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AAMC Releases Report on Conflict of Interest Guidelines Malpractice Update: States Say Federal Help Needed To Deal With Spiraling Costs Image Guided Surgery: Making "X-Ray Vision" A New Reality Medical Schools Branch Out: Regional Medical Campuses on the Rise Computer-Based MCAT Gets a Test in London "A Day in the Life of a Medical Student" A Word From the President
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Medical Schools Branch Out: Regional Medical Campuses on the RiseAs a child growing up in the Rio Grande Valley region of south Texas, Leonel Vela, M.D., Ph.D., already heard rumors regarding the establishment of a regional academic medical center in his community. “I remember hearing civic leaders talk about bringing a place to the Rio Grande that would train physicians to serve the local community,” says Dr. Vela, who is now the dean of the academic health center he heard about as a boy. The center, established in three different cities and part of the University of Texas Medical School at San Antonio (UTMSSA), comprises the first regional medical campuses of south Texas.
Campuses like UTMSSA’s — many of them located hundreds of miles away from their medical school's main campus — often play crucial roles in their communities, in addition to offering expanded clinical training opportunities for students and faculty. UT-San Antonio is one of many medical schools in the country that have opted to create regional campuses to complement their academic programs. According to a current AAMC study, 26 U.S. medical schools operate one or more regional clinical campuses, two more are developing branch campuses, and six medical schools run branch campuses for basic science instruction. The AAMC study, to be completed in the upcoming months, focuses on the history, organization, management, and impact on medical education of clinical campuses. “There are three components to our regional academic health center,” explains Dr. Vela. “The campus in Harlingen is part of the medical education division. Another campus in a community 40 miles west of Harlingen, still in the Rio Grande Valley, will house our medical research division. “A third campus that’s also part of the regional academic health center is a branch of the University of Texas Health Sciences Center in Houston, under the School of Public Health,” he adds. The regional academic health center will serve the four counties of the lower Rio Grande Valley, which has a population of a little more than one million people, approximately 85 percent of which is Mexican-American. According to Dr. Vela, that region is one of the most underserved areas in the country, and the number of students from the Rio Grande Valley who choose to pursue medical careers is relatively low.
“There is a lot of community interest in training physicians who are sensitive to the needs of the population here, and especially in training physicians who are from this area,” says Dr. Vela. “The arrival of this regional campus provides an opportunity for potential medical students from the area who wouldn’t otherwise pursue medicine as a career because of the prospect of having to leave their families for an extended period of time. Now they can see that as a realistic goal.” In addition to the benefits to the local community, students at UTMSSA also reap rewards. “Our school’s students have a great opportunity to train in a very unique venue where a confluence of factors provides them with unique training in the areas of environmental health, public health, and population-based medicine,” explains Dr. Vela. “We’re incorporating these various facets into our medical education, and we can do that because we have a population here in which these healthcare challenges are very salient. “Our students spend part of their training in different settings here in south Texas to learn about the cross-cultural implications of health; the culture of this area, and how that impacts health and well-being. Students also learn about the area’s environmental challenges and the kind of impact that has on the health status of their patients,” he says. West Virginia’s advancesWhen viewed in the context of workforce concerns, regional campuses such as Harlingen’s provide a much-needed service to places struggling with an undersupply of physicians, by training students from underserved communities who are likely to return to their hometowns to practice medicine. Another such campus has the potential to do just that in rural West Virginia. The West Virginia University School of Medicine (WVUSOM) is planning to open a regional campus in approximately five years in the city of Martinsburg. “Martinsburg is located in what is called the ‘eastern panhandle,’ which is a medically underserved area,” explains Michael Friedland, M.D., WVUSOM’s associate vice president for health sciences and dean of the Eastern Division. “That region has about half the amount of physicians the rest of the state has. Some regions in the eastern panhandle are reasonably well populated and still have major physician shortages. That fact, coupled with what is a significant population growth, has been one of the major stimuli behind the concept of a regional campus. “We’ll have a substantial emphasis on primary care and family medicine in our training here, and we’re going to have rotations into rural areas,” Dr. Friedland says. Although Martinsburg isn’t a rural area, it is surrounded by rural communities, with some as close as just a few miles. “We picked Martinsburg as the site of our regional campus because it has the most medical resources available in the panhandle,” he says. The fact that West Virginia has been one of the states hit hardest by the medical malpractice crisis, resulting in the out-migration of many of its M.D.’s, makes this kind of enterprise extremely valuable for the state’s underserved communities. “This regional campus will enable us to attract physicians into rural communities in a current climate that is extremely adverse,” he says. Similar to Texas, West Virginia also intends to recruit students from its regional campus’s community. “We want to create a pipeline so that our students can be identified as early as high school,” says Dr. Friedland. “We want to work with them while they’re in college, then continue doing so when they enroll in medical school and come to our campus.” This type of initiative often involves community partnerships. WVUSOM’s regional campus in Martinsburg joined forces with local hospitals, the Joan C. Edwards School of Medicine at Marshall University, and WVU’s School of Osteopathic Medicine. Similarly, Harlingen’s regional campus, Dr. Vela points out, “is in existence because of a very important community partnership involving the city of Harlingen, the chamber of commerce, the development corporation in the area, and a local medical center.” Another regional campus with a significant community partner is planned to open in 2005 in Fairfax, Va. The Virginia Commonwealth University School of Medicine (VCUSOM) has been given permission by the state’s general assembly to open a regional campus at Inova Fairfax Hospital. Although permission has already been granted, the school won’t have any students doing training there until the fall of 2005. Partnership opportunities“An affiliation with an outstanding not-for-profit health system that has been always interested and involved with medical education is a huge benefit for our institution,” says William Gleason, VCUSOM’s senior associate dean for finance and administration and associate vice president for health sciences. “Our partnership offers an opportunity for our medical students to have a variety of choices for their clinical experiences.” Inova Fairfax Hospital is a 656-bed regional medical center that serves the Washington, D.C., metropolitan area and is affiliated with the medical schools of Georgetown and George Washington universities. The hospital recently has been ranked the 24th best hospital in the country by a non-profit consumer education organization, and in July was named a top 100 hospital for the treatment of heart disease. Another advantage offered by the site of VCU’s new regional campus is its larger population base. “The population in Fairfax County is much more diverse than the one in Richmond, percentage-wise,” explains Gleason. “There are more Hispanics, Asians, and African Americans there. The population base there is also much bigger than the one in Richmond, and is growing at an incredible rate. “In the obstetrics area, Inova Hospital has more than 10,000 deli- veries a year; we have about 2,500 here. For students interested in certain areas, all these factors may present the possibility of a richer experience. The clinical experience in Fairfax is not necessarily better than the one medical students have in Richmond, but it’s a good alternative.” In addition, a lot of medical students at VCU come from Fairfax County and other regions of Northern Virginia, so many will likely be interested in doing their clinical training in Fairfax, says Gleason. “We also have opportunities for collaboration with Inova in bio-medical research, clinical trials, and outcome research,” he adds. “And there are potential opportunities for residency programs with Inova and VCU.” More work aheadUntil all these plans solidify, there is work to be done. “Between now and the fall of 2005 we will be developing our budget, which is something we’ve already made good progress on,” says Gleason. “We are now focusing on planning for the undergraduate medical education program, and we have appointed an associate dean for the regional campus and an assistant dean as well. They are both physician-employees of Inova, but they are now also faculty of VCU.” The regional campus recently had a consultation visit by the Liaison Committee on Medical Education (LCME) and the American Medical Association to get advice and input to ensure that the educational experience of students there is comparable to the one they receive at the main campus. One advantage of regional campuses, says Gleason, is that they allow institutions to expand their medical education programs in a very cost-effective manner. “The trend of regional medical campuses nationwide may also represent a realization by some medical schools that they might not be able to, for financial reasons or otherwise, offer the breadth and depth of experiences they’ve been able to give in the past. This might be the case sometimes by virtue of location, market factors, or funding. Opening up a regional cam-pus is a strategic move to solidify their educational base.” Most important, Gleason adds, is the role regional campuses may play in addressing workforce shortages. “We’re not expanding enrollment, but depending on what the future holds, if there is a need for more specialists and for increased production of physicians like there was during the 1960s and 1970s, we will have an expanded clinical training base opportunity.” -Suria Santana, ssantana@aamc.org |
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