by Nilanjana Bardhan and Gary Snyder
For most of the past decade, conventional wisdom in the osteopathic profession held that D.O. graduate medical education programs were not as strong as their allopathic (M.D.) counterparts. For several years, the D.O. profession witnessed an exodus of its graduates who opted to do their internship and residency training in M.D. programs. But those perceptions appear to be changing.
In today's world, the need for family medicine and primary care practitioners is being championed in town halls, board rooms and senate chambers across the country, and the osteopathic profession's strong track record of producing high numbers of primary care physicians has positioned it well in today's health care arena.
At the forefront of these changes is the consortium approach to medical education, and the Ohio University College of Osteopathic Medicine (OU-COM) has taken a leadership role in developing what many educators believe is one of the nation's model consortium programs for the delivery of predoctoral and postdoctoral medical education.
The Centers for Osteopathic Regional Education (CORE), created in 1995, are composed of five regional sites throughout Ohio, combining strengths of OU-COM with 13 osteopathic teaching hospitals throughout the state. Also affiliated with the CORE are four other osteopathic medical schools: the Kirksville (Mo.) College of Osteopathic Medicine; the University of Osteopathic Medicine and Health Sciences in Des Moines, Iowa; the University of New England College of Osteopathic Medicine in Biddeford, Maine; and Lake Erie College of Osteopathic Medicine in Erie, Pa. A number of students from the affiliated medical schools receive clinical training in the CORE system.
OU-COM officials say that in its two years of operation, the CORE has become the nation's largest and best-supported medical education consortium. About 300 medical students, 157 interns and 363 residents were training in the CORE system as of June.
OU-COM Dean Barbara Ross-Lee says the CORE was created with the goals of ensuring that tomorrow's osteopathic physicians receive an unequaled education by demanding consistent programming in all its hospitals; high standards for internships and residency training programs; integration of osteopathic principles and practices, medical ethics and basic sciences into clinical training; and utilization of state-of-the-art educational technology.
"The CORE raises the standards for medical education in this nation," says Ohio University President Robert Glidden. "Its foundation of dedicated physician-educators, advanced technology and curricula, and outstanding educational opportunities ensures trainees an unparalleled learning experience."
The CORE provides medical trainees with internships
and residencies in multiple specialties, a vast array of teaching
experts, and a number of training sites ranging from large urban
hospitals in Cleveland to rural community hospitals in Portsmouth. It
offers structure in education and clinical training by integrating
clerkship, internship and residency training programs and emphasizing
the importance of lifelong learning for physicians.
Innovative technology distinguishes the CORE as a "virtual" medical community within itself. Two distance-learning components provide the latest high-tech learning equipment for CORE students, interns, residents and faculty. The OhiONE -- Osteopathic Network of Excellence -- is a video conferencing and telemedicine network that provides real-time two-way video network communication between any number of CORE sites. The network began Jan. 1 and 12 of the 13 CORE teaching hospitals were online as of early June.
OhiONE gives CORE sites the ability to interact with other colleges of osteopathic medicine across the nation as well as other hospitals on the network, such as the Cleveland Clinic and Duke University. Users are able to converse back and forth during basic science and clinical tutorials; case-study presentations and discussions; live demonstrations of surgeries; examinations; and guest lectures.
The second distance-learning technology is COREnet, an online database system. A computer with a videodisc player at each of the teaching hospitals provides online access to the OU-COM curriculum database of lecture notes and syllabi; supplemental lectures on gross anatomy, dermatology and microanatomy; case simulations such as X-ray images, microscopic slides and heart and lung sounds; up-to-date research on the Internet; Ohio University's Health Sciences Library; the state's library system; and national databases such as MEDLINE and AIDSline. The system allows users quick access to about 38,000 medical slides and motion videos of up to 30 minutes in length.
Brian Phillips, OU-COM director for information technology, says the COREnet and OhiONE systems eventually will provide a cost-effective teaching environment through decreased travel costs and shared learning resources.
"There's a constant quest for knowledge in the CORE system which stimulates and motivates both teachers and trainees," says Stephen D'Abreau, D.O. '95, a CORE ob/gyn resident at Cuyahoga Falls General Hospital near Cleveland. "Exposure to new procedures isn't limited to an article in a journal." OU-COM's technological initiatives received a major boost recently with three grants totaling more than $530,000. "This technology can start to address and minimize the challenges of professional and geographic isolation for rural physicians - a barrier to recruiting and retaining primary care physicians in underserved areas," Ross-Lee says.
The college received a $326,000 grant in January from the U.S. Department of Agriculture to create the Southeast Ohio Health Education Network, which will be used for continuing medical education for rural health care workers across the region. Using two-way video technologies, the network is expected to allow health care professionals at five Southeastern Ohio sites to consult on medical cases. The project will begin late this summer.
OU-COM and OU's Institute for Local Government Administration and Rural Development received $77,000 from the Appalachian Regional Commission in October to create the Medical and Government Internet Coalition Network. The one-year project, which also begins operating this summer, aims to increase access to online technologies among local government officials and health care providers in 13 rural counties.
And the Brentwood Foundation in Cleveland awarded OU-COM $130,000 for distance-learning equipment at the Northeast Ohio CORE site, which will allow for "teleteaching" workshops for physician teachers in the CORE system.
An extensive administrative and educational infrastructure supports the CORE system. Each of the five regional CORE sites has an assistant dean who works closely with the hospital directors of medical education to provide educational support for students in the area.
But most of all, CORE is about the power of partnership, Ross-Lee says. In this age of rapid change and competition in the health care arena, she says the CORE stands tall as an example of what can be accomplished through shared resources, consistently held standards and a common vision.
"The CORE system is a giant leap forward in medical education," Ross-Lee says.
Nilanjana Bardhan is a journalism doctoral student and writer in OU-COM's Office of Communication. Gary Snyder, BSJ '86, is associate director of the office.
