Reinventing Medical School to Revolutionize Healthcare: Four Lessons for Business Education
Dan LeClair visited Dell Medical School with a mission to learn how an institution reinventing medical education can inspire innovation and change in business education.
I first read about Dell Medical School in Fast Company, in an October 2015 article titled “Reinventing Medical School.” Scheduled to open the following year, it would be the “first new medical school at a tier 1 research university in more than 50 years” and provide “a unique opportunity to build its curriculum, facilities, and priorities from the ground up.” But I soon realized that the idea behind Dell Medical School at the University of Texas, Austin, was much more than reinventing medical education; its real purpose was to revolutionize health care itself. Its leaders wanted to change the system, not just operate within the existing one.
Can you imagine such a bold, purposeful mission for a business school? I can; and I visited Dell Medical School in November with that in mind. I came away excited and armed with four lessons about innovation and change in business education.
- Count on the local community Universities and business schools are beginning to focus more on making a difference locally. This trend is especially pronounced among public institutions and is driven partly by the changing funding model in higher education. It is also a response to rising demands to demonstrate concrete social impact, beyond the rather abstract benefits of better-educated citizenry.
- Great people will come The higher education system—in America and globally—creates enormous pressure for schools to be like others. Rankings, for example, provide immense visibility but also foster homogeneity. They make change riskier. Going too far, too quickly might push away “top students” according to present standards, the ones who have high test scores and are well-positioned for post-graduate success in the current system. Similarly, it is risky for a school to fundamentally shift its approach to research without jeopardizing its ability to attract the best scholars. And regarding leadership staff, it is not easy to find change agents from among those who have built and succeeded in the existing system.
- Cut out the Krebs cycle “I received a lot of mail following my interview with Texas Monthly.” Johnston leans forward to tell me what he said:
- Wrap everything into a ball Like the third leg of a stool, the health care business—the clinics and medical centers—is essential to a medical school. It complements and supports medical education and the research enterprise. Established institutions are making money in the current fee-for-service system. The challenge for Dell Medical School: if they are going to change the system, they should probably avoid depending on it. Everything, according to Johnston, should wrap tightly into a ball. In business, we might call it strategic focus or consistency.
Now I think Dell Medical School is taking community engagement and local impact to another level. It “envisions Austin as a model healthy city,” and the city’s voters elected to increase their property taxes to help fund the school. The school receives 35 million USD annually from the tax. I’m not sure this was a first for a medical school, but I am convinced it won’t be the last time a community makes such a commitment. It is more than an investment in the health of its citizens—it is an investment in Austin’s economic development and in building an essential piece of a thriving startup scene and entrepreneurship ecosystem. The school founded the Texas Health Catalyst, for example, to “accelerate the translation of research to health products,” and already I’m told that health is now the fastest-growing space for new businesses supported by Capital Factory, Austin’s largest incubator and accelerator.
Relying on local communities for funding is not without challenges. It elevates its visibility in local politics and gives citizens a say in the formulating policy. Add “seasoned politician” to the growing list of success factors for deans.
The flip side is that being a part of something new and different and important matters to a growing number of people. Building a school on a grand purpose can offer huge benefits—one of which is that it attracts the people who share the same vision. Dell Medical School has already attracted top-notch scholars, people passionate about having an impact, who feel constrained at their current institutions.
For 50 spots in the first class, Dell Medical School received 4,528 applications (they predicted 2,000 to 3,000). Like other medical students, their successful candidates are overachievers. But they were selected as much for their connection to the vision and ability to work in teams as for their individual intellectual and leadership capabilities. The result was a diverse first class; they are scientists and serial entrepreneurs, artists and engineers, consultants and activists. Meet eight of the students in the initial class.
But what will happen when we drop them into the current residency system? Will they become part of the status quo? Inaugural dean, S. Clayborne “Clay” Johnston, is not worried. He believes these students will plant the seeds of change. After all, Johnston was educated in the current system, succeeded within it as a scholar, and has all the requisite experiences, attributes, and appearances of a classic dean. But make no mistake, he is an agent of change.
There’s this thing called the Krebs cycle—I’ve never used it since my memorization of it, which is, of course, gone. A childhood geneticist who treats patients with abnormalities in the Krebs cycle—okay, they should know it. But for the rest of us, it’s just been in the curriculum because that was one of the few things we knew about biochemistry fifty years ago. There are many, many examples like that.
A lot of content (“examples like that”) had to be left out of the curriculum to squeeze the basic sciences into 11 months. But the point is more about how medical students learn rather than what they learn. The Dell Medical School curriculum is based on team-learning, cases, and synthesis, rather than memorization. It recognizes that content is readily available and portends the advancement of artificial intelligence. And it reflects modern practice, which is not at all a solo exercise. I was especially impressed with their commitment to prepare students to “work on and among ‘interprofessional’ teams” throughout all four years of the curriculum.
Leadership training and clinical skills development are also incorporated across all four years. However, the most visible curricular connection to Dell’s mission will come in its signature third year, when students will choose between pursuing a master’s degree in public health, business administration, biomedical engineering, or educational psychology, or teaming-up with classmates to tackle a project to improve healthcare in the community.
As an aside, curricula innovation is hot now among medical schools. Many schools, including Harvard Medical School, have been revamping their curricula. The Liaison Committee on Medical Education, the U.S. medical school accrediting body, has been open and encouraging to innovation, and the American Medical Association has created a consortium of institutions committed to changing medical education. I was also told by my hosts at Dell that the research system has moved beyond silos and has thus enabled curricula change. The only constraint to change is apparently the licensure exams, which still emphasize core content.
So how will Dell Medical School create new clinical business models for itself and also enable organizations and institution to innovate and provide for a healthy community? For this they partnered with the College of Fine Arts at UT Austin to start the Design Institute for Health and hired two veterans of IDEO, a global design company, to take the lead. The institute will focus initially on three areas: a creative, collaborative model for improving health; platforms to enable new innovations in health; and a resource for design execution. And, it is these areas where Johnston admits the “rubber meets the road” in achieving their vision to build “a vital, inclusive health ecosystem.”
Whether it succeeds or not, I left Austin believing that Dell Medical School is forging new territory, helping us understand and build the professional schools of the future. They articulate shared visions for the community or communities they serve as well as for the professions they support, and they are designed to foster and enable change rather than to protect and perpetuate systems that no longer work.
Dan LeClair is focused on strategy and innovation in business education. You can follow him on Twitter @DrLeClair.