Connecting the dots for a medical school

By Fritz Klug
News Editor

The idea of having a medical school at Western Michigan University has been floating around since John Dunn began his tenure as president in 2007.
In the last six months though, that concept has begun to take form.

In November 2009, the WMU Board of Trustees announced an anonymous $1.8 million donation to hire a founding dean. After meeting with the Liaison Committee on Medical Education in January, WMU filed an application (with a $25,000 fee) to become a recognized candidate school in March.

The next steps will be some of the most difficult, Dunn said. Besides keeping up with the LCME’s standards to move on with the accreditation process, the school is also looking for the right founding dean to work with local hospitals, develop curriculum, and raise money.

“We have a long way to go,” Dunn said last week, “and some heavy lifting to do.”

Dunn is optimistic. The school would open in fall 2013 or 2014 with 200 to 250 students enrolled in the first four years.

“Our goal is not to be the biggest,” Dunn said. “Our marker will be on offering a rich and innovative curriculum committed to producing highly talented physicians of the highest quality.”

Private school, public university
WMU’s medical school would operate different from any other college currently in the university. It would exist as a private, nonprofit college within the university, funded solely by tuition and private donations, receiving no state support or general fund money.

Dunn said $175 to $300 million will have to be raised for an endowment to cover the medical school’s operating costs and financial aid for students. The endowment would generate $9 to $12 million a year that would be used for ongoing operational services.

To raise this money, Dunn said that the university is preparing a comprehensive campaign. He is optimistic that they will be able to get the funds.

“There is a certain amount of donor interest attracted in that area,” Dunn said. “There would be a phenomenal return [on the investment].”

Medical education in the United States is usually an eight-year process. Traditionally, the first two years are spent in the classroom and the second two are spent in hospitals doing clinical training. The student will then receive a MD degree and apply to residency programs across the country in the field of medicine they wish to practice.

There are 131 medical schools in the US, and WMU is one of 14 schools in the country currently seeking accreditation with the LCME.

Central Michigan University and Oakland University, along with WMU, would join medical schools at Michigan State University, the University of Michigan, and Wayne State University.

One of the reasons behind the batch of new schools is the predicted shortage of physicians. A recent Associated Press story projects a shortage of around 40,000 primary care doctors in the next decade, and studies show that Michigan will be short 4,400 physicians by 2020. With the recent health care reform, those numbers may increase as more people are insured and subsequently pursue medical attention.

The medical school at WMU would initially offer classroom and clinical coursework. New faculty and current medical professionals would teach the classes.

While a location has not been picked for the medical school building, Dunn said the current plan is to have it either on the Oakland Drive campus near the Health and Human Services Building and Kalamazoo Center for Medical Studies (KCMS) or in the proposed “life sciences corridor” in downtown Kalamazoo.

The residency program, Dunn said, would be under the auspices of local hospitals.

Much of the WMU School of Medicine will depend on how the curriculum is structured. Dunn said university representatives would be meeting with officials from Borgess and Bronson this Thursday, to begin planning.

“We will be looking at our new curricular model and decide what we want to be,” he said.

Community partners
The most commonly cited strength of a medical school at WMU is the life sciences industry already in Kalamazoo: Borgess Health and Bronson Healthcare Group, Stryker, and the Pharmacia/UpJohn pharmaceutical legacy, which is now owned by Pfizer.

Pat Dyson, CEO of Borgess, said the medical school would “add a dimension that is not fully available in Southwest Michigan.”

Borgess and Bronson have worked with WMU on the medical school since the beginning. Two studies conducted on the feasibility of the medical school in February 2008 and 2009 cite the two hospitals as core factors for the medical school.

“The concept is that all three entities are mutually dependent,” Dyson said. “We can’t do one without another.”

Borgess and Bronson already invest millions of dollars in the KCMS, where Michigan State University sends some 190 residents in 10 programs. KCMS is housed in the Unified Clinics building.

The problem of space comes when WMU opens its school.

“Medical schools normally don’t mingle,” Bronson’s CEO Dr. Scott D. Larson said.

KCMS would remain a community-based hospital.
While the specific expectations of both hospitals are yet to be determined, both Dyson and Larson agree that their overall role will be important in fostering medical and community support for the school.
“We have a real opportunity to take quality of care to the next level,” Larson said.

WMU’s College of Health and Human Services already has educational programs in blindness and low vision studies, holistic health care, occupational therapy, social work, alcohol and drug abuse, speech pathology and audiology, among other allied health disciplines.

Carol Sundberg, Ph.D., is the director of Unified Clinics, which provides clinical care for the Kalamazoo community as well as training students in the allied health programs.
Sundberg said that while there is some collaboration with UC and KCMS-MSU, she sees that there will be more collaboration with the WMU medical school because they are part of the same institution.

While most medical schools have allied health clinics like UC, Sundberg said WMU is unusual because it has the clinics without a medical school.

She said that while it may cause problems at first on the faculty level, working with the medical school will offer students an opportunity to work closer with MD students.

“Everyone in the hospital needs to work together,” said Linda Zoeller, director of the Bronson School of Nursing. “Not any one discipline can take care of a patient.”

The BSON has 270 students enrolled and partnered with 130 agencies, but a medical school at WMU could help build inter-professional teamwork.

While both directors look forward to the medical school, their exact role will remain undetermined until the curriculum is fully developed.

Strengths of a new curriculum
Dunn said the medical school’s curriculum would be centered on the needs of the patient.

“The niche will be quality,” he said.

There will also be collaboration with the rest of the university, Dunn said. The school of medicine will combine medicine with science, humanities and ethical programs the university already offers.

As an example, Dunn pointed to Dr. William G. Rantz, a professor in the College of Aviation who has done research on increasing flight safety.

“If someone on a flight, no matter their rank, sees something wrong, they speak up, no matter what,” Dunn said of the research.

This “strong emphasis to reduce mistakes” is something Dunn said he would like to see tied to personalized patient safety in the hospital.

Dunn said he would also like to add to patients’ comfort level by accepting MD applicants from diverse backgrounds as well as having physicians acquire another language.
“We want to provide them with a physician profile they are comfortable with.”

Two steps ahead in Rochester
Oakland University announced their plans for a medical school in 2007 and have received preliminary accreditation from the LCME. Oakland University is joining forces with Beaumont Hospitals.

“It’s a very logical move,” said Dr. Robert Folberg, founding dean of the Oakland University William Beaumont School of Medicine.

Hired in 2008, Folberg said that six strengths that the LCME cited in their review of the school included a strong relationship with Beaumont Hospitals, ample facilities for medical education, and “the talented, energetic, and experienced leadership team,” which has recruited people from Illinois, Wisconsin, Minnesota, New York and Pennsylvania.

The OUWBSM’s building is to be erected in the middle of OU’s campus, and the curriculum will include a variety of other programs including writing and rhetoric, critical thinking, the philosophy department, and business school.

As an applicant school, OUWBSM can begin accepting applications for the first class in fall 2011.

Folberg said that a charter class has 50 students, add 25 over four years, and plateau at 125 students.

Dean search
The next step for WMU’s medical school is to secure a founding dean to take over planning full-time.

Dr. Jack Luderer, director of WMU’s Biosciences Research and Commercialization Center, has been working with Dunn on the school and chairs the search committee for the dean.

“We want to get it right, this is not a race,” Luderer said. “We want to build a medical school for the next century or two.

The committee has met four times, and will continue to meet every other week until a dean is secured.

The dean, Luderer said, will be the “architect” for the new school. Unlike finding a replacement dean for a college, the med school candidates will be shown an idea, and not a building with faculty and developed programs.

While that scares some people away, it is a major draw for others. A new curriculum is the greatest strength Luderer sees in hiring the dean.

The dean will have to have an MD and prior leadership experience. The hardest part, Luderer said, is to find someone who can manage relationships with the hospitals, the university, the LCME, and other community organizations.

“[The dean] must understand that there is a higher purpose [for the school],” Ludere said.

Luderer estimates that there is a pool of around 3,000 eligible applicants of associate deans, former deans, retired deans, and clinical department chairs. Only a small percentage of that would be interested in leaving where they are and take the job.

While advertisements and mass mailings for the position will not begin until the end of the second quarter of 2010, Luderer has already received inquires about the position.

“It’s more important to get the right person,” Luderer said. “We want the dean to be a leader and bring experience to the table.”

“We’ll go as long as we need until we get a good person.”

The search will be a rolling process. Luderer said the search could take anywhere from the next six to 12 months.

Beyond medical education
Luderer sees the effects of the medical school reaching beyond the hospitals and sciences departments.

“[The school] can help WMU attract a different pool of undergraduates and provide better research dollars,” Luderer said. “It will yield a greater return for the whole university.”

Also, with the curriculum, Luderer said the school of medicine could work with departments across campus, such as the business of medicine.

“It’s best when Ph.D.s and MDs work together,” he said.

While the rest of the university is undergoing financial difficulties and decreased enrollment, Dunn doesn’t think the university is spreading itself too thin with the medical school.

“There is a window of opportunity,” he said. “The university needs to sustain its eye on growth.”

Dunn said there is an amount of recognition the medical school will bring to WMU.

“It will add a new chapter to our history.”