The Association of American Medical Colleges (AAMC) has called for a 30 percent increase in U.S. medical school enrollment by 2015 to address the nation’s physician shortage, which is especially severe in rural America. In New York, 25 percent of the state’s population lives in rural and poor inner city, medically underserved regions, while 91 percent of physicians in the state practice in urban counties. The Columbia-Bassett program responds to this need and, more recently, a call for the nation’s medical schools to explore ways to better equip physicians to deal with the health care needs of the 21st century.

In a report released earlier this year, the Josiah Macy Jr. Foundation recommends using this period of historic expansion in enrollment to advance the effectiveness of medical education and better align it with societal needs and expectations. The Chronicle of Higher Education characterized it as an opportunity to “update an outmoded physician-training model that has resulted in the wrong mix of people being trained in the wrong settings at too high a cost”.

In announcing the Columbia-Bassett venture, Lee Goldman, M.D., executive vice president for health and biomedical sciences and dean of the faculties of health sciences and medicine at Columbia University Medical Center, said, “Our goal is to encourage outstanding medical students to practice in rural areas and help them develop the skills necessary to shape the health care systems of the future. This innovative new campus may be the demonstration model for a much-needed new paradigm, which will catalyze care that is at once safer and less costly and inspire other medical schools to emulate and improve upon our example.” Goldman noted that Bassett is the ideal partner in this venture.  In addition to its extensive patient care network, Bassett offers demonstrated expertise in rural health care research through such programs as the Mithoefer Center for Rural Surgery and the New York Center for Agricultural Medicine and Health.

The partnership with Bassett comes at a time when Columbia is enhancing its educational model to be sure it continues to meet the demands of an increasingly challenging health care environment. The creation of a campus in upstate New York and the progressive curriculum in place at the Columbia-Bassett campus is consistent with that commitment. Ronald Drusin, M.D., vice dean for education at Columbia’s College of Physicians and Surgeons, said, “This program provides two unique learning experiences. The mission of the College of Physicians and Surgeons is to develop future leaders in patient care, research, education, and policy. The Bassett campus additionally provides students with learning opportunities in a rural setting with an emphasis on longitudinal patient relationships.”

Henry Weil, M.D., Columbia’s assistant dean for education, Bassett Healthcare, said, “One of the building blocks of health care reform is training that nurtures the compassionate physician while simultaneously immersing that doctor in leadership development and the systems underpinning effective health care delivery. In this new era of medical education, physician training is not just about medicine and science.”  The goal of the Columbia-Bassett curriculum, says Weil, is to turn out skilled clinicians who are passionate about patient care, good communicators, adept at evidence-based medicine, and accountable to society as responsible managers of the health care system. Toward that end, students will be exposed to learning typically far-removed from the medical school experience such as finance, risk management, patient safety, quality improvement and medical informatics.

The four-year program will graduate its first class in 2014. Students will spend their first year and a half at Columbia’s Manhattan campus. Bassett will be the host campus from the middle of the student’s second year until graduation. Students’ clinical experiences at Bassett’s Cooperstown campus will consist of a required one year experience followed by a year and a half of electives and pursuit of an area of concentration utilizing the full array of opportunities at both campuses. The curriculum will focus on the basic sciences at Columbia’s College of Physicians & Surgeons, followed by clinical training in a distinctive longitudinal program at Bassett. In contrast to most medical schools where students have blocks of experiences, abandoning one set of patients for the next, at Bassett students will care for patients over an extended span of time and have an opportunity to manage the care of individual patients from diagnosis to cure. They will get to know their patients as people and see a disease as a process, not a snapshot. Additionally, students will utilize advanced computer technology and an electronic medical record that links the Bassett network across five thousand square miles.

Walter Franck, M.D., Columbia’s senior associate dean for the Bassett affiliation, said, “The medical students who participate in the Columbia-Bassett program will experience all disciplines of clinical medicine, ranging from the broad spectrum of primary care to the wide variety of subspecialties in medicine. Our goal is to educate them in excellent practice taught in a rural setting.”

Applicants will be evaluated in accordance with Columbia’s rigorous academic standards and special emphasis will be placed on recruiting students from rural communities. Research has shown that recruitment and retention of rural physicians is most successful when it targets candidates who were raised in a rural community and have completed medical school and/or residency training in a similar environment.

Students who enroll in the program will receive $30,000 per year per student in tuition support for their medical school experience.  Dr. Weil noted, “In the face of educational debts that can exceed $200,000, many young physicians must make career decisions based upon maximizing their earning potential. We want to make rural practice a more attractive and viable option by limiting future debt through substantial financial assistance.”

Columbia UniversityCollege of Physicians and Surgeons

Columbia University’s College of Physicians and Surgeons is located on the health sciences campus in Manhattan, and was the first medical school in the United States to award the Doctor of Medicine (M.D.) degree.  One of the most selective medical schools in the United States (based on average MCAT, GPA, and acceptance rate in the 2009 US News and World Report), Columbia enrolls approximately 150-160 students per class. In 2007, 6,946 prospective students applied and 1,194 were interviewed for 155 spots.

Bassett Healthcare

The Bassett Healthcare system includes five hospitals, 28 community health centers and 13 school-based health centers across an area the size of Connecticut, providing an ideal and diverse environment for medical students. Bassett Healthcare’s fully salaried, not-for-profit model combines physician and administrative skills in the delivery of excellent, safe and evidence-based care to a population of patients located in medically underserved communities. Bassett has been a teaching affiliate of Columbia University’s College of Physicians and Surgeons since 1947, serving as a site for medical student clinical rotations and post-graduate residency training.