Medical schools offer new programs, invite collaboration

By Rob Heidrick Friday, 05 March 2010

A&M, UT to take on different roles in Central Texas health education, including community care and academic research

ROUND ROCK — 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 just more than 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.

“If the community and our elected officials have the vision of growing a full-scale college of medicine, I think 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 medical staff at St. David's, Seton and Scott & White work with A&M as adjunct faculty, and Seton Williamson 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.

Medical school in Austin?

Meanwhile, Seton is in the midst of overhauling its partnership with the University of Texas System, having finalized a new agreement in November with UT Southwestern Medical Center at Dallas, which will take over residency programs previously run by UT Medical Branch at Galveston.

The new Seton-UT Southwestern Institute for Clinical Investigation is expected to double the amount of graduate medical students doing residencies in Seton’s Austin-area hospitals, with a goal of 350 residents practicing annually when the program is at full capacity.

The affiliation is a major step toward establishing a full-scale medical school at UT Austin, said Greg Hartman, president and CEO of University Medical Center Brackenridge, the Seton hospital that will host many of the incoming residents. Many third- and fourth-year medical students already do their clinical training in Central Texas, he said.

“All we need is those first two years—which in some ways is the least important, but it’s obviously something we still want,” he said.

Hartman said UT officials have not committed to a timeline, but they anticipate creating a medical school in five to 10 years.

The ultimate vision is to create an academic health center, comprising a medical school, research and practical medicine, on par with top institutions such as Harvard University, Johns Hopkins University and Stanford University, said Dr. Kenneth Shine, executive vice chancellor for health affairs at the UT System.

At least $1.5 billion in new resources will be needed to create a four-year medical school, UT-Austin Executive Vice President and Provost Steven Leslie said.

He said the timing for opening a new school depends on the pace of economic recovery, and it would require funding from a variety of sources, such as philanthropy, businesses, state government and local taxes.

Different objectives

Hazelwood said the A&M Health Science Center’s focus on community-based care is distinct from the UT-Seton partnership’s goal of a full-blown academic health center.

“I see A&M’s objectives as a little bit different from UT Southwestern’s, in that A&M is really focused on producing practicing physicians and nurses,” Hazelwood said. “While that’s part of UT’s goal, they also are focused on producing academicians with double degrees in law and medicine or other types of things.”

The A&M Health Science Center’s Temple campus has a research affiliation with Scott & White’s hospital there, and the College of Medicine has academic research programs in College Station. Still, A&M is better known for training practical physicians than conducting medical research, Shine said.

“A&M is primarily a community-based institution,” Shine said. “That they will try to do research in Williamson County is entirely appropriate. [But] they will not be part of a research-intensive academic health center like in Austin.”

Nevertheless, Kotrla said the College of Medicine is prepared to facilitate an active medical research community in broader Central Texas.

Meanwhile, Round Rock community leaders are exploring the idea of building a research center on the Avery Centre tract between the Health Science Center and Seton Williamson. The building could be occupied by companies developing products such as cancer-fighting drugs, clean-energy systems and nanotechnology. These companies could share resources with the neighboring universities, said John Avery Sr., whose family owns the land on which the center could be built.

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, Hartman said.

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

“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.”