Community and collaboration are topics at VP Health Sciences candidate forum
Ellen Cosgrove, candidate for the position of Vice President for Health Affairs and Dean of the School of Medicine and Health Sciences, focused on community and collaboration at her public forum April 13.
Currently Regents’ Professor of Internal Medicine and Senior Associate Dean for Education at the University of New Mexico School of Medicine in Albuquerque, Cosgrove earned her bachelor’s degree in Russian history at the University of Pennsylvania and her M.D. from Hahnemann Medical College in Philadelphia. She did her internal medicine internship and residency at Presbyterian-University of Pennsylvania Medical in Philadelphia. She has been with UNM since her appointment in 1999 as a professor of internal medicine, and also serves as associate dean of continuing medical education. She was named senior associate dean for education in 2002. She served as a visiting professor at the International Research Center for Medical Education at the University of Tokyo in Japan from 2005 to 2006. She held various positions at Hahnemann School of Medicine, beginning as senior instructor in 1981 and moving through the ranks to professor before joining the University of New Mexico faculty in 1999. She has also served as attending physician at Hahnemann and at Monmouth Medical Center, which is affiliated with Hahnemann, and as director of medical education, associate dean for academic affairs, and medical director for ambulatory practice, all at Monmouth.
Cosgrove said she believes in being honest and forthright, and said that in her quest to become a medical school dean, UND is her top choice. She said she likes what the medical school stands for now, and what it can become. “I share your vision,” she said about the SMHS goal to become the best community medical school in the United States within the next decade. “You’re well on that path, and I’d like to be part of it.”
She said that the health care profession runs in her family: her father was a physician, and her mother a nurse; they had a medical office in their home. “I saw the commitment they brought to their work,” she said. “That is what inspired me to go into medicine. They cared for their friends and neighbors, served those in need, and gave back to the community.” She was proud to be accepted into Hahnemann, her father’s alma mater, and was asked to join the faculty there when she completed her residency.
Cosgrove said that as she’s researched the institution and received packets of information, she sees that a personal commitment to service shines through at UND. She was impressed by the 100th anniversary book, North Dakota, Heal Thyself (2005), and said the inspirational stories of sacrifice and commitment helped her understand why parents want to send their sons and daughters to the School of Medicine. She said that a research and economic development piece makes a compelling case for UND research and its impact on communities. She said she’s impressed by our areas of excellence, which create new knowledge, inspire students, and build community. She said she would bring her ethic of hard work, caring, and community commitment to the dean’s position.
If she were named dean, Cosgrove said, she would be a catalyst who carefully listens, finds centers of strength and inspiration within the community, and then move the institution forward. She said that UND is on the righ track, with students in the top 25th percentile nationally of the medical licensure exam.
“As the next dean, I would enhance and accelerate what you’re doing,” she said. “My approach would be to bring out the best of what’s already here.”
Cosgrove said she would focus on three main areas: community commitment, research and scholarship, and educational innovation and excellence.
Her goals for the first year would be to work with an already-convened group to fill 10 open faculty research positions. She would like to leverage them to augment existing levels of excellence while finding find new areas in which to excel, add new scientists, and stake a claim for national expertise in that discipline.
Goals for her second year include working with local hospitals to renew, refresh, and strengthen the role of community physicians. In its last accreditation report, UND received a commendation for community physician commitment to education. Cosgrove said she would like to re-examine that relationship and lay the groundwork for more recognition. More important, though, is to recommit to the covenant between practicing physicians and faculty to produce competent, caring physicians for the state and nation. Another priority is to expand the medical school as well as the number of residency slots and programs in the state. Health care reform, she said, could offer a new opportunity to attract students who would stay in North Dakota. This is at best a loosely coupled system, Cosgrove said, because the medical school does not control the number residency positions. UND needs to work in partnership with clinical sites in the state to identify areas of specialty that are not offered and would be of value to communities. She said said she has experience in expanding the numbers of residencies at UNM, and this experience may be applicable to UND. For example, she helped develop a dental residency using an innovative educational model that used both city and rural sites. This also allowed preceptors access to specialists for difficult cases. “It was win-win in bringing new services to New Mexico,” she said. “I could see that this model could work in North Dakota.”
She has five-year goals for UND, Cosgrave said. She sees three areas where UND shines. First is the commitment to the community – that attracted her, she said, and she would like to build on that, perhaps by getting to students earlier. She mentioned developing a B.A.-to-M.D. program in cooperation with other schools, including tribal colleges. She said she would like to put students into the community earlier in their education and as a result of medical school expansion. The University of New Mexico was able to expand its medical school by about a third with a new combined degree program linking undergraduate programs with medicine while supporting the Hispanic and American Indian communities. She said they had a 70 percent rural and minority enrollment in the first few years of the program. They had legislative support to fund needed special services to help support educationally disadvantaged students. “It changed some student’s lives,” Cosgrove said. “It opened the door to a career in medicine to students who may have never thought they would be able to achieve that goal.” Offering additional support to students resulted in a 95 percent retention rate. UND has had similar success with programs in medicine, physical therapy, and occupational therapy, and she believes there’s opportunity to bring more value to communities.”
Another way to strengthen the community connection is to continue partnerships with other institutions in North Dakota, similar to the BRIN and INBRE programs, which provide undergraduate research experience to students. She mentioned collaborative programs with other institutions, and said these have brought good laboratory jobs to communities, and could inspire rural and tribal students to think about careers in science and medicine.
Another example of innovation that links communities is cooperation between biochemistry at the University of Arizona and UND’s clinical laboratory science program. In the future, she would like to build on this by working to forge stronger relationships and aid rural communities.
The second strategic focus of her first five years would be to advance medical and biomedical research and scholarship. It’s critical to fill faculty positions and define a new direction for the school and identify new research centers of excellence, she said. She’s proud that she helped build practice-based research at UNM, where 200 practicing physicians have been engaged in translational research topics. Everyone benefits, she said, from creating new knowledge through research that matters. Other benefits include continuing education credits for the physicians, increased grant funding, and publication opportunities.
Her third strategic priority would be to strengthen education programs in medicine and health sciences. She said she believes our main purpose is to train skillful and compassionate physicians and professionals. She said she’s most excited to work with UND to take our already excellent educational programs even further. Cosgrove said she has experience doing this, and is proud of it. It was developed with a collaborative vision, not only with different departments but with the community and health department. In the eight years since its program began, this summer UNM will be the first in the nation to grant a certificate in public health to all M.D. graduates. She said this type of program is synergistic with our strengths at UND in patient-centered curriculum and community-based education. She said she’d like to move that forward and encourage us to be even more innovative in weaving community needs into the program. She said they’ve done that successfully at UNM, and not just in the medical program, but also in health programs. This results in richer scholarship, faculty advancement and development of new degree programs. As a result, Cosgrove said, faculty are equal and valued colleagues in allied health programs. She sees this as an area of strength at UND as well. She said her values and experience could work well with UND.
“Your school embodies the ideals I believe in and live by,” she said. She values excellence and feels her experience is well-matched to UND’s needs. She said she would welcome the challenge of being dean , joining in our vision of producing the next generation of health professionals and scientists to serve North Dakota and the nation.
She then took questions from the audience, the answers to which are summarized below.
When asked how she would deal with competition for resources, Cosgrove said she would work with people, get out of the way, and let them work. She said she’s not sure a scattershot approach will get us where we need to go. She said she would develop a common vision of where we are going as a school to fulfill UND’s goal of becoming the best community medical school in the United States.
She said she would undergo strategic planning with faculty, community physicians, and the community to refine our vision. She said she prefers big visions that are boiled down to one page. “If you produce a book, it’s exhausting,” she said. “And rather than being an inspiration and a guide, it becomes a straitjacket.” She said she doesn’t make decisions until she’s heard all sides and points of view. “There is a lot of talent at the school; we can take it to the next level,” she said.
Would she work with nursing? Cosgrove said that nurses are integral to the programs at UNM, and they include faculty from medicine, nursing, and pharmacy to provide an integrative experience for students. UNM was one of six schools selected to take part in a new Carnegie Foundation conference to develop innovative programs with nursing and medicine, Cosgrove said. She observed that as health care reform adds 35 million previously uninsured Americans, areas will have to collaborate to develop new models of care. She said it’s important to work together and think about things in a new way.
About an integrated medical curriculum and what she’d do to support the graduate mission, Cosgrove said UNM has made services available to biomedical sciences students as well as medical students. They have also added services to seven of eight programs in the diagnostic and therapeutic sciences (the eighth program had its own resources). She said services include wellness counseling, financial aid, and the formation of a graduate student association. As the office of research has evolved, she said, they consider students in these related programs as part of the medical school learners. She said they do not re-create programs available on the main campus, but provide necessary new services.
A family physician who serves rural and tribal areas asked what could be done to help recruit physicians to rural areas. Cosgrove said that as a practicing internist, she has seen interest in primary care decreasing nationwide. She cited the Quentin Burdick program which provided assistance for 14 years, and resulted in more than 70 percent of participants selecting rural areas. To be honest, she said, she does not believe the sole measure of success is the number of primary care practitioners who choose rural practices. There is no easy or ready answer, but she supports programs such as rural rotations, a B.A.-to-M.D. program that’s open to rural and tribal students, and other opportunities. She believes that expanding the medical school, and especially bringing in more rural and tribal students, could be helpful.
Cosgrove said she did not know that there was already a plan in place to strengthen connections between SMHS and communities, but that she had chosen that focus as a priority based on information she received from UND. Cross-campus connections are an exciting opportunity, she said, again mentioning the B.A.-to-M.D. program. At UNM, they have developed a tailored curriculum that includes collaboration with medical and Arts & Sciences faculty. She cited several examples, including working with a creative writing faculty member who helps students sharpen skills in narrative medicine and writing. UND has unique strengths in aerospace, for example, Cosgrove said, and she could see an interesting opportunity for collaboration.
Regarding focus of the 10 available faculty positions, Cosgrove said the options include strengthening concentrations, beginning a new focus, or a combination of the two. She said she has no position on the issue, but would like to think about creating a new concentration that, to be effective, must be synergistic with existing areas. “I have no hidden agenda,” she said. “I don’t have a team ready to move with me. I would like to work with chairs and researchers to take advantage of the opportunity.
There is clearly an opportunity for recruitment in the state if some tribes have not had INMED students admitted, Cosgrove said. She said she would like to talk to physicians and community members to discover barriers and find wa Mys to get and keep students in college. As part of the medical school expansion, she would like to target students from rural communities. “It can be done,” she said. “A dean can set the tone and see a vision. It will take a village to change the situation.”
There is some anger in rural areas about the dearth of graduating physicians who choose to practice in rural areas, said a physician. Cosgrove said that one answer could be to begin targeting and working with students earlier. “Students begin ruling out careers in fifth grade,” she said, when math and science become more challenging. New Mexico has a pipeline program that begins in junior high. The Dream Makers Program helps keep dreams alive for students, she said. It focuses on rural and American Indian students, and on keeping them in school. With mandatory tutoring, community housing, personal counseling, advising and addiction programs, it offers support that can increase success. Students must have academic preparation, and the program offers it, she said. Students can take that experience back to the community; the idea is to start community integration earlier than the residency.
Cosgrove said that she hopes she will be selected dean, and that if she were, this would not be the last public forum. The questions helped her get new ideas and learn more about us she said, and she hopes to work with us to create solutions.
