State
of the
School 2020 – 2021
Steven J. Scheinman, MD
President and Dean, Geisinger Commonwealth School of Medicine Executive Vice President and Chief Academic Officer, Geisinger
Table of contents Introduction............................................................................................................. 2 Benefits already realized through the integration............................................. 2
Tuition-free medical education..................................................................... 3
Research opportunities.................................................................................. 3
GME development.......................................................................................... 4
Pipeline opportunities and community engagement................................ 5
Campus reorganization.................................................................................. 7
Financial benefits............................................................................................ 8
Looking forward to 2020
MD curricular renewal.................................................................................... 9
Graduate program growth............................................................................. 10
Nursing education.......................................................................................... 11
Integration of education throughout Geisinger.......................................... 12
Our strategic direction........................................................................................... 14
Curricular innovation and primary care....................................................... 17 A robust portfolio of educational programs preparing leaders for the healthcare teams of the future......................................................... 18
Expanded community engagement............................................................. 18
Conclusion............................................................................................................... 20
State
of the
School 2020 – 2021
Jan. 28, 2020 – As we begin the year 2020, it is worth reflecting that this is now in our 11th year of operation as a medical school. We are no longer in our infancy. We have awarded 538 medical doctorates and 609 master’s degrees. Seventy-nine percent of our graduates are still in training, but we have welcomed 18 of our graduates back to the region to practice, and that number will grow further this year.
Geisinger Commonwealth School of Medicine is committed to non-discrimination in all employment and educational opportunities. 1
Introduction It is now more than three years since The Commonwealth Medical College became Geisinger Commonwealth School of Medicine. It’s been a period of great transition for all of us — so once again, at the beginning of my State of the School address, I want to offer my sincere thanks to all of you for having persisted and for continuing to make this essential transformation possible. We all understand that in becoming Geisinger, what we are engaged in is not just medical education. It’s much broader. And with this, we have been developing the concept of Education at Geisinger, and our role through Geisinger to improve community health and well-being.
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Benefits already realized through the integration It is fitting to begin this year’s State of the School address by reflecting on the enormous new opportunities that we’ve realized — and that never would have been possible had we not integrated into Geisinger. They include:
Tuition-free medical education Perhaps the most exciting development in the past year has been the launch of the Abigail Geisinger Scholars program and, more recently, the Geisinger Primary Care Scholars program. Both provide students with full tuition and fees in exchange for a commitment to work at Geisinger following residency training. The Geisinger Primary Care Scholars’ commitment is to work as primary care physicians. As you know, primary care is one of the most urgent needs in our communities, which is why we have taken action and invested significantly to alleviate this shortage. These primary care scholars will also receive a living stipend throughout medical school. Their curriculum will be enhanced in primary care, with clinical experiences offered in Geisinger’s innovative programs, including Geisinger 65 Forward and Geisinger at Home. We believe that this curricular emphasis, which will include population health, precision health, social determinants and other elements, coupled with these signature clinical experiences and the financial incentives, will make us uniquely attractive to medical school applicants who aspire to careers in primary care. Research opportunities The number of students pursuing research projects has more than doubled. In 2016, the year before we became Geisinger, 29 MD students did a summer research project; last summer there were 62. And 40 of these — nearly two-thirds — worked under the primary mentorship of 21 Geisinger researchers who engaged them in cutting-edge programs such as the
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MyCode® Community Health Initiative. When you include L-CHIP, QUICC and other student projects, as well as faculty collaborations, the Geisinger Commonwealth community participated in a total of 118 research projects at Geisinger. Through Sonia Lobo, PhD, our associate dean for medical student research, and Geisinger’s chief scientific officer David Ledbetter, PhD, we expect these student opportunities and faculty collaborations to grow. GME development Led by our associate dean for graduate medical education and designated institutional official for GME, Michelle Thompson, MD, our portfolio of residency and fellowship programs has grown substantially in the past three years. As TCMC we had no GME programs of our own. The number of accredited Geisinger programs has grown from 40 in 2016 to 60 this year, and trainees from 438 to 553. And as the programs grow, measures of quality are also improving. For example, all of these programs are fully accredited, and three-quarters of them — 46 — have no citations. Dr. Thompson is leading efforts strategically to expand our residency and fellowship programs, potentially substantially, and especially in northeast Pennsylvania, leveraging opportunities for new federal funding to address community needs. The new Internal Medicine residency at Geisinger Wyoming
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Valley Medical Center has received initial accreditation with no citations and with several commendations under its program director Wasique Mirza, MD. His team has interviewed 160 residency candidates and are in this year’s Match for a class of 13 to begin July 1, 2020. Pipeline opportunities and community engagement Supporting our research and academic goals, our REACH-HEI program and federallyfunded Center of Excellence (COE) continue making transformational strides to guide first-generation and minority students in pursuing their dreams to become physicians or healthcare professionals and to diversify the region’s healthcare workforce. The COE has supported a community health needs assessment survey, now being concluded, to gain an understanding of the Hispanic community’s views on health and their priorities. We have added 30 Geisinger physicians from among underrepresented minority groups to the COE’s preceptor and mentoring roster. And the center continues to support academic achievement of minority students who are now represented in student leadership here at Geisinger Commonwealth. REACH-HEI has also achieved significant milestones. Continuing its focus on economically and educationally disadvantaged youths,
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this year REACH-HEI served 380 young people through a variety of programs tailored to intermediate and high schools. In addition to the Scranton and Hazleton school districts, REACH-HEI now works with school districts farther afield across the region, including Wallenpaupack, Wayne, Shamokin and others. Since inception, REACH HEI has served more than 1,600 youth, of whom 100% graduated from high school and over 90% have continued to colleges and universities. Of those in college, 92% have entered health-related majors and 24% percent of those graduating are in post-graduate programs — including three at Geisinger Commonwealth. The impact of REACH-HEI, in so many ways, is at the core of our mission. For many of these young people, it has enabled them to break the cycle of poverty and pursue meaningful careers. We should take particular pride in their success, like that of the REACH-HEI student from Hazleton who is one of 20 high school students nationally to be admitted to Brown University’s six-year bachelor’sto-MD program with a scholarship for both his undergraduate and medical education. And we are proud of our faculty and medical and graduate students who volunteer and mentor our REACH-HEI and COE participants; they have made a transformational difference in the lives of these young people. These exciting programs are directed by Ida Castro, VP for Community Engagement and chief diversity officer. To these titles we have now added responsibilities as associate dean for Equity and Inclusion, reflecting my intent that equity and inclusion be values that are reflected in our academic programs and curricula.
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Campus reorganization Where previously our students had their clinical experiences with a variety of clinical partners and organizations, we now have a network of clinical campuses predominantly comprising two integrated care-delivery systems: Geisinger and Guthrie. They are overseen by Bill Jeffries, PhD, vice dean for Medical Education, and the regional deans. Access to Geisinger sites is ensured through the dean’s role as chief academic officer of the system; access to Guthrie is guaranteed through a long-term contract. Thus, we now have a much greater ability to assure stability of sites, comparability of experiences across campuses, adequacy of preceptors and partnerships on innovations. And we can build on the strength of a stable core of over 1,400 faculty preceptors at these sites.
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Financial benefits Of course, integration has substantially improved the finances of the school, as our CFO Ann Arvay would certainly attest. Thanks to Geisinger’s favorable bond rating, for example, we pay much less to service the school’s debt on this building. There have been savings thanks to the merging of some services, and in other ways as well. Altogether, the net savings to the school amounts to more than $1 million per year. But it’s not all about saving money, as valuable as that is. Our integration has made it possible to invest in new programs and to innovate, as we are doing with our new graduate degree programs, the Geisinger Scholars programs and MD curricular renewal.
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Looking forward to 2020 That’s what we’ve achieved already. I’m particularly excited about new efforts underway that will play out in this new year, both in a range of educational offerings and in the maturation of our integration into the Geisinger system.
MD curricular renewal In the last two years, as we approached the school’s 10th anniversary, we created a single Department of Medical Education and the faculty undertook a substantial effort to reassess the MD curriculum, all as a prelude to curricular renewal. Dr. Jeffries and I charged the curriculum committee to conceive a new course of study that would respect the factors that have helped our students succeed so well — active learning, longitudinal experiences, community engagement — but that will also: ●
Be fully horizontally integrated, with early meaningful clinical experiences and with fundamental science running across all four years
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Incorporate new content in a range of topics, including genomics, informatics, machine learning, resilience, the humanities, health policy, economics and patient safety — not episodically, but as threads woven throughout the curriculum
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Emphasize the importance of health overall rather than just managing diseases
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Place priority on professional identity formation
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The Medical Curriculum Committee named a task force, co-chaired by Dr. Jeffries and Neil Holland, MD, that is working to develop this curriculum. Its work will benefit greatly from Geisinger’s substantial strengths in research and in systems innovations. And the curricular renewal process will allow us to develop a focus on primary care as a fundamental principle of the curriculum, particularly to enrich the experiences of the Geisinger Primary Care Scholars. Graduate program growth The graduate school is expanding its portfolio of degree programs. This month our three new online master’s degrees were launched in partnership with the University of the Sciences in Healthcare Administration, Genomics and Biomedical Informatics. This year Scott Koerwer, EdD, vice dean for graduate studies, and his team will enrich each of these offerings with a Geisinger “point of view.” Tailored content is in development and will reflect our strengths in pharmacy system science, the MyCode initiative, artificial intelligence and other areas. Meanwhile, the Master of Biomedical Sciences program continues to grow, with more than 120 students enrolled in Scranton, Doylestown and now online as well. The Professional Science Master’s degree is now available, and we continue to pursue collaborative opportunities with schools including Marywood, The University of Scranton, Lehigh University and Bloomsburg University, just to name a few. In addition, several new degrees are in the concept stage, such as a proposed master’s of genetic counseling program, and may soon be ready for development.
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Nursing education This past year has also been significant for our many partnerships in nursing education. Rebecca Stoudt, DNP, became associate dean for nursing student education and has been leading some exciting discussions with our nursing partner schools in the community, working closely with Geisinger’s chief nursing officer, Janet Tomcavage. We have added two staff members to the team in Danville who will be invaluable in allowing Dr. Stoudt and Nicole Woll, PhD, MEd, associate chief academic officer for Interprofessional Education, to monitor and manage the more than 2,300 nursing students and 1,500 learners in advanced practice, pharmacy and other health professions who obtain their clinical experiences throughout Geisinger. We are beginning to develop interprofessional curricula for these health profession learners when they are here at Geisinger for educational experiences. Our partnerships with schools throughout the Geisinger region are valuable to the clinical system for recruiting staff and to our educational programs as opportunities for interprofessional experiences. With the addition of these staff members, we are now in a better position to coordinate these partnerships, prioritize them strategically and manage the finite capacity for learners, particularly in nursing and advanced practice. We are also working with these partner schools to develop curricula jointly, so that their students graduate prepared to provide the best care in an integrated clinical system.
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Integration of education throughout Geisinger As we enter our fourth year as part of Geisinger, the time is right to strengthen our ability to organize and define the integration of a medical school into a healthcare system, and to make sense of the essential role that education plays in realizing Geisinger’s enterprise strategy. Amy Allison
Some of this work has already been underway
Associate Dean for Library Services
since the beginning of the integration of the medical school. We have already successfully
integrated library functions under a single leader, Amy Allison, associate dean for library services, whose position merges that of med school library director and system librarian. We have the opportunity for similar integration with our simulation functions. These new structures will ensure that our learners and teachers consistently have high-quality experiences as they move throughout the Geisinger enterprise We’ve created the position of associate dean for clinical affairs and have named Jerry Maloney, DO, to that role. As chief medical officer for Geisinger hospitals, Dr. Maloney was already actively involved as a liaison for education within the clinical system. He serves on school committees and is director of the Geisinger Scholars programs. This role within the medical school fits with Dr. Maloney’s Gerald Maloney, DO Chief Medical Officer, Geisinger
ongoing role as CMO and will make him a key leader in promoting the integration of education throughout the clinical system.
A further step in fostering integration will be establishing roles for Geisinger’s clinical institute chairs in the medical school. We are actively discussing this with clinical leadership and hope to implement it in the next few months. This would give institute chairs a function analogous to that of clinical department chairs in a traditional medical school, including a formal role in the faculty appointment process and a meaningful
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voice in educational matters. Given their key positions, this would give education a set of powerful advocates within the clinical system. Education at Geisinger creates opportunities not only for students, but also professional development opportunities for residents, faculty and staff throughout Geisinger. The offices of Graduate Medical Education and Continuing Professional Development have been offering a range of courses that continue to grow. And our graduate school now offers several degrees online. This year we are creating the Geisinger Academy, an umbrella entity that will encompass our in-house and graduate courses with credits that can be applied to certificates or even master’s degrees. Courses include several that promote teaching skills, as well as fundamentals of research, statistics, bioethics, patient safety and communication skills. Certificates include the GME Scholars Program, a Medical Education Certificate and (with credits from our online graduate courses) certificates in Health Administration, Medical Informatics and Genomics. Dr. Nicole Woll, in her role as associate dean for faculty development, and Dr. Scott Koerwer, vice dean for graduate education, working with Dr. Michelle Thompson, associate dean for GME, oversee the Geisinger Academy. They are working on logistics of delivery of this educational material, planning to have it go live by July.
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Our strategic direction In 2018 we initiated a strategic planning process that accomplished several things. We reaffirmed our mission statement, unchanged since the school was founded:
Mission statement To educate aspiring physicians and scientists to serve society using a communitybased, patient-centered, interprofessional and evidence-based model of education that is committed to inclusion, promotes discovery and utilizes innovative techniques.
We crafted a vision statement that defined our strategic intent:
Vision statement We will educate the healthcare workforce of the future, leveraging our unique strengths to be regionally engaged and nationally relevant.
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And we identified seven initiatives toward achieving this vision, each with a leadership sponsor. Each of them has been propelled by opportunities created by being part of Geisinger: 1.
MD Curricular Renewal & Campus Delivery Redesign – W. Jeffries
2. Alleviate Student Debt – A. Arvay 3. GME Expansion – M. Thompson 4. Community Health Equity & Workforce Diversification – I. Castro 5. Expanding Educational Partnerships & Developing New Programming – S. Koerwer 6. Expanding Alumni Engagement – S. Scheinman 7. Student, Faculty and Staff Well-being – S. Scheinman In June, the Geisinger Health Board of Directors made official the appointment of Jaewon Ryu, MD, JD, as Geisinger’s president and CEO. This appointment was greeted with great and justifiable enthusiasm throughout the organization, and certainly at the medical school. Dr. Ryu has been a strong supporter of the school and our mission; he “gets” us. And with that, it is important for us to understand the vision that he has articulated for the Geisinger system as a whole, within which our strategic priorities fit well. His vision is summarized in a simple phrase: Make better health easier. It puts the focus on health rather than mere disease management. Not only does promoting health improve the lives of the people in our community, it also keeps people out of the hospital, which reduces the cost of healthcare. Because Geisinger is also a health plan,
Jaewon Ryu, MD, JD
its business model works best when
President and CEO, Geisinger
people are healthy and need less care.
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This vision to promote health rests on three strategic priorities: 1.
Address health overall and not just manage disease. Among other things, this means increasing the number of people who have the health plan product that offers incentives to promote health: Medicare Advantage.
2. Increase access — not just to care, but to resources promoting health. 3. Achieve operational excellence to ensure that the care that is given is the very best.
This vision — to make better health easier — is Geisinger’s “why.” Education at Geisinger, including but not limited to the medical school, is an important part of the “how.” Our curricular renewal will focus on health. The growth in our residency programs and our partnerships with educational programs in various professions will strengthen the workforce and help improve access. Our community outreach efforts will contribute to workforce diversity. And all of this will make our learning venues more valuable and accessible. Just as constant, equitable access to healthcare is necessary, so too is access to education. We are now delivering educational programs internally, to support our evolving workforce and healthcare delivery teams, and externally, to support future healthcare team members. We are now a multimodal, always-on education delivery system.
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So, in the context of this strategic framework, where would I like to see the medical school — and more broadly, Education at Geisinger — in the next 5 to 10 years? I see our exciting future in the framework of three strategic directions. 1. Curricular innovation and primary care. We will have a curriculum that has been reshaped to be fully horizontally integrated, with the clinical care that our graduates will ultimately deliver informing and guiding how we teach fundamental science, and with basic science enriching how we teach clinical care, across all four years. We will have a curricular focus on primary care, built around Geisinger’s signature primary care innovations. This unique focus will be recognized nationally as a model, and supported by Geisinger Scholars programs that enable students’ pursuit of their dreams. We will have strengthened our use of active learning, longitudinal experiences and community engagement and expanded our curricular content to include a range of forward-facing topics, accessible in multiple modes to meet learner needs. And we will do so in a setting that supports wellness and builds resilience. Together these will make our school a magnet for students aspiring to primary care and others seeking a strong foundation for specialties.
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2. A robust portfolio of educational programs preparing leaders for the healthcare teams of the future. In the coming years, our graduate programs will thrive based on innovating around Geisinger’s system and research strengths, producing leaders well-prepared in cutting-edge fields from genomics to artificial intelligence to pharmacy system science. Our residency and fellowship programs will continue to grow into a robust portfolio of programs in northeast Pennsylvania and elsewhere that address gaps in the community workforce and offer progressive training. Our partnerships with colleges and professional schools in nursing, advanced practice, pharmacy and a range of other professions will include jointly-developed curricula and valuable clinical experiences with meaningful interprofessional team-based experiences. Our nursing school in Lewistown will expand programmatically and geographically, offering opportunities for advancement for staff across the Geisinger system and to others. 3. Expanded community engagement. This school, founded by the community, will continue to nurture those community roots, always remaining TCMC — This Community’s Medical College — at its core. All of our learners will benefit from an expanded set of partnerships throughout the
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broader community across Geisinger’s footprint. Our pipeline programs will grow and offer greater opportunities for young people throughout our region for careers in healthcare and for advancement within those careers. Our programs will enrich the workforce by enhancing and celebrating diversity. Community service will be incorporated more organically into the MD curriculum and other curricula as service learning with meaningful outcomes.
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Conclusion With all of this in mind, I invite you to reflect upon the role you play to advance our vision and to continue working with me and our evolving teams within the medical school and throughout Education at Geisinger. As we work to evolve our strategic planning, both across the Geisinger enterprise and in education, we must think about evolving not just how we prepare our learners, but how we measure their success in becoming future leaders of healthcare teams. Our measures must be agile and interactive with our communities. Our programs and measures must be responsive to our system’s community health needs assessments — and all that we do as educators must lead to healthier, and ideally happier, communities. Our work, at Geisinger Commonwealth School of Medicine and throughout Education at Geisinger, is more than day-to-day job fulfillment. Our purpose is higher than merely checking boxes and moving on to the next task. Together, each one of us has a role in improving our community’s health and well-being. This is significant, meaningful work. I thank you all for your efforts in helping make our impact felt for the better every day.
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570-504-7000 geisinger.edu/gcsom