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A Voyage of Discovery
BUILDING ACADEMIC HEALTH CENTER INFRASTRUCTURE WORLDWIDE
President’s Address
Steven A. Wartman, MD, PhD, MACP, president and CEO, Association of Academic Health Centers
Calling academic health centers “unique trans-global organizations,” Wartman proposed the newly established AAHC International™ as the organization to promote academic health center collaboration worldwide and to ensure that academic health center leaders have a voice in international matters affecting health, research, and the economy.
Wartman cautioned leaders about finding “the right balance between the benefits and costs associated with globalization,” noting that “the benefits of progress and economic growth cannot be limited to one country or one segment of a population.” See the full address here: http://www.aahcdc.org/policy/promiseandpower08.php
Shanghai: Strategies, Innovation, and Visions for Education
Lily Hsu, RN, MSN, dean, School of Nursing, Shanghai Jiao Tong University
Hsu addressed the development of medical education and academic health centers in China.
- China would like to transform itself into an innovation-oriented country; life sciences will be a major focus of Chinese universities in the next century.
- There is an interest in promoting international integration and developing leaders with global vision.
- Most Chinese leaders are still trained abroad; however, higher education in China has been developing rapidly.
- Government investment in higher education has increased, and individual philanthropic funding from private donors is also becoming more emphasized.
- While the central government still owns the university system, institutions have been granted increasing operational independence.
- There are various educational systems and degree programs in the field of medicine in China—unifying this system will be a difficult undertaking.
Educational Patterns in China
Students learn mostly by rote. Chinese universities are struggling to develop characteristics in students and faculty that are not traditionally emphasized in Chinese culture, including:
- Innovation
- Inquisitiveness
- Embrace of educational methods such as problem-based learning, research-based learning, and case-based learning
There is also an effort to adopt themes from Western systems of higher education, including addressing institutional values and mission. Shanghai Jiao Tong University plans to put increased emphasis on research and innovation, as well as quality enhancement and ethical practices.
Pioneering Academic Health Center Strategies in Qatar
Daniel R. Alonso, MD, dean, Weill Cornell Medical College–Qatar
Weill Cornell Medical College-Qatar is not a separate school, but a branch campus of Weill Cornell Medical School. Cornell requested and was given significant assurances in its agreement with the Qatar Foundation that the branch campus could basically function in the same way as the New York campus. Cornell has an enormous level of independence and autonomy with respect to operations.
Types of faculty:
- Faculty recruited to be in residence in Qatar
- Distance faculty from New York who spend short periods of time teaching in Qatar
- Faculty located in New York who teach through distance learning, which may be live or recorded.
- Clinicians commissioned from the major health care provider in the region for clinical education purposes.
All faculty members are appointed by administrators in New York, not in Qatar, using the same standards and paying the same rates as they would in New York. The school anticipates a large influx of faculty with the establishment of a research program and the new teaching hospital.
Cornell’s committee on admissions in New York also chooses students for the Qatar program using the same standards as the U.S. program. To date, data show no statistical difference in course performance between students in Qatar and students in New York.
The challenges to establishing the medical school include:
- The local hospital system is not prepared for residencies, and does not meet ACGME standards. For this reason, the school encourages students to pursue graduate medical education in the U.S.
- A lack of research capacity in Qatar
Medical students do their clinical training through the regional health care provider, which achieved Joint Commission international accreditation in December 2006, and which is working toward JCAHO standards. One of Cornell’s goals is to help the region’s health care system move toward ACGME standards. The school also helps local hospitals recruit for vacant positions.
Roundtable on Research Issues
Edward D. Miller, MD, dean and chief executive officer, Johns Hopkins Medicine, The Johns Hopkins University
Philip Pizzo, MD, dean, school of medicine, Stanford University
Thomas Rosenquist, PhD, vice chancellor for research, University of Nebraska Medical Center
Competition and Expectation
- Dr. Miller noted the need to address the perceptions of local providers concerned with competition in the marketplace.
- Be aware that expectations of international partners can vary with regard to performance metrics and other elements of agreements.
- Hopkins’ contract was terminated early with some negative consequences.
- Johns Hopkins ended its research enterprise in Singapore, but has sustained its clinical program in the country, which has been more successful.
When exploring an international partnership:
- Be clear about the value that each side contributes to the deal and the resources required.
- Know what is expected of each party.
- Make sure you can deliver on your promises.
- Have a detailed, mutually agreed-upon exit plan that is codified.
Targeting Partners
- Carefully select a target institution and location.
- Show why your targeted school should pick you as a partner—i.e., demonstrate the areas in which you are a top school or a high-profile school, and try to find areas of compatibility.
- When you initially hold a meeting or make a visit, bring you’re A team—high-level people: deans, chancellors, VPs, VCs, and/or directors.
- Consider involving politicians—UNMC brought Nebraska’s Governor and others into the process.
- Make specific agreements—there are risks that come with having specific metrics, but they are essential.
Nebraska emphasizes that its agreements:
- Establish functional financial communities
- Are scalable
- Have some endurance
Considering the University Context
Stanford’s activities are framed in the context of the whole university, as opposed to the academic health center.
- Stanford has decided not to engage in clinical care in the international arena, but instead to focus on what Stanford is known for: innovation on a cross-disciplinary platform, and education and development of physician scientists and scholars.
- Medical students, residents, and faculty are enormously interested in global health—this has been a catalyst for Stanford’s international activities.
- A joint program between the School of Medicine and the School of Engineering was used as a platform to launch Stanford’s international activities.
- This program engages students to work on innovative solutions to practical problems.
- A joint program with India was established to bring students and faculty to Stanford to share in the experience of identifying problems relevant to India and to seek practical solutions to those problems.
- Stanford has also forged a relationship with a private health center in China to train and educate physician-scientists.