A new class of medical students has embarked on a unique clinical training journey in which they will track a single group of patients over time, following their care from primary-care doctors to surgical specialists to physical therapists or other providers, in both hospitals and community-based facilities across northern and central New Jersey.
The model — which differs from traditional programs that rotate medical students through a series of specialties, encountering different patients in each multi-week segment — is the result of a growing partnership between Morristown-based Atlantic Health System and Thomas Jefferson University, a Philadelphia college with roots nearly two centuries old. The Hackensack Meridian School of Medicine at Seton Hall University, which welcomed its first class this past summer, has embraced a similar approach.
Some 270 students from Jefferson’s Sidney Kimmel Medical College have been participating in more traditional third and fourth-year rotations at two of Atlantic’s main facilities, Morristown Medical Center and Overlook Medical Center, in Summit, since the summer of 2015, the partners said.
But the two organizations gathered earlier this month in Morristown to announce the novel program — the Longitudinal Integrated Clerkship (LIC) — and dedicate a regional campus of the Sidney Kimmel Medical College. Both Morristown and Overlook hospitals will provide the student services, but there are no immediate plans for additional buildings, officials said. The program comes as healthcare experts warn of a growing physician shortage, especially in behavioral health fields, that’s likely to worsen in the years to come.
“Today is all about our students, who are truly pioneers in medical education,” Atlantic’s president and CEO Brian Gragnolati said at the event; Atlantic is the third largest network in New Jersey with six hospitals and nearly 5,000 physicians.
The future of healthcare
“Their desire to learn and engage with patients in innovative ways will enable us to create the future of care we all envision — one that puts the patient at the center of a true network of personalized, accessible and affordable care designed for a lifetime of health and wellness,” he added.
The LIC program, which will add another six students in the coming months, will pair the third-year pupils with a select group of patients whom they will follow through their care at any of the hundreds of Atlantic Health sites in the region. This will enable the students to work directly with doctors, nurses, physicians’ assistants, midwives, counselors, and physical and occupational health experts based in hospitals, private offices and community clinics. The students can also return to Atlantic Health for their fourth year of medical school.
“The ability to train and learn from providers at every point of a patient’s journey, in a variety of settings, is an incredibly rich venue for education,” said Dr. Jim Alexander, a vascular surgeon and associate dean of the regional campus. “The impact we can have on preparing the next generation of health care providers through this collaboration is immense.”
While the LIC model is uncommon nationwide, Jefferson has created similar programs with hospital systems in Pennsylvania and in Camden, thanks to a partnership with Cooper University Health Care, Alexander said. But each program is unique to the setting and school.
The new partnership represents “a bold commitment to excellence in medical education by both institutions,” said Dr. Stephen K. Klasko, president and CEO of Jefferson University, which is known for its progressive educational programs. “It is the expression of a vision of the ideal physician, prepared to provide the best possible patient care in the 21st century,” he said.
Fewer doctors in NJ
While New Jersey has a robust roster of medical residencies — the three to seven years of hands-on, supervised training required to become board certified — with 43 of the state’s 71 acute-care hospitals involved with medical education, it has a lower number of actual residents for the population than many states, including its neighbors, research has found, in part because of the high cost of living and of doing business here.
The Garden State also has only a handful of medical schools, and a lower percentage of doctors in the pipeline than most states, including neighboring Pennsylvania and New York. Garden State-based programs include Rutgers New Jersey Medical School in Newark, Rutgers Robert Wood Johnson Medical School in New Brunswick, Rowan University’s School of Osteopathic Medicine in Stratford, and Cooper Medical School of Rowan University in Camden.
In addition, the Hackensack Meridian School of Medicine at Seton Hall University, which occupies the former corporate campus of drug giant Hoffman-LaRoche on the Nutley Clifton border, is the first private medical school to open in the state in 50 years. In an effort to improve care for the most vulnerable residents, HMSM students will work in teams to track the health of 90 families during their medical education, visiting them at home and at the doctor’s office, and meeting with community leaders and others to better understand the social factors impacting patient care.
Alliances like those between Hackensack Meridian and Seton Hall also illustrate the growing involvement of clinical networks in medical education. Last year RWJBarnabas Health, the state’s largest network of care, joined forces with Rutgers University to boost health-related research at the state school and unite the two organizations to improve population health across the state.
Hospital and other healthcare officials have embraced the growth of medical education in New Jersey in part to help the industry get ahead of an anticipated provider shortage in coming years. When opening the school with Seton Hall, Robert Garrett, co-CEO of Hackensack Meridian Health, warned of a shortage of some 3,000 doctors by 2020 and a study by the New Jersey Hospital Association found one in three physicians here are over age 60 — the third highest percentage nationwide.
Not the traditional way
The Sidney Kimmel regional campus helps strengthen Atlantic’s clinical abilities throughout its system, officials said, and it also adds to Jefferson’s growing presence in New Jersey. The organizations also share the belief that the LIC model will benefit the wider medical field in the future, as healthcare becomes less reliant on hospital treatment and providers become better integrated with all aspects of care, including critical social supports. Both organizations have invested significantly in the project, Alexander said.
For students, the LIC model represents an opportunity to explore different clinical paths and witness how patients progress through their care, explained Aisha Golaub, a Wayne native who is one of the six students selected for the new program. The experience will also help her decide what kind of medicine she wants to practice later on, she added.
“It was almost magical to see these fields converge and it felt like a sign that this year would be truly different than the traditional third-year experience,” Golaub said.