EBM and Clinical Support Librarians@UCHC

A blog for medical students, faculty and librarians about their use of evidence based medicine, clinical literature, Web 2.0, sources and search strategies

News, Academic Medicine, Medical Education: A New Clinical Enterprise

I read with interest a post by Jacob Goldstein on the Wall Street Journal Health Blog on Apr 4 2008 regarding plans for a new medical school on Long Island – which will be the first ever (and only) graduate medical educational institution in Nassau County (NY). His blog posting states that there are currently planned between 10-15 ‘start-up’ graduate medical schools to add to the existing 129 schools in the United States. Link here to the American Association of Medical Colleges for a list.

This new venture will be a collaboration between Hofstra University and North Shore-LIJ Health System, Long Island, NY. The proposed school has already chosen a founding dean, Dr. Lawrence G. Smith, and the first class is planned to enter in 2011. In the WSJ blog article, Dr. Smith is quoted:

There are two real costs to the startup of a medical school. One is the cost of staff and faculty prior to collecting tuition from students. That’s in the $15-$20 million range. And then you have to build a medical education center and a living facility. That’s the heart and soul of the medical school. Capitalizing both of the buildings together is going to be between $50 and $100 million. Nobody’s going to come up with money for that. That’s going to be a debt-service issue.

Also read a press release dated Jan 22 2008 from Dartmouth Medical School, in which Dr. David Goodman argues that increasing the numbers of medical students could place a financial burden on an already straining U.S. health care system.

Education for health professionals is not – and never should be – inexpensive.

Medical education takes many forms: seeing patients in all states of health, chronic and acute, young and old, in hospital or affiliated clinics (the buildings/facilities). Students learn in lectures from experienced physicians, researchers and allied health professionals (the clinician-educators) as well as hands-on learning from clinicians in the community.

On-site and at-hand for the graduate students are the core of the academy: men and women with years of experience in treating patients, teaching, demonstrating, researching, presenting, facilitating, guiding, giving advice. There are also many opportunities for laughter, sharing and collaboration.

The local community is another factor to consider, as students are required to travel around the state to observe healthcare delivery where it actually takes place. This semester, I have heard from 2nd year medical students who have – as observers – visited patients in residential nursing homes, met 13 and 14-year olds from urban Hartford neighborhoods and counseled them on safe sex practices and avoidance of STDs, sat in on Alcoholics Anonymous meetings, shadowed physicians in trauma/emergency rooms throughout the state (just to cite a few examples). Patients are a diverse group… those seen in an emergency room at 230am may differ demographically from those enrolled in a long-lasting clinical trial at the academic health center.

The people, the patients, the buildings and the resources for a medical school may be compared to a full symphony orchestra. Here are some of the things which come to mind that might keep Dr. Smith awake at night:

  • the ability of the institution to compete for, recruit, enroll and retain qualified applicants with a humanistic focus who can integrate and apply complex medical data in order to become successful practitioners. (Click here for AAMC links for future physicians).
  • recruit and retain a group of talented, experienced clinicians and biomedical researchers who are dedicated educators, academic scholars and proven grant-winners
  • sort out options of academic tenure; and unions for professional or clerical staff
  • recruit and retain a group of talented, experienced clinical hospital staff: nurses, allied health personnel, health care technologists, others
  • provide and maintain state of the art health care facilities which offer a diverse selection of clinical departments, hi-tech equipment and sufficient patient base to keep it funded
  • secure on-going financial support from the greater academic or governing institution
  • take actions to be in compliance with all accrediting bodies for hospital, higher education and also with a variety of state/local/federal laws governing healthcare facilities
  • devise strategies or plans for protection from potential threats to the viability of the enterprise… including political pressure from existing academic or clinical competitors
  • plan, construct, manage and maintain the physical buildings, systems and environments
  • finally, but not least of all: hire and retain non-teaching staff who are the daily face of the institution for everyone who enters the new building. These staff would be a diverse group of savvy, experienced administrators, managers, technicians and yes – librarians – who attend to the infrastructure, and complete the daily work of the facility seamlessly. These people will like working with the general public, patient and their families, students and faculty.

Now – what and who is missing from this list… Anyone care to comment?

Just as money, buildings and human talent are needed for a start-up academic health center to support the needs of Students, Patients, Staff, Facilities, Environmental Safety and IT… so are funds required for a health science library.

I wonder if the new medical school has plans for a new library and new staff? Everyone in the clinical enterprise requires access to current information in networked or print forms. Students need an attractive place to study and congregate (they study alot). Clinicians and graduate students need librarians to provide literature searches, train them to search efficiently, repair broken links to digital information, select pertinent databases to meet their needs for patient, research or grant funding knowledge management or demonstrate how to set up and run a new PDA or laptop.

We (in the library) aim to assist life-long learners. You could reasonably say that the health science library and the human staff there helps everyone in that new building.

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One response to “News, Academic Medicine, Medical Education: A New Clinical Enterprise

  1. Pingback: News, Academic Medicine, Medical Education: Check out these Comments « EBM and Clinical Support Librarians@UCHC

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