Thoughts on Fort Worth's new medical school

Today I went to the TCU Retirees luncheon to hear Dr. Stuart Flynn, the founding dean of the new TCU and UNTHSC medical school. As I listened to him talk about training empathetic students, memories of my own experience with osteopathic medical school came flooding back.

No, I never was a student, and I didn’t marry my husband until a few days after his graduation, so I didn’t really earn that PHT (pushing hubby through) certificate. But my affiliation with osteopathic medicine is lifelong, and my involvement with the Texas College of Osteopathic Medicine was intense in the 1970s. I am the daughter of the president of an osteopathic college, the sister of a former clinical dean of TCOM, the niece and cousin of several (most now passed on), and the aunt of two practicing D.O.s. I take my heritage seriously. My ex- was founding chair of the department of surgery when TCOM opened in 1970, and I was director of communications (and then assistant) in the late seventies. I like to say I grew up at TCOM and its sister hospital, Fort Worth Osteopathic.

I applauded today when Dr. Flynn stressed training empathetic scholars and the importance of the doctor/patient relationship. Patients, he said, want to be seen as people, not “the hip” in Room 215 or “the gallbladder” in 240. He talked about bedside manner, and teaching students to look a patient in the eye. All good stuff, and it took me back to the late ’70s when TCOM developed a whole new approach to the medical school curriculum. Instead of emphasizing the treatment of disease, they designed a curriculum that emphasized wellness and the prevention of disease. I remember my good friend Charles Ogilvie developed a wellness scale, with ten being optimum health and one, miserable illness. If I remember correctly, most people live at about six or seven, and the goal was to raise that number. So what happened? Students did abysmally on state medical exams. They had been taught humanistic medicine, but no one taught them to the test (teaching to the test is a problem with education from kindergarten on up to my mind).

So it’s lovely to see this more humane approach today, but to me it seemed like re-inventing the wheel. Especially with the new school’s close affiliation  with the parent of TCOM, where that philosophy has long prevailed.

My question to Dr. Flynn, had I lingered, would have been, “What does your school bring to the table that isn’t already on the table? Other than the fact that a medical school is a feather in TCU’s cap, what’s the reason for two medical schools in one city? Can Fort Worth, with only one major county/trauma hospital, provide enough clinical opportunities to train these young people? Empathy is major, but so is clinical knowledge and experience.

There is still a crying need for more physicians in Texas, especially in rural areas. This was the case when TCOM opened, with the stated goal of training physicians who would go into rural areas. But one of the arguments for an M.D. school has long been that it would attract heavier research funding. To my mind, research trains specialists who are unlikely to then go to rural areas where family physicians are needed.

I know my knowledge of medical education is woefully out of date. I do know, for instance, that students begin clinical experience in their first year instead of the old system whereby they spent the first two years studying basic sciences and the last two in clinical rotations. A great change that puts that doctor/patient relationship in the foreground immediately. And no more one-year internships, as in my day. Students must do a three- or four-year residency, with slots somehow assigned by some sort of national clearinghouse. Only there aren’t enough slots for the students that attend medical school. Is it fair to enroll a student for whom there might not be the required post-grad slot?

Maybe I’m just defensive about osteopathic medicine—a lifelong habit. But I really wish I could have talked with Dr. Flynn. Maybe he’ll talk to the retirees again in a couple of years and I can send him my questions. Who knows? It may all be clear by then. I wish the new school much success, but I don’t want it to crowd out traditional osteopathic medicine.