The Virginia Tech Carilion School of Medicine on Sunday will quietly become the ninth college of Virginia Tech.
Though pomp and circumstance will not herald the integration, the milestone marks a decade of growth through a partnership by a public university and a private nonprofit health system, and serves as a harbinger of the growth of health sciences in Roanoke.
“I think with Virginia Tech, if the medical school and research institute would not have been so successful, it wouldn’t have become such a big part of their vision for the future and their focus on Roanoke,” said the school’s founding dean, Dr. Cynda Johnson.
Johnson can watch out her office window on the Riverside campus as construction crews set the framework for a research institute expansion.
When she looks out another decade, she sees a health sciences city as envisioned by Tech and Carilion Clinic. A decade ago, she walked onto a brownfield charged with carrying out the partners’ initial vision to create a medical school that would train students differently than elsewhere.
People are also reading…
Early on, Tech and Carilion decided the medical school would be created alongside a research institute. They hired Johnson away from the Brody School of Medicine at East Carolina University to build the school and Michael Friedlander from Baylor University to build the research institute.
They wanted small classes of students who would be required to work in teams with each other, and with students and health professionals from other disciplines; to conduct a research project; and to learn through a problem-solving curriculum. For medical schools, Johnson said, these were then novel concepts.
Because it was all so new, Johnson said they chose to start out as a private school in order to earn accreditation and then eventually to become a college of Virginia Tech. When the partners announced two years ago that it was time to pursue integration, 104 people from the school, research institute, Tech and Carilion were assigned to 11 committees to work through the logistics.
One of the major hurdles was figuring out how to integrate all 769 faculty members. Of those, 409 are Carilion physicians and employees, and will remain so. Another five Carilion physicians, among the school’s senior leaders, will spend at least 40 percent of their time at the school.
The faculty also includes about 180 physicians in private practice or with the Salem VA Medical Center, and another 180 researchers, veterinarians and scientists whose primary roles are with other Tech departments.
Some 65 employees work full time exclusively for the medical school, five employees are shared with other departments, and the school employs 64 part-time standardized patients.
The challenge, Johnson said, was to figure out how to fit the school’s description of faculty, promotions and tenure into Tech’s.
“In the end we figured out a mutually positive way to have everybody have a place and to have all types of faculty be valued in the system. I think that was a pretty big accomplishment,” she said.
The financial arrangement between Tech and Carilion is not changing. The school operates on a $14.7 million annual budget, with $7.3 million coming from tuition, and about $600,000 from fees.
The balance, about $6.8 million, is the cost to educate medical students that exceeds tuition, as is typical of medical schools.
“The medical school creates unique, ongoing value for VT and Carilion Clinic, so they will continue to share in funding the shortfall relative to the value they each receive,” Tech spokeswoman Tracy Vosburgh said.
“We’ll continue to support the operations of the school financially to reflect the value that the school provides to Carilion and, in broader terms, the associated community benefit,” said Carilion spokesman Chris Turnbull. “Also, medical students will continue to do rotations at Carilion facilities, just as they do now.”
Integration doesn’t change the finances, the teaching or the curriculum for the students.
But it will expand “opportunities for students and faculty to do research and to connect more seamlessly with their academic colleagues across disciplines,” Turnbull said.
The integration committees looked at those opportunities.
“What came out of it was much more robust than I thought. Everyone thought of something — resources to share, new positions, new degrees we might offer and building together,” she said. “We actually went away thinking, ‘Wow, there’s a bunch of stuff.’”
For instance, the medical school recently learned it is the new Area Health Education Center in this part of Virginia, tasked with increasing the number of health care professionals. Through the integration process, Johnson said she learned that cooperative extension, housed in Tech’s College of Agriculture and Life Sciences, is also charged with improving community health.
With both being part of the same university, collaborating on increasing access to health care providers becomes easier.
“All of the sudden, we realized one thing is leading to another and to another, and we haven’t even gotten to July 1 yet,” she said.
Retirement plans
The medical school graduated its first students in 2014. On July 30, its ninth class of 43 students will enter the school and become the first to be educated entirely as Hokies. They will join the three other classes that total 126 students.
The school has no immediate plans to increase class size. Johnson said they weighed growth when plans were announced in 2016 to double the size of the research institute and for Tech to expand a health sciences campus in Roanoke.
“We’ve always promised our students the same personalized experience and we told them, ourselves and our faculty we wouldn’t expand the school at the expense of the experience,” she said. “So looking at the clinical aspects and the research opportunities, we believe that those need to keep growing, this building needs to be built, more researchers need to come into town and then in the next five years, we would look at incrementally increasing the class size.”
Johnson won’t be dean when that happens. She announced earlier this year that she would retire once a search committee names her replacement.
She’ll turn 67 in July, she has a 2-year-old grandson, and her physician husband, Dr. Bruce Johnson, is also retiring. They plan to remain in Roanoke but travel and enjoy a leisurely life. It’s the right time, she said.
“We’re integrating into Tech, and it’s all ready to be tucked in. I want the new dean to have an opportunity for a vision,” she said. “I guess the other thing is I’ve never been able to back away from anything, so if I didn’t have a trigger or a target, I’d be here another 30 years.”
Johnson said she’s asked friends about their retirement and they say they are just as busy as ever.
“I tell them, ‘Well, you’re not a role model,’” she said. “I’ve worked continuously. With both of my kids, I delivered someone else’s baby the day before I delivered my own, and three days afterward. There were not a lot of break points.”
Women were pioneers in medicine then, especially those who aspired to leadership. When Johnson retires she will have set the nation’s record for being the longest-serving woman dean of a medical school.
In her first year as a dean, she was one of seven women serving as deans of medical schools. Now there are about 20, she said.
“The percentage is still low,” she said. “There is still a lot of good work to do.”
Just as many women as men are entering the Virginia Tech Carilion medical school. Last year’s class had one more woman than men; the new class will have one more man than women.
But the first year, there were only 16 women out of a class of 43.
“Boy, did we get right on it. I was a female and my vice dean was a female, and we didn’t even consider the fact that it might turn out that way,” she said.
“There are all kinds of social issues to discuss, but by the time we tried to figure out what some of those parameters were, as the years have gone by, we have been much more equal numbers,” she said.
That first year, about 1,685 people applied for admission. By the fourth year, applications had grown to more than 4,000 with three-quarters of them being academically qualified to enter the school.
Since the start, the medical school has invited members of the community to serve on interview teams.
“We did in part to engage the community, but also because it’s the right thing to do to ask the community who do you want for the future to be your doctor,” she said.
They’re looking for not just students who excel academically but who can collaborate in teams and who will develop into physician thought leaders.
Those requirements will not change, she said.