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Live Blogging: AAMC Medical Education Meeting 2014 — Nov. 8 & 9

November 9, 2014

Faculty Development in Longitudinal Integrated Clerkships (LICs)

Susan Perlis, PhD, CMSRU Associate Dean for Medical Education, had the opportunity to lead a discussion with colleagues from the United States And Canada about faculty development in LICs.  A variety of suggestions for creating activities that are convenient and timely for faculty were shared that we can incorporate in our CLIC.

Educational Scholarship in the Digital Age

Speed dating is not for singles anymore!  This session used a speed dating technique to enable participants to visit a variety of educational scholarship publishers to discuss the advantages of using each to promote our research.

Medicare Maze: When Payment  Policy Meets Health System Rule 

The AAMC update on Medicare funding focused on the changes to the Affordable Care Act (With 24 states not expanding Medicaid, three million fewer citizens will have access to insurance. Possible future Medicare cuts to hospitals may put more than 20% of payments at risk.).

On the physician side, nine percent of reimbursement may also be reduced if certain “value” goals are not met.

Finally, despite the conundrum of not enough residency spots for graduates of U.S. medical schools, it’s highly unlikely that Medicare will increase the number of funded slots to hospital GME programs, especially with the shift from inpatient to outpatient care as well as the focus on alternate payment methods.

Oath Taking in Academic Medicine: Expanding the Commitment to Ethics within the Profession

Oath taking Common Themes:

1.  Ceremony and Ritual are important to our human experience.
2.  The taking of a medical oath is the active acceptance of a normative identity.

Oath themes-Respecting patients & teachers, confidentiality, humility, avoiding harm & injustice, advancing medical knowledge, advancing one’s own knowledge, serving public health, & placing interests of patient ahead of self.
Main themes of the future: Graduating classes crafting their own commencement oath.

The oath as still sacred in the 21st century with regard to professionalism in an age of specialization and team delivery models.

GSA/NEGSA Business meetings (Group of Student Affairs/NE Group on Student Affairs)

Both the national and NE Group on Student Affairs held their meetings to update constituencies of key changes affecting medical students and residents at every level. Topics included: residency application services and their policies, protocols for the MSPE (medical student performance evaluations), new immigration status options on AMCAS applications, global health learning opportunities, the national funding climate, student loan forgiveness programs, and expected Day 1 competencies in residency programs.  The need for a unified voice in support of increasing federal support of residency spots was highlighted, and all members of the academic medical community are asked to visit aamcaction.org to learn more about advocacy on this issue.‎

How PIVIO can help students become doctors – the AAMC & NBME new career documentation platform

The PIVIO service was presented and demonstrated to the target audience. Audience members were encouraged to request specific uses and needs in order to explore the range (and limits) of PIVIO functions. Questions about user control of private data and likelihood of PIVIO becoming a required service were addressed.   The presenter acknowledged that user control and institutional use of data will be an issue that must be determined as the platform evolves.  He also recognized that there is likelihood of PIVIO becoming a required service for medical students and residents (for a subscription fee), but that AAMC does not require any of the current services.  Instead, the user schools were identified as the institutions driving the requirements for MCAT, AMCAS, ERAS, etc.

A new approach: creating leaders.

This thought leader session led by Wiley Souba and Gretchen Caughman challenged attendees to look at leadership mastery from a phenomenological perspective instead of an epistemological perspective.  The main take away: we need to think about how our context (hidden beliefs and assumptions) frames how we view what is happening in our lives.  This matches how we act which impacts our performance.  When we reframe how we view situations we see a situation from a variety of perspectives and can develop better solutions.

Town Hall with Darrel Kirch, MD

This open discussion forum fostered a rich discussion of the concerns facing everyone in the academic medicine community.  Dr. Kirch answered questions regarding:

^AAMC advocacy in Washington, D.C. and the current political climate affecting our institutions.

^The role of AAMC fee-requiring services in the debt burden of medical students, and the debt burden in general for them.  Noted was the inability of deans to control medical school tuition increases.

^The inconsistency of promoting work-life balance for medical students and residents without institutional culture changes to support the rhetoric.

^The disconnect between OSR delegates and other AAMC groups in action plans, specifically the separation of OSR meetings from key policy discussions with other groups. Ways to increase OSR presence were highlighted, with follow-up discussion planned after the town hall.

^“Dealing with the failure of our successes” in holistic admissions for medical schools.  A robust and frank discussion about the seemingly stagnant culture of resident selection among program directors  – despite the changing culture of medical school admissions – resulted.  The adherence to test scores and first time pass rates was upheld from program directors present, emphasizing that program accreditation must be safeguarded, as well as career integrity for all residency program graduates. This idea was summarized with “multiple choice tests don’t go away.” Dr. Kirch emphasized that the AAMC data analyses must find a way to identify the attributes valued by program directors while allowing for holistic consideration of candidates.

^The role of leadership in academic medicine, and potential ways to foster leadership development along the continuum of medical training.




Live Blogging: AAMC Medical Education Meeting 2014 – Friday, November 7

November 8, 2014

Council of Deans Meeting

At the Council of Deans’ meeting, AAMC President and CEO Dr. Darrell Kirch spoke about the GME “crunch” – not enough positions for graduates of U.S. medical schools.

Medical students who will graduate in the spring are submitting residency applications in astounding numbers. As of the end of September, 42,000 fourth year students had submitted 3.1 million residency applications or an average of 71 applications per student.

 “Moving icebergs: practical solutions for successfully implementing interprofessional education (IPE) at your institution”

Implementing interprofessional curricula is challenging due to unaddressed and unrecognized institutional and cultural barriers. This session was led by a group of Josiah Macy scholars with experience in designing and implementing IPE at their institutions. During the workshop portion of the session, clear strategies were utilized to successfully implement a specific IPE experience. Utilizing the Kotter change process, a case of a failed IPE program was analyzed.

 “What motivates learners to flip over the flipped classroom? Exploring the implications for faculty and student development.”

The neurosciences course at the University of North Carolina was discussed at this session. The curriculum for this course was totally flipped and utilized a variety of independent learning materials including digital flashcards, videos, readings, interactive computer modules, and USMLE practice questions. They were unable to document any change in student performance or in the course evaluations. Sixty-five percent of students favored a curriculum that is mixed between flips and lectures. The sentiment was expressed that students in a totally flipped curriculum miss the sense of community with their classmates, not necessarily that they favored lecture as pedagogy over the flipped curriculum. The physiology curriculum at Duke, which is also flipped, was discussed. Two interesting and unique aspects were that the course director was available to answer questions from 7:30 a.m. to 5:30 p.m. daily and the course was set up so students could do modules together, appealing to their sense of community. In this example, student performance was improved as was satisfaction with the course. The presenter stated that, in his experience, the flipped curriculum “made smart kids smarter.”

Student Blog: OSR Regional Business Meeting — By Rebecca Lee (M3), Gita Byraiah (M3), Imoh Ikpot (M3), Matt Chorney (M2)

The issue of mounting student debt was addressed. Ways to address this included discussions on: merits of 3 year programs to reduce cost; hosting premeds and residents during interviews; each school should contribute to an MSAR like document detailing cheap transportation, food, and lodging options near each school; asking AAMC to be more transparent about where our test fees are going: for example if we have to pay thousands of dollars for step 2 CS, where us that money going toward? Also presented was that loan repayment programs should be advertised far earlier in the process to attract candidates to med school who would otherwise rule out this profession because of the prohibitive cost of entry .

Related to this was a call that increased attention to mental health care of students as the phenomenon of depression among medical students is real and worsened by the financial concerns.

Student health services that are accessible for medical students was also discussed. CMSRU has a unique wellness program set up and our services and how they work were shared with the other medical schools. A lot of ideas like the weekly yoga sessions, running club, meditation sessions and other services run by Wellness were well received by other medical students. Also the Advisory College system as a way to vent and share ideas with other students within the school was well liked by other medical students as well.

GME: no solutions to funding shortage crisis as of yet, however students should continue to be vocal about advocating for this issue.

Statement from the OSR about wellness, balance, and a demand for a healthy learning environment: https://www.aamc.org/download/408212/data/learningenvironmentstatementdownload.pdf.

 New resources:

– Residency travel “toolkit.” This is a collaborative document that we can feel free to contribute to (need AAMC log in): https://www.mededportal.org/icollaborative/resource/3810

The opportunity to meet and talk with students from other schools has been as useful as the formal sessions. Our students have seen the Johns Hopkins has an Advisory College system very similar to ours. They are also learning that many schools approach the curriculum the way that CMSRU now does but our ALG process is fairly unique.




Live Blogging the AAMC Annual Session – Thursday, November 6

November 7, 2014

Accelerating learning. Fostering connections. 

Thursday, November 6

“Healthcare transformation:  Affirming the central role of medical education” 

The meeting started with a plenary session entitled “Healthcare transformation: Affirming the central role of medical education” given by Dr. Darrell Kirch. He spoke of the growing sense of uncertainty in academic medicine in the United States and tied it to the political landscape with a deeply divided government and populace. Medical schools in the United States are becoming more and more dependent on clinical revenues. This worked well for many years but this funding source is in jeopardy since teaching hospitals will see significant cuts in funding in addition to cuts in GME funding. The United States is highly dependent on academic medical centers to meet needs. Teaching hospitals make up only 5 percent of US hospitals but deliver over 25% of care and almost 40% of charity care. Medical school should be drivers of innovation. The goal should be the triple aim of better care of the individual; better health for the population; and reducing per capita course of care.

“How do we teach doctors to lead? Designing leadership curricula for undergraduate medical education through a competency model.”

This session examined the leadership curricula in undergraduate medical education and presented existing curricula at two medical schools, Duke and Uniformed Services University. Two models of leadership were discussed. At Duke, students and residents developed the Feagin Scholars program for medical leaders. It consists of a longitudinal curriculum, workshops, and events embedded into existing courses. There are 33 competencies. The core principles at the heart of the model include: acting with personal integrity, communicating effectively, pursuing excellence, patient centeredness, and serving selflessly. The three domains include knowledge, emotional intelligence, and teamwork.

LCME survey prep information session

This session was a discussion of best practices for an effective self-study an independent student analysis for a full survey visit. It consisted of presentations by a medical education dean and recent graduates who were  closely involved in their schools’ accreditation processes. The top 10 areas of noncompliance on full surveys and the most common areas of compliance with monitoring were reviewed and discussed.

Session on innovative programs to develop leaders in urban settings.

UCLA, University of Wisconsin and University of Illinois presented their programs. Although each program is customized, they all are striving to produce community – responsive physician leaders. Most of the programs have a separate admissions process and most offer the opportunity for dual degrees – either an MPH, an MPP or an MBA. Assessments of the programs show a high percentage of graduates doing the residencies in underserved areas, pursuing primary care, and practicing in their local area.

Preserving the medical education mission in a time of declining revenues.

The last plenary of the day was a discussion of preserving the medical education mission in a time of declining revenues. Obstacles to proper alignment between a medical school and its clinical enterprise were reviewed including culture, different values surrounding process, and business focus. Areas for alignment include recruitment and retention of the physician workforce, the learning and practicing environment, and quality initiatives.




Live Blogging Learn.Serve.Lead in Chicago!

November 4, 2014

Watch here over the next week for updates from this year’s AAMC Medical Education and Annual Sessions – we’re so excited to be here!




Are We Heading for Graduate Medical Education Judgment Day?

October 8, 2014

Since the earliest days of this blog, the challenges facing graduate medical education (GME) in this country have been a frequent topic. Now, the much-anticipated report on GME from the Institute of Medicine (IOM) has finally been released and, not surprisingly, the findings and recommendations from the distinguished group of authors have caused much stir and consternation.

The recommendations in “Graduate Medical Education that Meets the Nations’ Health Needs” (http://www.iom.edu/~/media/Files/Report%20Files/2014/GME/GME-REC.pdf ) can be briefly summarized as follows:

* Maintain the current levels of Federal funding for the next ten years, but switch to a pay for performance methodology that ensures accountability and incentivizes innovation

* Build a Medicare GME policy and financing infrastructure, including establishment of a GME Policy Council within Health and Human Services, establishment of a GME Center within the Centers of Medicare and Medicaid Services, development of a strategic plan, robust data collection, and provision of annual progress reports to Congress and the Executive Branch

­* Create a single GME entity with two divisions: one to support the operation aspects of current programs, and one to support new transformational approaches to GME

* Modernize and simplify the Medicare GME payment methodology, funding residency positions at a set per resident amount that is adjusted annually based on the overall GME operational funds available, with performance-based incentives

* Maintain Medicaid GME funding at the state’s discretion but require the same transparency and accountability as with the “new” Medicare GME funding guidelines

Now understand that the IOM has no ability to change the law governing how Federal financing of GME positions occurs. None. But please don’t underestimate the influence of the IOM – one need only recall their 1999 report “To Err is Human” which brought the enormous consequences and impact of medical errors to the spotlight and resulted in a transformational rethinking of clinical care provision. And so while we don’t know the ultimate influence this report will have on policy, it is painfully clear that GME has been headed for some time to its Judgment Day – too little money in Medicare, too big of a physician shortage, inadequate availability of GME positions and lack alignment of GME programs with the looming gaps, especially in primary care.

At the very least, this report is incredibly disruptive in its recommendations and the reaction from the key stakeholders has been profound. Physician groups, hospitals and health systems, the academic medical community and others have pushed back and pushed back hard.

As laid out in previous blogs, the call has typically been for more Federal funding of GME positions as a way to solve this conundrum. But Medicare, perhaps far from the best source for subsidizing GME expansion, is running out of money, and pre-IOM report publications have already predicted a decline, rather than an increase, in government support, even for currently funded positions. If not the Feds, then maybe insurance companies or the states can find the dollars. But, does anyone really believe this is going to happen?

Beyond the IOM’s recommendations, the report is replete with some bombshells. The document takes issue with the current and previous oversight of GME funding, implying (at least to me) that less than optimal stewardship has gotten us to the untenable situation we are in today. Perhaps most unsettling to many is the IOM’s conclusion that no, we don’t and won’t actually have a dearth of doctors, even in primary care, because we really should be focusing on care provision by non-physician providers. Heresy! shout many. Also, the report suggests that training (and dollars) needs to move from the hospitals – today the recipients of the lion’s share of the funding – to ambulatory settings, where the majority of clinical care takes place.

The best solutions to meet the health care needs of our country are going to have to come from the academic and clinical care communities.  These highly invested groups must put aside individual agendas and work with the government to figure this out. Denial of the need for near-term change, and short-term self-preservation decisions will not provide the solutions that can promote and preserve a healthcare system that addresses the needs of the citizens of this country.

Paul Katz, MD
Dean
Cooper Medical School of Rowan University

 




Being “a Professional” and “Professionalism” — Not the Same

September 15, 2014

This week we’ll celebrate a grand event – the White Coat Ceremony – where we welcome the Class of 2018 to the profession of medicine. While many schools hold this ceremony at the beginning of the school year, we do so prior to the “Week on the Wards” a full-time immersion experience where CMSRU students rotate through the different inpatient services.

And while the day will “formally” welcome these 72 future physicians to our profession, this welcome also occurred on their first day of orientation. At that time, I told them that, right or wrong, like it or not, they were now part of the profession, and they would forever be judged, viewed, and measured in this way. I also mentioned that the first evidence of this might happen as early as Thanksgiving break, when their Aunt Sally asks for an evaluation of her:

  1. Arthritis
  2. Rash
  3. Best friend’s diabetes
  4. Fill in the blank
  5. All of the above.

But really, their lives are now forever changed. Not only in those situations with patients and their families, but all of the time. 24/7. Being in this wonderful line of work is associated with great privilege but also with great responsibility. So, I tell our first years that the “burden” of this is with them at ALL times – not just in the classroom or at the bedside, but all of the time, no matter what they are doing.

At CMSRU, we’ve talked a lot about “professionalism”. It is one of the nine competencies for our students and it something upon which they are, in fact, evaluated. Passing the exams is expected. Likewise is behaving professionally.

Being in a “profession” does not always equate with acting “professionally”. No doubt, recent National Football League (NFL) outcast Ray Rice was in a profession. Professional football. His heinous behavior off the field demonstrated a lack of professionalism – at the very least.

NFL Rule 12 – Player Conduct; Section 3 – Unsportsmanlike Conduct; Article 1:
“There shall be no unsportsmanlike conduct. This applies to any act which is contrary to the generally understood principles of sportsmanship.”

Well, it’s a bit more than a 15-yard penalty this time, Mr. Rice.

For those in our wonderful field, professionalism must be a constant part of our lives and yes, I believe we should be held to a higher standard than most. Professionalism in the hospital, on rounds, in the clinic is expected, of course. But also beyond the clinical setting – in the classroom, among colleagues, on Facebook, at the grocery store, at a party. We are accountable for own actions and we must hold our peers to the fundamental tenets of professionalism.

So a warm welcome to the CMSRU Class of 2018!  We know that you can and will continue to raise the bar – not only for excellence in the delivery of care, but also in setting the standard for professionalism in medicine.

Paul Katz, MD
Dean
Cooper Medical School of Rowan University

 




Summertime and the Livin’ is Easy?

August 27, 2014

As the summer winds down and as now we are firmly in the 2014-15 academic year, I think it’s a good opportunity to review what’s been going on at CMSRU over the last few months.

Needless to say, we’ve been busy! Between wrapping up last year and preparing for the exciting things ahead, the team has been hard at work. What follows is a very brief summary of a few of the things we’ve been up to.

Provisional Accreditation from the LCME. In this blog, we’ve previously talked about the journey to full accreditation for a new school. In 2011, we received Preliminary Accreditation from the Liaison Committee on Medical Education, thereby allowing us to enroll the Charter Class in August, 2012.

In June we received the good news that we had been granted Provisional Accreditation – the second of three steps. In addition to receiving kudos from the site visitors, we were found to have no deficiencies, similar to our first visit! Notably, we received comments that we were “creating the medical school of the future”, something that makes us quite proud.

Next step? The LCME visit for Full Accreditation will occur in the spring of 2016, during the Charter Class’ final year. Just this week, our team began the process to prepare for this important event.

Phase 1 Retreat. The summer heralded the completion of Phase 1 – the first two years of the four-year curriculum – and what better time to review what had occurred? In a daylong retreat involving the faculty and staff who had shepherded this Phase, a thorough review of the accomplishments and challenges were discussed, with implementation plans created for some changes in this academic year. As a medical school committed to continuous assessment and quality improvement, we look forward to seeing the impact of these changes – and while our fundamental curricular structure is largely unchanged, we believe that these edits will further enhance the CMSRU experience.

Cooper Longitudinal Integrated Clerkship (CLIC). Last month, the Charter Class began Phase 2 of the curriculum in the CLIC. Typically, this year is largely hospital-based with sequential 4-8 week rotations (e.g. Surgery, Psychiatry, Neurology, etc.). But medicine is really not practiced this way anymore – it’s following patients across the continuum of venues (inpatient and outpatient) and managing illness over time. And don’t forget prevention – so critical to the nation’s health.

More closely mimicking the way medicine is and will be practiced, the Charter Class embarked in early July on the CLIC. Focusing initially on hospital immersion in the six core medical disciplines, in this novel clinical curriculum, the class continues to build their “own” portfolio of patients (expanding that which began in the first month of their first year!) under the tutelage of faculty physician preceptors. As they follow their cohort of patients over the year, the students will come to understand the critical elements of the continuum and transitions of care; and the necessary development of relationships with patients, faculty and all members of the health care team; and each other. We truly believe that this approach will embed knowledge and experiences that will serve our graduates throughout their careers.

Our Neighborhood. There is a LOT of activity in the Lanning Square neighborhood that is our home. Immediately south of the CMSRU building, construction is well underway on the KIPP Cooper Norcross Academy, New Jersey’s first renaissance public school. This month, 100 kindergarten students from Camden will start their education. Growing to K-12 with over a thousand students, we are excited to welcome our new neighbors and we look forward to building on the interactions that have already started with CMSRU.

 To our east, directly across South Broadway additional construction has started – a block long array of buildings that will house over 100 beds of apartment housing for CMSRU students as well as ground floor retail. With occupancy planned for the summer of 2015, this important project is well underway.

While there are other items on the “list of summer time activities”, this space will permit no more and I look forward to sharing more in the weeks ahead. So while the livin’ hasn’t exactly been easy, it has been exciting!!

Paul Katz, MD
Dean
Cooper Medical School of Rowan University

 

 




Keeping the doctor well: National Stress Awareness Day

May 5, 2014

Recently, CMSRU’s chapter of the Student National Medical Association (SNMA), the oldest and largest student-run organization focused on the needs and concerns of medical students of color, helped our school celebrate National Stress Awareness Day (NSAD). NSAD was started by the Health Resource Network (more info here) in 1992 to raise awareness of stress.  While stress is a national issue, among medical students it is even more troublesome.

A recent pilot study (here) from the Association of American Medical Colleges (AAMC) revealed a high prevalence of psychological distress among U.S. medical students, and noted that the effects of stress may be more deleterious to the well-being of the groups that are traditionally underrepresented in medicine.  The negative consequences of distress during medical training, such as reduced empathy, lower ethical conduct, and substance abuse are problematic, particularly if they undermine the goal of graduating knowledgeable, effective, and professional physicians.

In light of these troublesome data, several medical schools are working to develop wellness initiatives to mitigate student stress and its long-term consequences. Take for example, Vanderbilt Medical School in Nashville; it is among the most innovative and forward thinking schools as pertains to wellness. Just two weeks ago, CMSRU’s Chief Student Affairs Officer and I visited the school to learn more about how their students are incorporating wellness into their curriculum. Vanderbilt’s program is a student-run initiative comprised of five committees, each supporting a different area of student well-being—physical, emotional/spiritual, interpersonal, academic/professional, and environmental/community. Throughout the year, the committees organize various program events and offer resources for medical students including an annual, daylong wellness retreat where students are excused from their classes and clerkship obligations to focus on their own well-being.

Therapy dogs provide a welcome respite from medical school stressors at CMSRU

At CMSRU, we’ve established our own Wellness Committee comprised of faculty, staff and students that have both passion for and expertise in a variety of wellness applications including yoga, meditation, fitness, psychiatry, nutrition, and research. This Committee is focused on understanding the needs of our student community in order to build programs that will best serve them. Thus far, our committee has established a mission and vision and has secured dedicated space in our educational facility to support wellness activities. The Wellness Committee is also working to incorporate wellness awareness and activities into CMSRU’s curriculum.

As mentioned earlier, members of the Wellness Committee recently worked in conjunction with the SNMA group on CMSRU’s National Stress Awareness Day activities. With the goal of reducing stress for their peers, members the SNMA group planned a day that included fresh fruit, a quiet ‘meditation’ room, lunchtime chair massages, and the biggest crowd pleaser – therapy dogs. Two dogs and their trainers were available during the day to help promote a stress-free envi­ronment for our students. All agreed that it was a resounding success!

It will be important, going forward, to examine whether these interventions reduce the perceived stress of medical students and, specifically, if they are helpful for the student subgroups that were recently identified as those most negatively affected by the medical school experience.  With the advent of the Affordable Care Act (ACA), there is a new focus on preventive medicine and on keeping people well. If we intend to prepare physicians to think differently, it’s time that medical schools begin taking a different approach – one that not only teaches students how to make patients well, but how to be well and stay well themselves.

 

Patricia Vanston, MS
Associate Dean for Program and Business Development
Cooper Medical School of Rowan University




Thank You for Not Selling!

February 21, 2014

When I was a medicine resident at the University of Florida, the cheapest place to buy cigarettes in Gainesville was the Veterans Administration Hospital. The great irony of this was not lost on my colleagues and me.

We covered inpatient units filled with servicemen (there were few women at that time), many with chronic lung disease, head and neck malignancies, cardiovascular disease, lung cancer and permanent tracheostomies. Our efforts to make them well were seemingly counterbalanced by the large “Smoking Lounges” on each floor – complete with large screen (at the time – 26 inches!) TV’s, comfortable seating and ashtrays where the cigarettes purchased on the lower level of the hospital could be savored.

Eventually, the VA discontinued this practice as more and more data appeared about the risks of smoking. And while the first Surgeon General’s report (www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm) on the adverse consequences of tobacco usage appeared five decades ago, we only just now see a major tobacco retailer, CVS Caremark, halting sales in its stores. Change takes time.

CVS, the current leader in sales nationally among all drugstore chains, has gotten into the business of providing health care. With CVS’s almost 8,000 U.S. stores and nearly a thousand MinuteClinics® –  providing medical care delivered by primary care nurse practitioners and physician assistants, pharmacist-administered vaccinations, medication counseling, blood pressure monitoring and routine laboratory testing (no appointments needed and most insurance accepted – thank you very much!)- combined with millions of people now able to access care through the Affordable Care Act, the company is clearly positioned for expansion of care delivery services. So, CVS has come to the same conclusion as the Department of Veterans Affairs – albeit decades later – providing health care and selling tobacco are incompatible.

The financial losses resulting from ceasing their tobacco sales will be substantial, but as number 13 on the Fortune 500 list, CVS likely understands economics. So kudos to them for aligning social responsibility and business.

For those who have historically purchased tobacco from CVS, there are too many alternative options to count. But what about when the next drugstore chain or big box franchise or convenience store network does the same thing? And the next one after that? Incremental, but very public, changes in the availability of tobacco products such as this one will continue – “peer” pressure is very powerful.

While tobacco usage in our country has significantly declined since the first Surgeon General’s report, this improvement is far from uniform across age group, gender, race, personal income and educational level. There is still much to do. Let us hope that the other businesses see the wisdom in CVS’s decision.

P.S.  While we are on the topic of health promotion, perhaps we can discuss the snack food, sugar-containing soda and beer sold at CVS. Associations with adverse health outcomes exist for these too, right? Shouldn’t that stop as well? A thought for a future blog…

Paul Katz, MD
Dean
Cooper Medical School of Rowan University 




Access to Education and Opportunity

February 4, 2014

“The function of education is to teach one to think intensively and to think critically. Intelligence plus character – that is the goal of true education.”

 Dr. Martin Luther King, Jr.

 

Last month, our students arranged a “Martin Luther King, Jr. Day of Service” just as the Charter Class had done the previous year. Entirely student-organized and -led, nearly 80 young people ages 3-18 from the City of Camden were welcomed to CMSRU. The sessions planned were intended to be both educational and fun: reading food labels, the “new” food plate, exercise, the sugar content of soft drinks, anatomy of the brain, microscopy and more.

Not surprisingly the youngsters were captivated by what they witnessed as they were exposed for the first time to practical demonstrations of science and health. I am very proud of our students – they are truly committed to the City of Camden and to helping it regain its past glory – a commitment that we all share.  Imagine what outstanding physicians they will become!

The children of our city, like all children, have the right to high quality education, and while Camden has struggled in this and many other areas, the signs of hope are there. New charter schools (K-12) are imminent and the “meds and eds” are helping to drive much-needed change which brings hope and opportunity to Camden’s residents.

I recently finished reading a remarkable book, “First Class: The Legacy of Dunbar, America’s First Black Public High School” by Alison Stewart (Chicago Review Press, 2013). Stewart, whose parents are Dunbar graduates, relates the history of the Paul Laurence Dunbar High School in Washington, DC – the country’s first public high school for black students. From humble beginnings during post-Civil War Reconstruction, Dunbar became an “elite” school in the nation’s capitol after the turn of the century.  Ironically, it lost this distinction when desegregation occurred. The list of those who attended Dunbar is remarkable – political leaders, high-ranking military officials, educators, lawyers, business heads  – and the academic rigor of the high school propelled the school’s graduates into top colleges and universities.

It is hard to imagine now, but Washington was a sleepy southern town until the Kennedy family arrived and it was plagued with the same prejudices seen throughout the U.S. Prior to the creation of what would eventually become Dunbar High School, education for black children was almost non-existent in the District of Columbia, so the creation of a school that attained this stature is truly remarkable.

Unfortunately, desegregation led to the redistribution of Dunbar students and this, plus the politics of the city’s school system, resulted in hard times – poor academics, dilapidation of the building and the myriad of problems that continue to plague our cities’ public schools. And while hope remains that Dunbar will eventually return to its glory days, its future, and the future of its students, remains uncertain.

Such is the same in Camden, and it will take time, perseverance, money and commitment to get the schools to a place where students thrive and opportunities for success become the rule, rather than the exception. In the last blog, I wrote about the disturbing paucity of African-American men in our country’s medical schools – but the problem does not primarily reside with the medical schools, but with our system of public education that is lacking in so many ways.

So I hope that the MLK Day of Service at CMSRU will help depict to the children of Camden what is possible. It is incumbent upon all of us to help provide them with the education that will allow their dreams to become reality.

Paul Katz, MD
Dean
Cooper Medical School of Rowan University 




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