New York Medical College is one tough school to get into.
Just ask the 9,810 applicants who are rejected each year.
With 190 slots available, getting into the medical school on the Grasslands Reservation in Valhalla is no easy task. A third of this year”™s class came from New York state.
Founded in 1860 by a group led by editor and orator William Cullen Bryant, the college today consists of the Graduate School of Basic Medical Sciences, the School of Health Sciences and Practice, as well as the School of Medicine.
As the college prepares a two-year-long series of events to marks its 150 years, Dr. Karl Adler, president and CEO, offered a look into the future in an exclusive interview.
The college is in the midst of expanding ”“ physically and with its curricula.
In 2005, the college bought a building on the Grasslands campus that housed the Institute for Cancer Prevention, which went bankrupt in 2004.
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Adler said the college is awaiting funding, which he described as imminent, to rehab the building on Dana Road. The school is seeking the funding from the New York state “Gen*NY*sis” program to modify the infrastructure so as to create the Hudson Valley Biotechnology Center for Disaster Medicine and Emerging Infections.
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“The center would be used for three major purposes: one, expand our research; two, to continue to develop the disaster medicine program; and three, as part of our educational agenda, to develop a clinical teaching center where you use actors and mannequins to teach disaster medicine, etc.,” Adler said.
The college also applied for a $15 million grant from the National Institutes of Health. The money was made available to the NIH from the American Recovery and Reinvestment Act of 2009.
According to its application, the college estimates it will achieve full occupancy of the building by June 1, 2011. It expects to have 136 full-time jobs and 46 part-time jobs.
The proposed biotech center would also “generate additional enterprise opportunities and partnerships with private biotechnology firms,” according to the college”™s application to Gen*NY*sis. The 122,000-square-foot building has about 76,000 square feet of net rentable space.
The college is the seventh-largest employer in Westchester with 1,313 employees and another 401 in New York City. The college runs Metropolitan Hospital Center, part of New York City”™s Health and Hospitals Corp. The hospital and college became affiliated in 1875, making it the longest affiliation in the nation.
Because of its location, Westchester County is a natural for the location of a center for disaster medicine, Adler said. The county hosts much of New York City”™s fresh water supplies, is a major evacuation route for the city and is “target rich” with a nuclear power plant, major corporations and extensive commuter rail and highways.
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With these variables serving as incentive, the college created the Center for Disaster Medicine in the School of Public Health, Adler said. As a mainstream or “allopathic medical school,” he said, there is a need to develop significant research because “within that environment is the best way to teach health professionals.”
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Another aspect of the proposed center that Adler touted was a laboratory to study and prepare for emerging or recurring infectious diseases.
“Improving the health care of the population is a high priority,” he said.
“The college has had a long history of being involved in the development of vaccines for flu,” Adler said. “A fellow by the name of Edwin Kilbourne was the first one to develop vaccine for swine flu. He played a key role in the development of swine flu vaccine in 1976.”
Now retired, Kilbourne is professor emeritus of microbiology and immunology with the medical college. However, his work continues through his colleague, Doris Bucher, an associate professor of microbiology and immunology at the college.
“She has developed the basic framework for the new swine flu vaccine,” Adler said. “She, for the last several years, has submitted what we call seed vaccines for various flus. Her lab tries to address what is the next big disease, flu.”
Adler said the college was involved in another historic health pandemic in 1918, dubbed the Spanish Flu.
“The dean of the college at that time was Dr. Royal Copeland. Dr. Copeland was dean up until 1918 when he became health commissioner for the city of New York. He is credited with reducing significantly the effect of the pandemic of 1918.”
New York Medical College has also been actively involved in stem cell research in regard to the heart.
“Piero Anversa, now at Harvard, in early 2000 developed a mechanism to have cardiac cells grow more rapidly outside the body and then reinject the cells into the diseased part of the heart,” Adler said.
“The concept would ultimately be to take someone with significant heart disease and take some of the normal heart cells and have them grow three times faster and reinject into the diseased part of the heart.”
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Another area of research is Lyme disease. “Gary Wormser, our chief of infectious disease, has done major work in AIDS and probably a leading authority on Lyme disease,” Adler said.
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He cited research on Lyme disease, as well, noting cutting edge work is being done “right here in Westchester.”
While research expands and finding cures for diseases continues, one of the major problems facing America is a shortage of primary care physicians, according to Adler.
Adler was dean at the college in the late 1980s to 1994. In the mid-1980s, “only about 8 to 9 percent of our graduates were going into primary care disciplines.”
With the help of a grant from The Robert Wood Johnson Foundation and “working with a couple of key people on faculty, we were able to increase the number going into primary care in the mid-90s to 50 percent.”
He is still trying to get more graduates to go into primary care disciplines such as general internal medicine, family medicine or pediatrics. Prior to his push in the early 1990s, graduates were going into subspecialties of internal medicine, cardiology, pulmonology and radiology.
To keep primary care in focus, the college is exposing students to clinical medicine early on with role models.
“In their first year, a student participates in a physician”™s office. So with 190 students, you need 190 physicians. They learn how to take a history, how to deal with a patient and that continues in their second year. There”™s significant exposure in the first two years which traditionally”¦ was physical diagnosis. Now we”™re exposing them to patient care right up front.”
As the nation changes, so does teaching medicine, Adler said. One new course is cultural determinants of health care. “In a significant number of our affiliated hospitals, including Westchester (Medical Center), St. Vincent”™s and Metropolitan, our students are exposed to a world population. People make decisions about health care a lot based on what their cultural background is.”
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Regardless of the public health plan that Congress and Americans decide on, it”™s going to require more primary care doctors and more allied health workers, such as physical and occupational therapists, physician assistants and nurse practitioners, Adler said.
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The big problem of trying to get more people to go into primary care is because the rewards of primary care are lower than those disciplines that are procedure oriented, Adler said.
“Our present health system pays for people to do something; it doesn”™t reward people for cognitive thinking. And that”™s a problem. Some of the plans I heard from Washington are going to lower the procedural disciplines by 10 percent and elevate the primary care by a few percentage points. But we”™re talking a real major disparity. So, a student who goes to medical school accumulates a significant amount of debt. And the debts are getting bigger and bigger. When they go out and make a decision on what they”™re going to be doing, they”™re now making decisions on how can they pay off their debt as quickly as possible,” Adler said.
“The only way you”™re going to be successful doing that is to reward people for cognitive actions as opposed to just procedures.”
