FEATURE

First Class

Virginia Tech Carilion’s first 40 doctors graduate

by Mason Adams

Forty medical students made history in May as the first graduating class at the Virginia Tech Carilion School of Medicine (VTC). Based on their experiences over four years at the school in Roanoke, they'll make talented doctors, too. Instead of long lectures in voluminous lecture halls, the school uses small class sizes and "problem-based" learning to produce graduates who can quickly adapt to new technology and ideas at the forefront of modern medicine.

"Succeeding at a new school demands bright, entrepreneurial students—confident self-starters," said Dr. Cynda Johnson, founding dean of the school, at the graduation ceremony. "We needed their student perspective and active participation to develop and refine the cutting-edge curriculum that would make the Virginia Tech Carilion School of Medicine a premier medical school for the 21st century."

The ceremony marked a major milestone in the life of the school, opened in 2010. The school's approach, melding the basic science, life science, bioinformatics, and engineering strengths of Virginia Tech with the medical practice and medical education experience of Carilion Clinic, has garnered attention: Demand for the 42 student spots in each class has grown, from 1,650 applicants the first year to 3,553 for the fall's incoming class. Additionally, the school, complemented by the Virginia Tech Carilion Research Institute, has sparked a wealth of economic activity around its Roanoke location.

The medical school's biggest value, however, comes from its students. Every one of the 40 graduates was accepted into a residency program, and more than half were accepted to their first choice.

Match Day 2014

The three incoming first-year students profiled by Virginia Tech Magazine four years ago said this spring that VTC had prepared them well.

Credit their preparation both to the school's focus on research and to its innovative problem-based curriculum, which eschews a more traditional lecture format in favor of actual patient cases. Guided by faculty facilitators, student teams work through each case together while researching relevant topics. At the end of each case study, they participate in a private session with the physician and patient.

"[Problem-based learning] definitely challenges you to be more of a critical thinker as opposed to reading a textbook and knowing the facts," said Raeva Malik, who was accepted into a residency in internal medicine at George Washington University.

After two years, students move into a clinical setting at Roanoke Carilion Memorial Hospital, essentially assuming the roles of entry-level residents and applying the learning style to real cases.

"We're doing better preparation for what it's actually like to practice medicine," said Robert Brown, who was accepted into a residency combining emergency medicine and internal medicine at the University of Maryland. "You need to identify where you're missing information, figure out how to find it, and how to incorporate that into the application."

Early results suggest that the curriculum has been effective: Every student in the inaugural class passed Step 1 of the U.S. medical licensing exam on the first attempt, and as a whole, the class scored significantly higher than the national mean score.

VTC's research component amplifies the "problem-based" learning style. Each student must complete a research project of publishable quality, giving him or her an opportunity to build knowledge of a real-world issue while working closely with Carilion physicians and Virginia Tech researchers. Johnson said the requirement has produced unexpected benefits, helping to draw more physicians into a research frame of mind as they work with students.

Perhaps more importantly, the approach gives VTC students a head start in learning about doctor-patient relationships. In fact, Johnson refers to the curriculum not as "problem-based" but as "patient-centered."

"You're working through patient cases from the beginning of medical school," Malik said. "You're introduced to patient-doctor relationships early on, so when you start working in a hospital in the third and fourth years, you already have that foundation."

For Don Vile, who worked in software engineering before deciding his true passion was in medicine, the experience with patients was crucial, and it ties directly into Virginia Tech's motto of Ut Prosim (That I May Serve).

"Service is certainly a big part of medicine, and it's part of why I decided to go into medicine," said Vile, who plans to pursue a career in oncology after his internal medicine residency at Wake Forest University. I can think about several patients where I wanted to be there to help to the extent possible. I was driven to go above and beyond to meet the needs of these patients."

Vile was one of six class members elected to the Allopathic Medicines National Honor Society, which carries a motto from its founder, William Root, that is similar to Virginia Tech's: "Be Worthy to Serve the Suffering."

Brown, who was also elected to the honor society, cast his role as a doctor as one of service, not just to individuals but to society as a whole.

"I want to be there to help people to reach their full potential, whether that's being there for a grandchild's birthday or to paint the next masterpiece," Brown said. "We're here really to make a better community in service of performing our job."

That ethos was picked up by the entire class, Johnson said. For instance, students staffed Roanoke's Bradley Free Clinic every Thursday night. Faculty members served as the licensed attending physicians but second-, third-, and fourth-year students all participated, with upperclassmen helping to mentor the newer ones.

Now, with the inaugural class on its way, the medical school continues to evolve and prepare the next generations of physicians.

"This is a great starting place, but we're not finished," Johnson said. "We've set a culture we renew and refresh every day."