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Medical schools offer new programs, invite collaboration

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By Rob Heidrick and Patrick Brendel Friday, 12 March 2010

WILLIAMSON COUNTY — The College of Nursing at Texas A&M Health Science Center in Round Rock will start out as a small operation when it opens this June. The first group of students includes two classes of 10 students each—one program for new students and one accelerated track for nurses returning to the field after working in other disciplines. The opening of the new school represents the next stage of growth on a campus that has sprung up seemingly overnight.

The first building on the medical school’s new campus opened in December on a tract that borders Seton Medical Center Williamson, the new Austin Community College campus and Texas State University’s Round Rock Higher Education Center—which is in the process of adding a nursing school of its own. The Health Science Center received state funding and completed construction on the building within a span of about two years.

“In an amazingly short amount of time, we have come from nothing,” said Dr. Kathryn Kotrla, associate dean of the Health Science Center’s College of Medicine in Round Rock.

With continued community support, A&M is on track to further extend the range of programs offered in Round Rock, including a pharmacy school and other health professions education programs—perhaps even a four-year medical school, Kotrla said.

Medical schools serve different functions in their home communities, depending on the region’s needs and the goals of the institutions. While every school has its own approach, two distinct models of medical education have taken shape as the Texas A&M Health Science Center and the University of Texas discuss ideas for future programs.

Community-based medical education

Students training to practice medicine work closely with local hospitals and clinics, interacting directly with patients and learning how to treat them in a real-world setting.
Community physicians often serve as advisers and clerkship faculty.
In Round Rock, the Texas A&M Health Science Center College of Medicine provides clinical training for third- and fourth-year medical students, offering rotations in family medicine, internal medicine, obstetrics/gynecology, pediatrics, psychiatry and surgery.
A&M’s local partners include Lone Star Circle of Care, Seton Medical Center Williamson, St. David’s Round Rock Medical Center and Scott & White Healthcare–Round Rock.
The College of Nursing will partner with Seton on an accelerated nursing program.
Other community-based medical programs are offered at UT Medical Branch at Galveston, Baylor College of Medicine and UT Southwestern.

Research-intensive medical education

Medical schools work with hospitals to recruit researchers in a range of scientific disciplines.
Hospitals, with input from their partner universities, determine the focus of research. The university typically invites researchers to serve on faculty.
Researchers usually come with grants to study new medicines and technologies, assisted by graduate students working toward advanced degrees.
The University of Texas System recently made an agreement with the Seton Family of Hospitals to send graduate students from the UT Southwestern Medical Center at Dallas to conduct their rotations in Seton’s Austin-area hospitals.
The new Seton-UT Southwestern Institute for Clinical Investigation will employ about 16 research scientists in its first year.
The Dell Pediatric Research Institute, a venture between Seton and UT Austin, opens in April.
Other examples of research-oriented universities include Harvard, Johns Hopkins and Stanford.

Regional collaboration

The Texas A&M Health Science Center’s new Round Rock campus includes a 15,000-sq.-ft., state-of-the-artsimulation lab that will become a key element in training students within a hospital environment. The lab could also provide opportunities for partnering with other educational institutions across the region, said Dr. Kathryn Kotrla, associate dean of the College of Medicine in Round Rock.
The simulation center features several computer-controlled mannequins that display vital signs and simulate a range of medical conditions.
A mock delivery room houses a mannequin that simulates childbirth, and another room trains students to care for elderly patients with limited mobility.
A simulated operating and emergency room features the same type of equipment used in hospital ERs, and ceiling-mounted video cameras record students’ response to simulated emergencies.
The Health Science Center College of Nursing now participates in a simulation education project with students from Austin Community College, Texas State University, Blinn College, Mary Hardin Baylor University and Texas Tech University at Marble Falls. The project began in January and will run for at least one year.

“If the community and our elected officials have the vision of growing a full-scale college of medicine, this community and the people in it can have anything they set their minds to,” she said.

Regional medical network

The College of Medicine began offering clinical clerkships to its third- and fourth-year students in Round Rock in 2008, and since then, the school has established affiliation agreements or other partnerships with every major healthcare institution in Williamson County.

Seton Medical Center Williamson, St. David’s Round Rock Medical Center and Scott & White Healthcare–Round Rock are each involved in training A&M students as they go through their rotations. The Lone Star Circle of Care operates several clinics and a pharmacy inside the Health Science Center building, which will also function as major teaching sites for HSC students.

“We are actually in our infancy in terms of working with the Health Science Center, but they are off to a very strong start,” said Mark Hazelwood, president and CEO of the north market of the Seton Family of Hospitals, which includes Seton Williamson.

Seton donated $3.5 million toward startup costs to open the LSCC clinics, and in February the organization pledged another $600,000 to the College of Nursing. St. David’s Community Health Foundation pledged $250,000 for development of A&M’s Round Rock campus, and in 2006, the foundation donated $6 million to establish Texas State University’s nursing school, which opens this fall as the St. David’s School of Nursing.

Some members of the Seton Williamson medical staff work with A&M as adjunct faculty—as does St. David's and Scott & White in Round Rock—and the hospital partnered with the nursing school on its accelerated Bachelor of Science program.

“The hospitals work with the schools of nursing to ask what they can do to recruit,” said Sharon A. Wilkerson, R.N., dean of the Texas A&M Health Science Center College of Nursing. “They come to talk with our accelerated students about their intern program. That’s very appealing to new graduates.”

Just as the community has supported Round Rock’s medical schools in their early years, Wilkerson said the schools are poised to return the favor by producing the area’s first generation of locally trained physicians and nurses.

“Students educated in Williamson County are going to be looking to Williamson County for their first jobs in those hospitals,” she said.

Collaboration, competition

A&M and UT officials, as well as their partner hospitals, contend that their overlapping ambitions to create medical schools are being pursued amicably.

Part of the reason for that is practical: Animosity might cause both schools to lose out on potential funding, Hazelwood said.

“From a political standpoint, they don’t want to get into a competition with each other before the legislature as they try to attract funding for different programs,” he said.

Texas faces several challenges to providing reliable healthcare, which behooves the schools to work together, said Greg Hartman, president and CEO of University Medical Center Brackenridge.

The area has a shortage of practicing doctors, with about 155 physicians per 100,000 people, compared to the national average of about 220, he said. Extra medical schools could help address that shortage, while improving indigent care and providing an economic boost.

“I don’t think there’s a competitive sense to this at all. I think it’s really a collaborative sense, in that both schools offer different strengths to what they bring to Central Texas,” Hartman said. “And in Central Texas we need so much in terms of academic medicine and we have so much potential to take advantage of it.”