Chairs group addressing funding, residencies, student debt
Karen Antman, dean of the BU School of Medicine and provost of the Medical Campus, has added another title to her résumé: chair of the Council of Deans of the Association of American Medical Colleges (AAMC).
“It’s actually kind of fun,” Antman says of her new position. “We find out that the things we’re dealing with here at BU are things our colleagues are dealing with all over the country.”
The goal of the AAMC is to strengthen medical care by supporting education, research, and patient care activities carried out by its member institutions. Antman’s responsibilities include representing the interests of council members to the rest of the association and beyond, on topics ranging from research funding from the National Institutes of Health to the shortage of primary care physicians for an aging US citizenry.
“Although the American population was increasing, the experts thought we wouldn’t need that many more doctors, because everybody would be in managed care. But it didn’t turn out that way,” Antman says. “Experts now project not only too few physicians, but particularly too few primary care doctors. We have about two-thirds specialists, whereas much of the developed world has about two-thirds primary care doctors. We have fewer physicians per 100,000 Americans than other developed countries.”
Another pressing issue facing medical school deans, Antman says, is the need for more residency positions. Physicians who graduate from medical school cannot get a license without doing a residency, where they practice under supervision. Available residency slots are growing much more slowly than the number of graduates from medical (MD) and osteopathic medicine (DO) schools. US citizens graduating from international medical schools are also competing for residency slots. “For the first time, a substantial number of US medical school graduates are not matching to residencies,” she says, but this has not yet become a particular problem at MED.
Founded in 1876, the nonprofit AAMC represents all 144 accredited medical schools in the United States and all 17 in Canada, nearly 400 teaching hospitals and health systems, and 90 academic and scientific societies. It represents 148,000 faculty members, 115,000 resident physicians, and 83,000 medical students.
Making the deans’ interests known in Washington is part of the job, but don’t call it lobbying: “We prefer to call it education,” Antman says.
At BU, Antman oversees the operations of the School of Medicine, the Goldman School of Dental Medicine, and the School of Public Health. Among her tasks as chair of the deans council will be fostering discussions on research, education, and administrative best practices. She says that a frequent discussion topic recently has been the best way for medical students to master the enormous amount of required material. That no longer means eight hours of lectures a day, a notably ineffective way to learn.
“The new pedagogy requires students to learn the material from didactic modules available online and come prepared to apply that knowledge in class discussions during the day,” Antman says. “Seeing patients is particularly helpful.…It’s a lot easier to remember Mrs. Smith’s peripheral neuropathy, a common complication of diabetes, and the drugs that she takes and any side effects than it is to memorize the names of drugs and their effects and side effects without the patient context.”
Her role with the council also gives her a chance to talk up MED. “The opportunity to showcase the University naturally is a real advantage,” Antman says, particularly its achievements in innovative research and teaching.
“The NIH knows us and they fund us disproportionately well,” she says. “I want to keep that going. As chair, you get a bully pulpit to support NIH funding and federal funding in general, which is incredibly important.”
Rising student debt is another major concern among deans of medical schools. “The median debt for a medical student is about $180,000,” Antman says. When you factor in that they frequently marry one another—“They don’t see anybody else for four years,” she says—“they can have a $400,000 mortgage without the house.”
To help remedy that situation here, on Antman’s watch a $30 million medical student residence was built on the Medical Campus; it opened in 2012.
“The reason we started planning it was because living in Boston is more expensive than for other medical schools, so we had to put in housing that was affordable,” she says. “It turned out to be so much better for lots of other reasons, including collegiality and safety, but the first reason was trying to manage student debt.”
Antman was to have succeeded the outgoing deans council chair in November, but stepped forward to begin the post when her predecessor changed jobs. (She had been chair-elect for the past year and a half and also sits on the AAMC board of directors.)
“Karen Antman brings experience and a remarkable clarity of thought, and she’s an excellent communicator,” says John E. Prescott, AAMC chief academic officer. The association welcomes 25 to 30 new deans a year, and Antman is especially effective in reaching out to help them “not just survive, but thrive” in the job, says Prescott.
That’s important given “the pace of change right now confronting all of academic medicine,” he says. Deans are faced with “the complexities of a constantly changing patient care environment and dwindling resources in research, and they’re asked to do incredibly more complex jobs across all the missions.”
For leadership conference issue discussions, the AAMC typically invites representatives of its various constituencies. “They put us in a room all at the same time,” Antman says. “We’ll have 15 deans, 15 hospital directors, faculty, practice planners, residents, and students in the room, and we’ll go after an area. It’s complex to put it mildly.”
Not long ago, she says, one such gathering tackled faculty complaints that the emphasis on seeing patients quickly was squeezing out time for teaching and research.
“I thought that was just us, and we get down there and find it’s a national problem,” Antman says. The AAMC offers “a forum where you can get the groups together, and in quite a civilized way, hash out differences.”
This BU Today story was written by Joel Brown