By Edward Telzak, MD, Chair, Medicine
‘A new medical school run by the City University of New York will open with its first class in fall 2016 after receiving preliminary accreditation…The school, the CUNY School of Medicine…will begin with 70 students and have a partnership with the St. Barnabas Health System in the South Bronx.’
So began an article on July 14, 2015 in The New York Times. With a similar philosophical and operational mission, it seemed logical that the City University of New York School of Medicine (CUNY SOM) and SBH Health System would come together to form what will likely become the most progressive and formidable primary care-focused School of Medicine and medical center in New York.
Following initial discussions that began more than five years ago between the Dean of the Sophie Davis School of Biomedical Education, Dr. Maurizio Trevisan, and former SBH President/CEO Dr. Scott Cooper, the two institutions embarked on a long-term project with the goal of establishing a high quality Liaison Committee on Medical Education (LCME)-approved medical school that emphasizes the principles of primary care medicine and the training of physicians from racial and ethnic groups historically underrepresented in medicine.
The CUNY School of Medicine is an outgrowth of the success of the Sophie Davis School of Biomedical Education. Founded in 1973, the Sophie Davis School operated under a Cooperative School Model. Talented students recruited from high school completed the requirements for a Bachelor of Science degree and the traditional curriculum of the first two years of medical school within five years on the City College campus in West Harlem.
These students subsequently transferred to one of six cooperating medical schools to complete their clinical clerkship years and, if successful, were awarded an MD degree from the school in which they completed their clinical education. However, changes in medical education, including the shortage of clerkship availability due to the expansion of existing medical school class size and preference for offshore medical schools because of financial pressures, resulted in reduced opportunities for clinical training for Sophie Davis students. Over time, the Cooperative Medical Schools model became unsustainable. To continue its commitment to train students from economically disadvantaged backgrounds and racial and ethnic minorities, and to provide a large cadre of primary care practitioners committed to serving poor communities in New York City and elsewhere, Sophie Davis embarked on a process to become a full MD-degree granting institution accredited by the LCME. Critical to this effort was finding a strong and committed health care clinical partner with similar goals.
Established in 1866, SBH is a not-for-profit “safety-net” health care provider that plays an essential role in delivering health care in the South and Central Bronx, medically underserved minority communities which rank among the poorest urban areas in the United States. In addition, SBH’s network provides the breadth and depth in clinical services that CUNY SOM required with robust inpatient, outpatient and emergency medical, mental health and dental services. It operates a 422-bed acute care community hospital and Level II Trauma Center authorized to treat the most critically ill and severely injured patients. SBH’s New York State-designated Stroke Center and AIDS Center ensure access to much-needed quality services in the South/Central Bronx. Most importantly to support the CUNY SOM mission, SBH is also a major provider of ambulatory care services, with more than 250,000 outpatient visits annually. Its primary care physicians, specialists and subspecialists offer the necessary expertise to meet patients’ challenging and evolving healthcare needs and students’ educational needs. Mental health services are provided by SBH Behavioral Health (formerly Fordham-Tremont Community Mental Health Center), which operates six programs that meet the mental health needs of adults, teenagers and children. SBH Behavioral Health handles more than 93,000 visits annually, underscoring the crucial need for these services in the Bronx and the important role of this facility in the network.
Critically important to a new medical school, SBH has a long history of dedication to both undergraduate and graduate medical education. SBH sponsors ACGME-accredited residency programs in Internal Medicine, Pediatrics, Emergency Medicine and Psychiatry and non-ACGME residency and fellowships that are accredited by the American Osteopathic Association(AOA) in Dermatology, Internal Medicine, Family Practice, Surgery, Plastic and Reconstructive Surgery, Surgical Critical Care, Osteopathic and Manipulative Medicine, as well as other residency programs in Pediatric Dental Medicine and Podiatry. During the course of the academic year, there are approximately 250 resident physicians and well over 100 medical students from the Albert Einstein College of Medicine, New York College of Osteopathic Medicine, and the CUNY SOM learning and working at SBHHS.
Since 2015, SBH’s clinical faculty has participated as members of the core teaching faculty of the LCME provisionally-approved medical school curriculum. For the 2016 – 2017 academic year it is estimated that over 100 SBH faculty have spent more than 1800 hours dedicated to the pre-clinical education of CUNY SOM students. This includes the Organ Systems Course, Practice of Medicine, Introduction to Clinical Medicine and Physical Diagnosis courses. SBH clinical faculty has worked alongside CUNY SOM faculty in jointly developing, evaluating and revising these courses and other components of the pre-clinical course curricula. SBH is now deeply involved with CUNY faculty in developing the entire range of high quality clinical clerkships (scheduled to begin in July 2018) for the 6th and 7th year students who will do the majority of their clinical training at SBH.
Much remains to be accomplished and these are uncertain times, especially when it comes to medical training and caring for the poor. Funding remains a challenge for both the CUNY SOM and SBH. Federal funding for Medicaid, the major insurer for SBH patients, and the nature of the current health care system is under significant threat and may look quite different over the next five to 10 years. And yet, the two institutions remain fully committed to caring for the poor and training the next generation of physicians who will deliver comprehensive, compassionate and evidence-based care to populations such as those that reside in the south and central Bronx. It’s a mission that is too important not to succeed.
Dr. Edward Telzak