International University officials already presented plans to the state's Board of Governors for a medical school on its campus in Miami.

UCF recently completed a feasibility study underscoring the need for two new medical schools in the state of Florida and plans to submit a formal proposal to the Board of Governors within the next three to four months.

"It showed that there was a growing need for physicians on the national scene and certainly in Florida," said Terry Hickey, UCF provost and vice president of academic affairs. "In fact, the shortage may be more acute in Florida than in many other states."

Short of opening an independent medical school, other schools are forging partnerships to alleviate the shortage of physicians in underserved areas of the state. A case in point is that of Florida Atlantic University (FAU), based in Boca Raton, which teamed up with the University of Miami to open the University of Miami Miller School of Medicine at Florida Atlantic University. This regional campus of the University of Miami opened to its first class of students last August and offers a curriculum for years one and two.

While the administration does not plan to pursue an independent medical school, it hopes to eventually expand to include all four years, according to Michael Friedland, M.D., FAU's senior associate dean for biomedical science.

Northern Neighbors

Roger Strasser, M.D., Dean, Northern Ontario School of Medicine

Across the border in Canada, another new medical school is preparing to open its doors this August to its inaugural class. Northern Ontario School of Medicine, a partnership between Lakehead University in Thunder Bay and Laurentian University in Sudbury, is the first new medical school in Ontario in 32 years. When the next school year starts, Canada will have 17 accredited medical schools.

A serious shortage of physicians has plagued the remote provinces of northern Ontario for years. The new school hopes to be instrumental in reversing this chronic shortage by developing a curriculum designed to train physicians who are uniquely qualified to practice medicine in rural areas. The curriculum addresses the specific health needs of the region's diverse cultures, which include the aboriginal and the French-speaking Franco-Ontarian populations, according to Roger Strasser, M.D., the school's founding dean.

Northern Ontario school officials wrestled with the difficulty of combining medical faculty from two universities, Lakehead and Laurentian, which are 800 miles apart. Because this configuration is new to Canada, there are no examples to follow, according to Dr. Strasser.

"In almost every sense, as we move forward we're breaking new ground," Strasser said.

A perceived need for medical education in southern New Jersey is prompting officials at the University of Medicine and Dentistry of New Jersey (UMDNJ) Robert Wood Johnson Medical School to evaluate its clinical campus at Cooper University Hospital in Camden. School, and hospital officials are considering expansion of the current two-year program to a four-year program. At this time, more than 50 percent of qualified medical school applicants from New Jersey enroll in medical schools outside of the state, according to AAMC statistics. This fact, combined with the national reports of a physician shortage, led to the consideration of expanding the Camden program.

Southwest Passage

Jose Manuel de la Rose, M.D., Regional Dean, Texas Tech University Health Sciences Center

In El Paso, Texas Tech University Health Sciences Center has received legislative approval to expand from a two-year program to a full four-year independently accredited program. The university anticipates its first new medical school class in 2008, according to J. Manuel de la Rosa, M.D., regional dean of the university's El Paso campus.

"It's a great opportunity because we can build from the ground up," said Dr. de la Rosa, who also advised other schools attempting expansion to work closely with the LCME. "We can build a new curriculum, a new faculty and a whole new culture of learning in the institution."

In 1996, when Texas Tech University Health Sciences Center first raised the possibility of expansion, university officials had to counteract the widely held belief, based on trends from the 1980s and early 1990s, that a physician surplus existed, according to Dr. de la Rosa.

"I think it's gotten a little easier, especially with predictions of physician shortages," he said. "Some of the state legislators living through physician shortage issues in their own home communities can deal with the fact that physician shortages in the state are quite acute."

Sachin Parikh

This spring the focus will be on the FSU College of Medicine's 30-member inaugural class. With their May graduation rapidly approaching, the fledgling school's students are now competing for coveted residency positions with graduates from older, more established schools. But if inaugural-class member Parikh is an example, FSU students already are making a competitive entry into the workforce. And what comes after residency for soon-to-be Dr. Parikh? He says he plans to treat underserved urban populations in the United States while making time in his schedule to participate in medical missions abroad.

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