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From the Blue Ridge Business Journal
Vision becomes reality
When class begins at 8 a.m. Monday the relationship between Virginia Tech and Roanoke will enter a new phase as 42 students start medical school.
Monday is the beginning of orientation week, and the dean of the newly minted Virginia Tech Carilion School of Medicine promised the students will be learning medicine from Day One.
VTC Dean Dr. Cynda Johnson will present the first case study that will be used to teach the students about diagnosing a patient and the science they need to know. She didn't want to reveal much about the case, but said it is something "very personal to me as a physician and to me personally."
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In many ways, the opening of the new school is intertwined with the personal experiences of its leaders. It marks a significant undertaking for Virginia Tech and for Carilion Clinic, which formed the public-private partnership as a way to boost their individual organizations and the region's economy.
It also has significant implications for the larger community that reach beyond the obvious goal of educating doctors. For many in the community, VTC marks a way to build a reputation that better connects the Roanoke and New River valleys.
"The relationship between Virginia Tech and the clinic is an important dynamic for us and for the future of the region," Carilion Clinic CEO Dr. Ed Murphy said. "This is the best opportunity for the best future for our region. As we move forward, only good can come from it."
Murphy and Virginia Tech President Charles Steger are responsible for conceiving and initiating the opening of a medical school in Roanoke.
Steger said the two began talking about 2004 as they discussed ways to energize the local economy.
"We were saying what can we do because we are responsible for two of the largest employers in the region," Steger said.
A 2006 trip to the Cleveland Clinic persuaded the two leaders to move forward with the plan.
From the beginning, the school was intended to have a strong scientific research component. Early on, the curriculum would have added a fifth year for students to provide a specialized education that prioritized biomedical research. Johnson nixed that plan, saying the same research expectations could be met in the normal four years.
As students have moved to Roanoke, many in the community are eager to see the ties with Virginia Tech grow.
"I'm convinced in this beautiful scenic region in which we live, we allow barriers, far more psychological than geographic, to get in our way," said Joyce Waugh, president of the Roanoke Regional Chamber of Commerce. "By making the tie to Virginia Tech, we are making that regional connection stronger and I would say making the psychological barrier less noticeable. It just brings our two valleys closer together."
Waugh said the excitement among business owners is palpable as they meet students and see faculty move to the area. She added that the research component that rests with the Virginia Tech Carilion Research Institute, which opens Sept. 1, is an important factor in the enthusiasm of the business community because of the potential for spinoff companies and new jobs.
"I think the combination has far more impact than the parts, each of which will boost our region's image as well as bring an intellectual boost to the community," Waugh said.
Already the name recognition of Virginia Tech among students helped attract the first class. Lindsay Makara, 22, said the connection to Tech took some of the risk out of being part of a startup medical school.
"Because it is Virginia Tech, to me it is a little more stable," she said. "I have pretty good faith in them. They all came from good backgrounds, and I think they know what they are doing. ... It seems very well designed."
Steger said VTC students will be fully integrated into the university's student body.
Makara, who has an undergraduate degree in biology from the University of Virginia, moved last weekend to Roanoke and said she is proud to be part of the school's inaugural class. She applied to 21 schools and said after visiting VTC for her interview that it became her top choice.
"It just seems really new and fresh and exciting, and that they have some different ideas about med school," she said.
Number 131
Charms with the number 131 are among the merchandise VTC plans to sell. Proceeds from all VTC logo T-shirts, hats and other items go to support scholarships for students.
But the number 131 is special because VTC is the 131st medical school in the United States and Canada offering a doctor of medicine degree to receive preliminary accreditation from the Liaison Committee on Medical Education.
It will forever be the 131st medical school.
VTC is part of a boom of new medical schools to open across the country after nearly 30 years of stagnant growth. These new schools, more than dozen of which are in the works, are seeking to fill a need that has been growing in American health care for decades.
Last year, four new medical schools opened in the country and accounted for half of the overall increase in student enrollment figures. Another dozen existing medical schools expanded their 2009 class size by 7 percent or more.
VTC is one of seven schools to have preliminary accreditation status, which means it has yet to graduate its first class. Another eight schools are in the process of applying to be able to recruit their first classes. During the 1980s and '90s, only one new medical school opened nationwide.
When Murphy and Steger first broached the subject of opening a new medical school, they were aware of the need for more doctors.
In June 2006, citing evidence of a national physician shortage, the Association of American Medical Colleges called for enrollment at U.S. medical schools to increase 30 percent by 2015. The association specifically asked for new allopathic, or traditional, medical schools, as well as increased enrollment at existing schools. Just a year earlier, the association had suggested a 15 percent increase in medical school enrollment would address the work force issues.
In January 2007, Murphy and Steger announced their vision for VTC in Roanoke.
"We thought the window would close very soon, and I think that is playing itself out," Steger said of the call to open new medical schools.
By academic standards, the process of starting a new school has moved extremely quickly, Steger said.
He said the role that research will play with the medical school and larger university is key to putting VTC on the map.
"We have a chance to really plow some new ground," he said. "It's an exciting time."
VTC's role in addressing the physician work force shortfall will be small because the class size was intentionally kept small.
Johnson said that although she is well aware of the need for more physicians, she is more interested in educating doctors who will be able to lead the way as the nation's health care field evolves.
A new way of teaching
Johnson, however, said VTC is having an impact on the national endeavor to improve medical education.
"There probably isn't a new school developing that hasn't called to talk about what we are doing and how we're doing," Johnson said. "We have the early information that they do like it because schools are calling to say, 'Wow we would like to learn from you, we would like to do this, too.' "
There is a move away from the traditional medical school curriculum that focuses on two years of scientific foundations and two years of practical experience in a clinical setting.
In June, three authors writing for The Carnegie Foundation for the Advancement of Teaching called for a reform of medical education. They said medical education is at a crossroads between the traditional methods of teaching that were established in 1910 and a newer wave of teaching.
Johnson and VTC have embraced the newer concepts, choosing to focus on clinical experiences to better teach the biology that all doctors must know.
All 42 students will follow the same schedule of course work. Together they will attend lectures, take anatomy and choose research projects. They will also learn various aspects of medicine by solving certain case studies each week. The students will be broken up into six groups of seven students, where they will help diagnose a patient by learning about his or her condition from various clues, such as test results and symptoms.
Each Friday, the students will meet the patient, or the patient's family on which the week's lesson was based. Nearly all of the cases are based on area patients.
It's called the patient-centered learning model and it follows the basic educational principles of problem-based learning. It puts the science into the context of a real patient.
Students will research and teach various topics that will help them to understand the patient's condition.
"The word doctor means teacher. Not everyone knows that," said Richard Vari, VTC's associate dean for medical education. "And you have to be a good teacher to be a good doctor."
Vari will be among six facilitators helping the students work in the small groups. Some of the facilitators are physicians, but some, like Vari, are not.
Vari came to Roanoke from the University of North Dakota School of Medicine & Health Sciences, where he was part of a team to rewrite the curriculum from a traditional-based lecture system to the patient-centered model.
"I think everybody would do this if they could, if they see it," Vari said of the new approach to teaching.
Vari said he was converted to the new system from the moment he visited a school that was already implementing it, the University of Missouri-Columbia School of Medicine.
"When we went to Missouri, we saw the students there were engaged, excited and enthused about learning. We knew we had to do this," he said.
VTC hired Vari for his expertise in this teaching method.
The method is intended to go beyond the classroom.
Many of the more than 350 faculty members are doctors at Carilion, or already professors at Virginia Tech.
Each student will be paired with a doctor mentor. Dr. Howard Graman, chairman of primary care at Carilion, is on the faculty and one of the mentors.
Graman's primary job is as an upper management administrator at Carilion, but he sees patients on Thursday afternoons. During that time, a student will shadow him.
"This student will spend time regularly with me in my clinic at my elbow seeing what I do," Graman said.
Each student will be assigned to the same doctor for a two-year stint. It is designed to give students clinical exposure from the beginning, instead of waiting until they are in their third year of medical school before stepping into a patient's room.
The community's role
Even as the school's doors open Monday for the first class, the administration is already preparing for next year.
So far, more than 500 applications are being reviewed and 40 potential students have been invited to interview Aug. 28 for a spot in next year's class. Rolling admissions will continue into 2011. For the first class, about 1,650 total applications were received.
In the meantime, the school is busy recruiting people from the community to help with the interviewing process, a coveted job. Johnson said people approach her regularly about participating.
Now Johnson said she is focused on honing that excitement to get the community involved in other ways. She is actively soliciting cash donations to support scholarship funds for students. Already the school has given every student a one-year scholarship of $42,500 to cover tuition and fees. Two students in the incoming class are on full Army scholarships.
"I would like to scholarship this second class," she said.
She said her primary goal is to offer scholarships for the first year, but she is interested in raising money to help students pay for the education during the subsequent three years.
The money for the charter class scholarships came from $20 million in startup costs dedicated to the school. Another $50 million in startup costs is set aside for the research institute. The startup money is from Carilion and Virginia Tech.
Johnson said she is mostly focused on raising cash donations, but that she is entertaining endowment offers. Fundraising is also getting support from the highest levels, with Steger helping to bring in endowments for the medical school. He said he thought a couple of endowments had already been made.
"I think we will see a very positive support," Steger said.
Neither Virginia Tech, which is managing financial donations for the medical school through its foundation, nor VTC would release how much the endowments were for or how much money has been raised. A university spokesman said those amounts have not yet been made public.