June 21, 2013
Dr. Heidi Chumley was appointed executive dean and chief academic officer for American University of the Caribbean School of Medicine (AUC) in March. Dr. Chumley joined AUC following an eight-year career at the University of Kansas School of Medicine, where she most recently served as associate vice chancellor for educational resources and interprofessional education. On the occasion of her 90-day anniversary, Dr. Chumley sat down for a conversation on what she has learned so far, and where AUC is headed.
Q: Ninety days into your tenure as executive dean at AUC, what has impressed you the most?
HC: When I was first getting to know AUC as a candidate for the executive dean position, a lot of people talked to me about the school’s mission. A few people would refer to the mission explicitly, but many more simply talked about the school to me in a way that conveyed their part in providing an excellent medical education to qualified students of diverse backgrounds. In other words, the AUC mission is not just something that we post up on the walls or embroider onto banners. It’s a lived mission. Since coming on board and spending more time with the faculty, students, and all the colleagues in support roles on the St. Maarten campus and in our stateside office, I’ve come to feel this even more.
The impact of the mission is obvious when you talk to students. They have amazing stories and experiences to share, and when you see how hard they work and the sacrifices they are making, you’re really motivated to do more to support them. The faculty are inspiring in a different way. We have faculty who have left high-ranking positions in prestigious US institutions to come here – and it’s because they want to commit their energy and time to teaching.
Q: What are your top immediate priorities as the school’s leader?
HC: The three top priorities for this year are to enhance the clinical education, connect the campuses, and optimize the educational process. The clinical education spans all semesters, but the steepest critical learning curve occurs during the clinical cores. We will be working this year to provide additional academic support and career guidance during this critical time. We need more cross-talk between our medical science campus and clinical training sites, and among the clinical training sites. This is critical to the continual improvement of our academic program and our day-to-day operations. The educational processes touch every part of each student’s education – from moving to St. Maarten, to scheduling clinical cores and electives, through the residency match and graduation. Our processes impact each student’s education and my desire is that our processes are transparent, fair, and as smooth as possible. I can’t promise the students that they won’t ever be frustrated and I can’t promise the students that they will always agree with changes. But I can promise that we will be working towards transparent, fair, and smooth educational processes.
Q: AUC is in the midst of a major expansion to the campus, including a new academic building slated to open this fall. How will these changes to the campus impact the education provided at AUC?
HC: AUC has often been described as having a high-touch learning environment in which faculty work closely with students to help them acquire medical sciences knowledge, and in which students have ample opportunity for small-group learning, particularly for clinical skills acquisition. I’ve heard directly from students about how much additional time outside of class that faculty are willing to devote to help them grasp a new concept. Students also comment on the camaraderie that exists between them: the way they coach each other and support each other. This kind of environment is central to what AUC offers. It’s part of what defines us as an institution.
Our faculty, staff, and students have done well in our current facilities. At the same time, we need to continually assess how well our learning environment is serving the needs of our students and faculty, not just in terms of the interactions between them, but in the use of instructional technology. The new building adds excellent spaces for anatomy, clinical skills training, and simulation enhancements, as well as more student study space and testing facilities.
Q: AUC students and faculty alike prize the school’s community feeling, epitomized by the relatively small class sizes and close faculty-student interaction. What do you say to those who see the new building under construction and worry that expansion will result in a loss of that community feel?
HC: The community environment at AUC is part of what’s attractive about the school. Certainly it was a factor in my decision to join the institution. I think it’s important to understand that despite any changes we make to the physical infrastructure of the school, or any of the technology that supports it, we still have the same goals: providing students with an excellent medical sciences foundation, helping them acquire clinical skills, and preparing them to launch successful careers. Technology or new buildings don’t supplant those goals – they complement everything we are doing already to achieve them.
I think our students understand this. In some areas, such as the study of anatomy, it just makes sense for us to take advantage of innovation. For certain other learning experiences, such as integrated clinical medicine, students and faculty can both see that we simply need more space where learning can happen. AUC has grown incrementally over the last several years, and likely will continue to do so, as more people who aspire to become physicians learn about us.
Q: The Association of American Medical Colleges (AAMC) reported last fall that US medical schools plan to increase enrollment dramatically. Last year the rate of increase in US medical schools was only 1.5 percent, but are you concerned that increased enrollment in US schools will make it more difficult for AUC to find highly qualified applicants?
HC: Enrollment in US schools grew by 1.5 percent, but the number of first-time applicants grew by more than twice that at 3.4 percent from the previous year. The desire to attend medical school is outpacing the US schools’ capacity to enroll every qualified student. In fact, over the last 10 years, it has gotten more difficult to secure a spot in a US medical school. In 2003, the acceptance rate for US schools overall was 50 percent. Today it’s about 45 percent.
I believe AUC continues to be a good option for those students that the US schools cannot accommodate. I believe that a majority of the students we attract to AUC are that five percent – the students who fall just outside the class size cutoff for the US schools.
Q: Along the same lines, there is a lot of discussion on student chat boards and elsewhere about concerns that growing enrollment in US medical schools, coupled with slow growth in the number of residency positions, will result in a difficult outlook for students at schools like AUC. What effect, if any, do you think increased enrollment in US schools will have on AUC graduates’ ability to compete for a residency position?
HC: I do understand students’ concerns about the match – it is critically important and I know it is a source of high anxiety for many. Success obtaining a residency depends in large part on the student’s performance in the medical sciences and clinical programs, their experience, and their performance on USMLE Step 1. This goes for all students regardless of where they study. We are confident that at AUC, we are preparing our students to meet these criteria.
AUC students achieved a 96 percent first-time pass rate on Step 1 in 2012, equal to the performance of US and Canadian students, and five percentage points better of students in osteopathic medicine programs. And the early returns from this year look great so far. Our faculty and students are ecstatic about this – it’s a point of pride, and clearly they are doing something right.
Our students also need to shine during their clinical rotations and electives – another huge boost to them when they apply for residency. We need to be sure they have the tools to do so. As an institution, we need to tell the AUC story so that residency program directors understand the high quality of AUC students. And we need to ensure that students receive clear guidance about how to approach the match in a manner that gives them the best chance to obtain a residency position.
Q: In the 2013 match, 64% of AUC students who matched secured a position in primary care: family medicine, internal medicine, or pediatrics. Would you say that AUC has a special focus on graduating primary care physicians, or is this data a byproduct of the competitive landscape for residency – that is, that international medical graduates tend to land in less competitive specialties?
HC: First of all, as a family physician, I’m excited by the percentage of AUC graduates who enter residency in a primary care specialty. There is no doubt in my mind that there is a nationwide shortage of primary care physicians.
At the same time, it’s true that in the simple mathematical terms of number of available positions, primary care specialties are less competitive than, say, dermatology, which had 38 positions in the match this year, or plastic surgery, which only had 116.
However, one’s specialty choice may be driven by many factors beyond simply the likelihood of securing a position. A study of 2012 medical school graduates found that personality fit and the content of the specialty were overwhelming more important in one’s choice of specialty than competitiveness. So what does that mean for our graduates self-selecting into primary care specialties? In terms of personality, it means physicians who are interested in building long-term relationships with their patients, whether children or adults. A pediatrician, for example, has the opportunity to watch a family grow over time. Similarly a physician practicing family medicine might help an individual through a wide range of health challenges, from acute illnesses to chronic diseases. This is rewarding work when performed by one who fits the profile.
Another attribute of our students that might contribute to the percentage who match into primary care is a sense of service. So many of our students talk about a long-held desire to serve their communities. I am proud that many do so.
Q: What differentiates AUC from other medical schools in the Caribbean?
HC: AUC has a small community feel. Students know each other and faculty and staff know the students. An equally important question is what positively differentiates AUC from other medical schools in the United States. The most important difference is that the medical sciences faculty members are dedicated to teaching. They are not juggling research or clinical responsibilities. That is why the faculty can provide the personal attention that the students mention as one of the best things about AUC.
Q: What are your impressions so far of Sint Maarten?
HC: St. Maarten is known as the “friendly island.” It’s a beautiful place and I have felt very welcome here. Spending time in St. Maarten has helped me understand, at least in a small way, what it is like for our students who come here to study medicine. I’ve learned where to get groceries, what the options are for housing close to campus, and how to spot the speed bumps before hitting them at full speed. I love the ocean and find the sound of the waves rejuvenating.
But as much as I like Sint Maarten, I am also looking forward to continuing to develop relationships with our team in Coral Gables and to visiting our main clinical partners over the next year.