Medical education continues to grow in New Jersey — in size and scope — thanks to a small but novel new option for clinical training in South Jersey.
Starting last month, AtlantiCare became the fifth regional campus of the Geisinger Commonwealth School of Medicine, a community-focused undergraduate system based in central Pennsylvania. The first class, comprised of 16 third-year students, began the yearlong Atlantic County program in July.
GCSOM, unlike most medical education models, provides extensive outpatient experience, in addition to hospital exposure, so students can better understand the patients they serve and the social factors that impact their health, according to Geisinger. On average, GCSOM has close to 500 students, including an average of 110 in the third-year class, the group that spreads itself among the five regional campuses for clinical experience.
In addition, both partners said AtlantiCare — which has facilities in Atlantic City and Galloway Township, plus offices and other regional sites — offers GCSOM’s student body something they can’t find at the school’s four rural Pennsylvania campuses: a truly diverse patient population.
“America is a diverse country,” said Dr. Steven Scheinman, president and dean of GCSOM. “If the only patients (physicians) really understand are patients who look like them, they’re going to be very incomplete doctors.”
“So much of the relationship between the patient and the doctor is about trust,” Scheinman said. Trust matters when it comes to learning more about patients’ lives, which has become a growing focus for clinicians as recent research has shown that social factors like poverty, racism and education have an outsized impact on patients’ wellbeing.
“And so much of a patient’s health has nothing to do with medical care,” Scheinman added.
AtlantiCare also offers geriatric experience
AtlantiCare also exposes students to international tourists in Atlantic City and summer visitors throughout the region, plus offers geriatric experience at its mainland locations, explained Doctor of Osteopathy Dominick Zampino, the director of academic affairs for AtlantiCare and the regional associate dean for the GCSOM program.
Students are “getting a very broad experience that is very unique and that they may not be getting at the other (GCSOM) sites,” Zampino said. “We have so many opportunities within Atlantic, Ocean and Cape May counties.”
Scheinman also credited “clinical expertise and educational experience” and leadership skills of the AtlantiCare staff with making the partnership a good fit for GCSOM. The two organizations already shared some significant connections: AtlantiCare became a member of the Geisinger health system about five years ago, and Geisinger integrated with the Commonwealth School in 2017.
AtlantiCare is one of the 43 hospital systems in New Jersey that provides graduate medical education, or residency programs for those who have graduated from medical school. For years, it has also worked with other regional medical schools to host third-year students; typically, medical schools involve two years of primarily classroom-based education, then several years of clinical experience.
But the partnership with GCSOM goes beyond these existing programs, Zampino said, and offers a unique approach for students. “This is a longitudinal integrated curriculum,” he explained, referring to tracking the same patients over time, “which is very different from what most of us went through in medical school and very different from most current medical schools.”
The model, which the GCSOM campuses share, allows students to spend half a year in a hospital setting, rotating among family medicine, internal medicine, OB/GYN, pediatrics, psychiatry and surgery. While that part is fairly standard, Zampino said, in the second six months, there’s a twist: Students are assigned to physicians in each of those specialties and work with them, and their patients, for the rest of the year.
“It’s meant to foster more than the traditional relationship of the physician acting as a preceptor to that student and develop more of a relationship of mentor or coach,” Zampino said. “It’s also meant to foster more of a continuous experience so (students) can start to see and develop relationships with the same or similar sets of patients over that time.”
Similar medical education models in NJ
Other versions of longitudinal medical education models exist in New Jersey. Last year, the Morristown-based Atlantic Health System and Philadelphia’s Thomas Jefferson University’s Sidney Kimmel Medical College added a longitudinal program that enables students to follow patients to many providers throughout the system of care. Atlantic Health has several hundred third- and fourth-year medical students at its main facilities and also provides graduate medical education.
This approach is also catching on at The Hackensack Meridian School of Medicine at Seton Hall University, which opened last summer. The first private medical school to open in the state in 50 years, it has built a program that specifically focuses students on the health of families in the community.
The Geisinger program also has other novel features, officials said. The school is the only one in the nation to have been founded by a community coalition of doctors, business leaders and several attorneys, joining forces to boost the number of healthcare providers in northeastern and central Pennsylvania and improve residents’ access to quality care. The group raised funds, created a program and welcomed its first class in 2009; an academic building in Scranton followed in 2011.
Unlike most medical schools, Scheinman said GCSOM did not have a teaching hospital of its own when founded, but now depends on facilities at its regional campuses — including Geisinger Medical Center in Danville, PA — for clinical training. Most hospitals in that part of Pennsylvania were small community facilities, he said, so the coalition sought to develop a new model to prepare students not just for hospital work but for outpatient care, which is an essential component of the region’s health system.
“Much less is happening in the hospital and much more is happening in the outpatient setting,” Scheinman said.
GCSOM students are also involved with the local community from the start of their medical education, Scheinman noted. While most schools focus on classroom learning in the first years, Geisinger students spend three-quarters of their time on group learning projects, examining case studies or engaged with other hands-on education.
They are also required to perform 100 hours of community service as undergraduates, he said.
“We want to teach them not just the science of medicine, but the art,” Scheinman said. “And the art is centered around understanding your patients, not just understanding the disease.”