AAMC President Finds CoM Programs 'Innovative' and a 'Model for the Nation'

Darrell Kirch, MD, made his first visit to the University of Cincinnati last week as president and chief executive officer of the Association of American Medical Colleges (AAMC). While here he met with William Ball, MD, dean of the College of Medicine and senior vice president for health affairs, Richard Lofgren, MD, president and CEO of UC Health, students, and numerous other leaders from the college and across campus. The two-day visit was part of Kirch's regular efforts to visit medical schools and teaching hospitals across the country.

A distinguished physician, educator and medical scientist, Kirch has led the AAMC since July 2006. The Washington, D.C.-based organization represents all 144 U.S. and 17 accredited Canadian medical schools, nearly 400 major teaching hospitals and health systems and 90 academic and scientific societies. Before joining the AAMC, Kirch served for six years as senior vice president for health affairs, dean of the college of medicine and CEO of the Milton S. Hershey Medical Center at Pennsylvania State University. A psychiatrist and neuroscientist, he previously served as dean of the Medical College of Georgia and as scientific director at the National Institute of Mental Health.

At the end of his visit, Kirch reflected on his two days of meetings.

What brought you to UC?

I make frequent visits to campuses, but had not had an occasion yet to visit UC since I became AAMC president. Chris Smith, from the UC Foundation, and I were together at a meeting in Atlanta earlier this year and committed to each other to make it happen. Chris took the lead on planning a great two-day visit for me. It was both enjoyable and very stimulating in terms of the many discussions I was able to have.

Do you have any connections to Cincinnati or the University of Cincinnati?

My boyhood hero was Oscar Robertson. He was such a fantastic athlete both at the University and later with the Cincinnati Royals. I grew up in Denver, which at that time didn't have any of the major league sports teams, so I looked elsewhere for those role models. He was not only an incredible athlete, but also an impressive individual. I was pleased to learn that he's still an active part of the university community.

What were some of the things you learned about the College of Medicine and Academic Health Center?

I had an opportunity to learn about a number of innovations occurring here, work that is being driven by champions at all levels, from students to senior leaders. You have some programs that I would view as models for the nation. For example, the new undergraduate bachelor's degree in medical sciences that Dr. Anil Menon is directing is a wonderful blend for any undergraduate interested in a career in the health sciences. It is designed to achieve a balance of the core elements of the biological and natural sciences, as well as making important links to the humanities and the liberal arts. If I were entering college thinking about a future in a health profession, this UC program would have enormous appeal to me.

Dr. Barbara Tobias (professor of family and community medicine) and Tammy Mentzel (project manager and research associate in the UC College of Nursing) described the work they are doing with their Urban Universities for Health grant. Their program is a powerful model for avoiding being an "ivory tower" institution and instead engaging in a truly meaningful way with your community around its health care needs and health workforce needs. [Editor's note: Urban Universities for Health is a program made possible by a cooperative agreement from the NIH National Institute on Minority Health and Health Disparities through the Association of American Medical Colleges.]

I know that it is always challenging to do a major rethinking and redesign of a medical school curriculum, but what has been put into place here over the last few years has, I think, brought the University of Cincinnati College of Medicine to a state-of-the-art medical curriculum. Medical science is changing so rapidly, we need to be exceptionally nimble and flexible in curricular design and the use of technology. Clearly the faculty at UC are committed to that.

I would be remiss if I didn't also talk about one of the current keys for success in an academic health center: the alignment among the health colleges deans, as well as the alignment between the university leadership and the health system. I had a chance to have multiple discussions with the provost, Dr. Beverly Davenport, Dr. Ball, the other deans for nursing, allied health sciences and pharmacy, and Dr. Rick Lofgren from the health system. They clearly are working to achieve the kind of tight alignment that we need in an academic health center to meet the challenges we face.

Did you have a chance to meet with our students?

It always is a high point of a campus visit to meet with students, and I had an opportunity to have lunch with a dozen students that ranged from some just finishing their first week of medical school to students nearing the end of a combined MD/PhD program. Their enthusiasm and their incredible energy about the future of health care made me feel reassured, not only as president of the AAMC, but also as someone who very well may be one of their patients in the future. I think a lot of the physicians of my generation have been challenged by all the changes occurring in health care and have lost some of their enthusiasm for medicine. What I really appreciate about your students is that they don't fear change, they embrace it. Whether it's the use of technology or improving their person-to-person communication skills, they want to take it on. They are as enthusiastic a group as I've ever seen.

What surprised you most during your visit?

It has been at least 20 years since I was last in Cincinnati, and I must say that I was surprised both by how vibrant the city has become and also by the incredible growth in the entire medical center complex, from the university programs to UC Health and the Children's Hospital. Cincinnati has become an epicenter for the future of health care, something I now appreciate in a very direct way.

The College of Medicine's incoming class is 51 percent female. What is your reaction to that?

One of the things that I was pleased to see here is the commitment not only to gender diversity, but also to diversity of all kinds. I had a chance to meet with the admissions staff, and it's clear that the College of Medicine, as well as the entire university, is truly committed to having the diversity of its student body reflect the growing diversity of our nation. This is increasingly important because we face deep health disparities in our nation, and diversity among health professionals is one important tool for us to help us address those disparities.

What are some of the major issues facing medical schools that concern you?

It unfortunately is a long list. One major concern for me, a concern that I know the UC leadership shares, is the level of debt that students accumulate in the course of their education. Fortunately UC and other medical schools are focused on fundraising for scholarships to help students alleviate that debt. Another concern is the challenge faced by the faculty because of the stagnation in NIH research funding. I had several discussions here at UC that illustrated how that prevents science from moving forward as quickly as it could. Then, on top of these concerns, we all are faced with rapid changes occurring in the design of and payment for health care. Challenges are facing us on all fronts, education, research and health care!

Your reaction to the College of Medicine's bicentennial in 2019?

I see the fact that the university, starting with the establishment of the College of Medicine, is two centuries old as a statement about how important health care has been in the history of Cincinnati and Ohio. It shows that, even in the early years of our nation, there were people who understood the importance of health professions education. Today, health care represents the fastest growing part of our economy. This UC bicentennial is not simply an accomplishment in terms of number of years, but actually is powerful reminder of the centrality of health in our national past and our global future.