The federal government has deemed all but two of Alabama’s 67 counties medically underserved areas, with 60 counties lacking enough primary care physicians. The state needs more than 400 additional primary care physicians to provide Alabamans with decent health care, according to a report recently released by the Alabama Rural Health Association.
Granted provisional accreditation by the AOA Commission on Osteopathic College Accreditation (COCA), the Alabama College of Osteopathic Medicine (ACOM) in Dothan intends to help reverse the shortfall. The first four-year osteopathic medical school based in Alabama, ACOM is also believed to be the first DO school established solely by a medical center or hospital.
Scheduled to open in 2013, the school is an academic division of Southeast Alabama Medical Center (SAMC) in Dothan, which is in the far southeast corner of the state. A 420-bed regional referral center, the hospital serves more than 600,000 people in Alabama, Georgia and the Florida panhandle.
“SAMC has an open-heart surgery unit, a cancer center, a women’s health center that delivers 1,600 infants a year, and an emergency department that sees roughly 65,000 patients a year, including many with significant trauma,” says Craig J. Lenz, DO, ACOM’s dean. “The hospital does everything except transplants. We’ll be able to use these great resources in the classroom and in the clinical training of our students.”
SAMC is preparing to open four AOA-approved residency programs by 2015—in family medicine, general internal medicine, emergency medicine and psychiatry. Given that physicians tend to practice close to where they train, the hospital aims to strengthen southeast Alabama’s medical workforce. Short some 40 physicians across all specialties, SAMC hopes to tap many of these future DOs for its own needs, Dr. Lenz says.
Decade in the making
Southeast Alabama Medical Center first became interested in osteopathic medical education in 2003, when approached about establishing rotations for students who were from Alabama but attending out-of-state DO schools. Wil Baker, PhD, the executive director of what was to become the Alabama Medical Education Consortium (AMEC), began calling on Ronald S. Owen, SAMC’s president and CEO.
“We started our dialogue then and, in 2005, took our first student, a military veteran in his 40s,” Owen recalls. “He was very mature and a great student. The next year, we took two or three more students. Now we take six to eight per year.”
Calling itself a “medical school without walls,” AMEC encourages and helps premed students from Alabama colleges who are likely to pursue primary care to apply to one of eight partnering osteopathic medical schools. The admitted students spend their first two years on the campus of their DO school but return to Alabama for their third- and fourth-year clinical clerkships, which are scheduled and coordinated by AMEC. The consortium and ACOM are in the process of developing residency training programs in Alabama for DO graduates.
“AMEC has been very successful, with more than 80% of the trainees going into primary care and other urgently needed specialties. About 175 students and residents are in the pipeline right now,” says Owen, an Alabama native who joined SAMC 15 years ago.
Pleased with his hospital’s initial foray into training medical students, Owen became more active in AMEC and soon began brainstorming with other consortium members about the feasibility of starting an osteopathic medical school with walls in Alabama, which has two MD schools: the University of Alabama School of Medicine in Birmingham and the University of South Alabama College of Medicine in Mobile.
Determining that a DO school would be viable economically and logistically, SAMC entered into a partnership with Troy University in Dothan. But due to financial pressures, Troy later withdrew from the effort.
“All of a sudden, what we thought was going to be a capital commitment of $25 million or so jumped to $75 million without Troy,” Owen says. “Our governing board had to analyze whether we as a hospital could operate a quality college of osteopathic medicine on our own without adversely affecting the care of our patients.” Reassured of the undertaking’s feasibility, the board decided to go forward.
“The reason we’re doing this is the scarcity of physicians,” Owen says. “We use up a lot of time, money and other resources recruiting them. So we decided to grow our own.”
After conducting a national search for a dean, SAMC hired Dr. Lenz in August 2010. A former dean of the Western University of Health Sciences College of Osteopathic Medicine of the Pacific in Pomona, Calif., he worked with AOA President-elect Ray E. Stowers, DO, as a founding dean of the Lincoln Memorial University-DeBusk College of Osteopathic Medicine in Harrogate, Tenn., starting in the fall of 2005.
“Craig brings tremendous experience in how to put a college together, develop a curriculum and recruit faculty and students,” Owen says.
ACOM will use a discipline-based curricular model in the first six months of the first year to give students a thorough grounding in the basic sciences. After that, the curriculum will be systems-based, with students studying each organ system separately, from respiratory to renal. “It’s a strong, well-supported curricular model,” Dr. Lenz says.
The curriculum will also be paperless. “The entire building, which is under construction about a mile from the hospital, will be hard-wired to carry all of our texts and presentations,” Dr. Lenz says. “Everything will be done electronically.”
Students will serve their third- and fourth-year clinical clerkships at SAMC and the more than 30 other clinical sites currently coordinated by AMEC. Dr. Lenz expects that many of the graduates will train in the 75 or so residency positions to be developed at SAMC, as well as the other OGME positions AMEC is working to establish. “The entire infrastructure of AMEC will be part of our school starting in 2015,” he says.
The receipt of COCA’s provisional accreditation means that ACOM can begin recruiting and accepting students. “We will recruit heavily from Alabama and expect a lot of students will also come from Georgia and Florida,” Owen says. “But we’ll accept students from all over.”
The school has been busy recruiting administrators and leading faculty members—without difficulty, Dr. Lenz is quick to point out. “We have already hired 17 people in key leadership positions, several of whom are from Alabama,” he says. “A lot of people want to come here because Dothan is a wonderful place to live, with plenty of parks and shopping. And it is only an hour and a half way from some of the nicest beaches in the Florida panhandle.”