Foundations for the Future and Sustainability of our Medical College

During yesterday’s virtual town hall meeting, many NSU MD students and faculty asked about our level of preparedness and the extent to which we have planned for the post-COVID-19 era. My response to them underscores both the gravity of the situation and our unique ability to adapt to our circumstances successfully, ensuring that the steps our College takes today will position us even more expediently for success and preeminence in the future.

Unquestionably, the coronavirus pandemic is having an unprecedented impact on academic medicine and higher education. At present, this global outbreak has kept us contained in our homes, socially distanced from each other. We have had to reprioritize every aspect of our lives, including how we teach, learn, discover, and practice. This new reality feels unsettling, exacerbated by the fact that it will likely continue for some time. Social distancing, and the rising number of cases in our community, raise many new questions as to the societal impact of this new normal. As a society, we are seeking reassurance about our questions related to health security, economic viability, national supply chains, models of discovery and learning, and the implications for underserved populations, the elderly, and those with pre-existing conditions. All these questions reflect many of the uncertainties voiced by our students, faculty, and community, concerning critical aspects of teaching, research, campus management, finance, and academic operations for years to come. Therefore, our College, as part of the larger NSU community, is demonstrating the agility needed to rapidly adapt and appropriately respond to the multi-faceted challenges that will be the “new normal” after COVID-19.

When responding to the rapid, unanticipated changes inherent to a crisis of this magnitude, we must first look to our core values; the values upon which we, as an organization, have established our academic mission. Our core values and mission won’t change, but our tactics and strategies are constantly evolving in response to the current environmental conditions. Dr. Hanbury’s greatly anticipated Vision 2025 will remind us of our core values and mission, guiding each decision we make and action we take as we adjust to the “new normal” and thrive under his leadership in this extraordinary time of change.

It is important to remember that dramatic change in higher education has historically been the rule, not the exception. As outlined in Clark Kerr’s Chronology [Kerr, The Uses of the University, 1966], perhaps the most important book on the modern university system ever written, Kerr shows that crisis moments provide new opportunities for innovation and enhanced operational efficiencies, thereby improving educational opportunities and learning outcomes for students. Today, it has become clear that any adaptive change within a university system in response to societal shifts must not rely solely on traditional academic models of efficiency, but, rather, requires broader community alliances, especially with the business community through public/private partnerships.

At the college level, I feel confident that the foundation we have established for our new medical college provides the necessary stability to withstand any of the current challenges and even excel in this time of uncertainty. These are the foundational assets that will help us thrive, will ensure our long-term success, and will propel us toward preeminence:

1. Increasing Program Demand: There continues to be an ever-increasing demand for the NSU MD program. Since the charter application cycle in 2017, our College has realized a 63% increase in overall applications. Further, in the 2018-19 application cycle, NSU MD experienced the largest increase in total applications (13%) among any of the MD programs in Florida. For our third class of students who begin their studies this July, we received an unprecedented volume of applicants: 5,390 primary and 3,240 secondary applications, for only 50 admittance slots. Today, our College has established a strong and highly diverse national presence, with students from 16 different states represented in the Fall 2019 matriculating class. Equally notable, NSU MD has also experienced an impressive 73% increase in the number of applicants classifying as underrepresented minorities in medicine. Our program has meanwhile maintained a highly competitive academic profile, with an average MCAT of 513 and an average overall GPA of 3.75, very comparable to other MD conferring programs in the state of Florida (512 and 3.8, respectively).

2. Hospital Partnership: We enjoy a uniquely strong and solid affiliation with our hospital partner, Hospital Corporation of America (HCA), with mutual interests for future growth in the undergraduate, graduate, and continuous medical education (CME) markets. HCA is the second-largest hospital system in the U.S. and is the national leader in graduate medical education (residencies).

3. Innovation in Virtual Learning: As a new, emerging program, we have the ability to be more agile, flexible, and responsive than larger, more established medical schools. We are able to recognize and seize opportunities quickly, shifting our responses proactively, anticipating the manner in which external conditions will morph daily. This is particularly relevant to medical innovation as exemplified by our team’s ability to transition to an online medical instruction system in record time and to convert the entire pre-clinical curriculum into a virtual platform. This transition not only included traditional lecture-based learning, but also active learning pedagogies employed by our Colleges, such as problem-based learning (PBL), team-based learning (TBL), and skill assessments, a heroic undertaking that required major faculty and IT support and effort. We expect some of these advances will be here to stay. Of course, not everything can or should become virtual, but, wherever these new practices translate into efficiencies, without sacrificing quality, they will be adopted and implemented so that our curriculum remains state-of-the-art.

4. Innovations in Telemedicine and Access to Care: The pandemic is dramatically accelerating change with regard to how and where healthcare is delivered. For years, telemedicine has lingered on the sidelines, offering potential as a cost-controlling, high convenience system. While it has become more relevant in rural settings over time, it has not fully moved into the mainstream. Now, out of necessity, the number of remote office visits occurring nationally has exploded as traditional-care settings are overwhelmed by the pandemic, and citizens are encouraged to stay home. There are containment-related benefits to this shift, by keeping contagious patients out of the regional transit system, out of the waiting rooms and, most importantly, away from other patients with underlying health conditions that put them at greater risk. There are also access-to-care benefits related to this shift. Healthcare in South Florida is highly fragmented; its citizens have historically grappled with how to successfully navigate the complexity of the system. Telemedicine introduces reliability and simplicity to the system. Patients can access care more easily and earlier in the disease trajectory, receiving diagnoses, treatments, and reassurance before a health condition becomes a crisis. Our College faculty have already begun important work in characterizing the fragmentation of care in South Florida, improving patient navigation of the healthcare system, and addressing issues related to patient access to care, making us uniquely poised to be a significant player in this new normal. A major obstacle that has prevented telemedicine from becoming mainstream was Medicare’s refusal to reimburse for this type of service—something that will, no doubt, also change as a result of COVID-19.

5. New Flanking Educational Programs: In August 2020, the College will launch a new Master of Biomedical Sciences (MBS) program, re-designed to foster advanced scientific and medical knowledge, medical training, and research experience. The program provides a graduate-level foundation for students wishing to enter health professions programs, Ph.D. programs, or health science careers. Further, we have partnered with the Huizenga College of Business and Entrepreneurship to prepare for a novel, interdisciplinary, undergraduate pre-med program called Business of Medicine Innovation (BMI). It will enable learning at the intersection of business, science, and medicine while preparing students for admittance to top-ranked medical schools and MBA programs of excellence. NSU’s rich, collaborative academic culture is reflected in these and other complementary educational programs. The thoughtful addition of these new programs will enable undergraduate and graduate students, including those of diverse ethnic and socioeconomic backgrounds, to become competitive for admittance to the NSU MD or other health professions degree-granting programs.

These combined foundational assets position our medical school to thrive and succeed even in these times of uncertainty. Moreover, they will continue to propel us forward in our quest for preeminence, as a college and as an institution. Be assured, we are monitoring unfolding developments and are well-positioned to respond and adapt as needed. Governor Cuomo, in his update to New Yorkers yesterday, said that, in times like these, we should remember two phrases: “Excelsior,” a Latin word meaning “ever upward” or “still higher,” and “E Pluribus Unum,” a Latin phrase meaning, “Out of many, one,” which appears on the Great Seal of the United States of America. His advice resonates strongly with us too. We will move past this challenge in the coming days and weeks, and we will do it by adhering to our core values and mission, and by uniting and working together as One NSU. Thank you for your support in these trying times. We will rise above it, together!

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