Despite pandemic, UH medical school launches today
Breanna Chachere has wanted to be a doctor since she was 8 years old, sensitive even in her youth to health care inequities that beset people of color.
The anticipation built as Chachere was selected in June as part of the inaugural class of the University of Houston’s new medical school, focused on training primary care doctors to practice in underserved areas. It culminated last Monday morning with the simplest of actions: Chachere walked to her living room and logged on to her computer.
“That’s how I started medical school,” she said at the conclusion of the UH medical school’s last day of orientation Thursday. “It felt extremely surreal.”
Houston’s first new medical college in nearly half a century begins classes Monday, faced with all the usual challenges involving a school started from scratch — plus a pandemic. Like all schools since the spring, it will offer instruction remotely until COVID-19 subsides to a point that administrators deem it safe enough to teach on campus.
It might sound like just the new normal in higher education, but such challenges carry particularly heavy burdens given first-year medical students typically require hands-on instruction to learn gross anatomy and how to take physical exams. Moreover, it’s a key time for team building, considered essential to the sense of community the profession stresses.
The challenges have required UH to adjust and improvise, something that won’t stop anytime soon.
“We’re building the airplane as we’re flying it,” Dr. Stephen Spann, founding dean of the UH College of Medicine, told the inaugural class last Monday, the first day of orientation. “This requires
flexibility, adaptability, tolerance of ambiguity and uncertainty and patience, all key attitudes and skills required of great physicians.”
The same phenomenon is occurring in Conroe, 40 miles north of Houston, where Sam Houston State University also is about to launch a new medical school. Its school of osteopathy will begin classes online on Monday, Aug. 10.
The two colleges are among just four new U.S. medical schools — the others are in California — starting amid the pandemic.
Spann, a longtime Houston medical educator who attended orientation as a first-year Baylor College of Medicine student 48 years ago, was recruited by UH in 2015 to develop a different kind of medical school. The idea was a school dedicated to training doctors interested in overcoming the social determinants now believed to contribute to 80 percent of preventable death and serious disease.
Nothing has shone a spotlight on health disparities like COVID-19, Spann told students at the orientation, a fact much of his audience of new medical students knows all too well — almost three-quarters are Hispanic and African American. The two populations have been hardest hit by the disease.
The pandemic’s effect at UH hit at the least opportune of times — after medical school leaders began considering applicants for the first class. It interviewed 48 of 170 applicants in person, then had to switch to remote interviews. School officials scrambled to develop a virtual tour of the school and mini-interview sessions with multiple officials.
In the end, the majority of students UH ended up selecting accepted without ever setting foot on campus.
“It would have been easy to say, ‘Perhaps we should hold off a year because of all the difficulties,’ ” said Dr. Ruth Bush, the UH college’s associate dean of medical education. “But it’s more important now than ever that we contribute to the population of physicians.”
The pandemic’s medical school disruptions also included orientation, one of the signature events for first-year medical students. UH’s plans evolved from holding all of it on campus to bringing students in person for some events to making it all remote. The last was decided at the 11th hour.
Dr. Sue Cox, chair of medical education at Dell Medical School at the University of Texas at Austin, said UH’s task will get even more challenging after courses begin. She remembers the benefits of face-toface conversations when Dell opened four years ago, the ease of walking to a colleague’s office to discuss issues. “You just don’t feel the same connectivity, the same energy on Zoom,” Cox said.
UH student David Jacobson already laments the lack of such connectivity with teachers.
“My favorite part of class is the part after the lecture where you follow up with the professor about a question,” said Jacobson, an Arizona State University graduate who worked in EMS before applying to UH. “I had an online conversation with one of the teachers and that was her favorite part, too, the time when you really build relationships.”
UH’s plans call for students to come on campus in coming weeks for limited, creatively staged instruction — namely, that of gross anatomy and physical exam taking, basic skills for which remote learning is no substitute. Under the plans, for instance, no more than two students will be stationed at one table during dissections on cadavers, a far cry from the traditional model.
Spann acknowledges that instilling team building virtually will be one of the new school’s greatest challenges. How, after all, do you duplicate exercises such as one school’s use of zip-lining as part of orientation or spring-break trips taken by the majority of the class?
UH’s efforts include students developing their own version of the Hippocratic oath, to be displayed on campus and recited together at the school’s upcoming white coat ceremony, a ritual in which the apparel is placed on each student’s shoulders. The ritual signifies students’ entrance into the medical profession.
The students, 30 in all, have acted on their own as well. Chachere, who got her bachelor’s in psychology from Rice University, then a master’s in public health at Boston University, started a group chat in which all introduced themselves, became acquainted and pledged to be collaborative, not competitive.
After the killings of George Floyd, Ahmaud Arbery and Breonna Taylor, the class drafted a pledge of unity and solidarity, including principles to uphold throughout their careers, such as speaking out against injustice and using their voices to work towards health equity in marginalized communities like the Third Ward and East End.
Spann downplays the special work the pandemic required, noting UH had almost four months to prepare, during which time officials have held virtual meetings, conferences and even classes in other colleges.
“Challenges come up,” Spann said. “That’s life. That’s what the practice of medicine is about.”