REW: The Scranton Temple residency program, which operates an internal medicine residency that functions out of Mercy and Moses Taylor hospitals, had board members who are local entrepreneurs and who stimulated conversation on developing a medical school. The residency program started in 1977 and had trained 213 people in internal medicine – 110 of whom had practiced in the region. Some board members were impressed that we could have, and should have, done a great deal more to develop medical education in the region, in light of the impact of the residency program. At the same time, physicians here were quite concerned about medical manpower issues, particularly reactions to the medical malpractice and liability crisis. We felt that a defensive strategy was not going to be effective, and that we really needed some positive ways to deal with medical manpower. The real issue was that we couldn’t attract physicians here, and physicians developed this idea of renewal through education. We had the interest of business people in the community, the interest of physicians who were struggling to deal with the manpower issues, and the residency program having been a very effective way to renew medical manpower in the field of internal medicine. So we decided to try to address the issues through a bold initiative: developing a medical school.

REW: The consortium was responsible for doing a feasibility study and is now moving into the planning phase. Its members include several physicians and four hospital administrators – from Mercy Hospital, Moses Taylor Hospital, Community Medical Center and Wilkes Barre General Hospital – as well as Blue Cross of Northeastern Pennsylvania, and State Senator Bob Mellow.

REW: State Senator Bob Mellow helped us with a $700,000 state capital appropriation to conduct the feasibility study, which was commissioned in the winter of 2004 and completed this July. The feasibility study was conducted by looking at national and regional needs, and at recent start-up activities at medical schools in the United States – including those at Florida Central University and Florida Atlantic and recent efforts in Phoenix. It examined various options, including developing a campus with an existing medical school, looking at a new allopathic medical school, a new osteopathic medical school, and affiliating or becoming a part of a local university. After carefully examining the various choices, with the goals in mind of manpower renewal and economic impact on the community, it was decided that we would develop a freestanding, independent, allopathic medical school. It says that we need a medical school, that it would have profound impact on renewal of medical manpower in the region and in the country, and that it would also have a profound economic impact in the community. The demand is there. According to the Association of American Medical Colleges, about 54.5 percent of applicants to U.S. medical schools do not matriculate – are not accepted. In 2005 there were 1283 applicants to Pennsylvania medical schools, 675 of whom did not matriculate; 384 matriculated in state – which is 29.9 percent of the total – and 224 matriculated out of state.

REW: We have engaged a search firm to search for a dean, a firm to raise funds, and an architectural firm. We are looking at sites and beginning structural and curriculum plans. The target launch date for the school is August 2009.

REW: We need to raise about $100 million. We’re approaching the Commonwealth, health insurers, the community, philanthropic foundations. We’re confident, obviously, or we wouldn’t be proceeding. The Commonwealth has authorized $35 million for the project in the administration’s capital budget.

REW: We’ve talked about that, but there are no defined conclusions yet. We are clearly interested in local impact, no question about it. There is a maldistribution of medical education in Pennsylvania, and in the country. But there’s also a huge national need that calls for the graduation of at least 30 percent more medical students. And there’s probably an international need, in that 50 percent of first year residents – people who’ve just finished medical school – are not graduates of U.S. medical colleges. In essence, we are taking a scarce resource from underdeveloped countries. We have not completed our design of this medical school, but I think we have to be cognizant of the regional need we have, the state need that exists, the national need and the fact that there’s an international need. Physicians are attracted to practice around institutions of medical education. As I cited with my residency program, half of the graduates practiced in the region. There are good data on that. If you look at the distribution of physicians in Pennsylvania, they’re disproportionately higher around Philadelphia and Pittsburgh, where you have medical schools.

REW: We chose Scranton because people who are involved are from Scranton. If you look on a map of Pennsylvania, there are five medical schools in Philadelphia, one in Hershey, one in Pittsburgh, and one in Erie. It’s like an "L" from Erie to Philadelphia, and there’s this glaring lack of any medical schools in northeastern Pennsylvania. So, northeastern Pa. seemed like a very logical place, and the entrepreneurial and medical leadership came from Scranton. We’ve looked at 15 or 16 specific proposed locations, and the considerations that go in to that include: availability of adequate land for the startup and continued development of medical school, economic impact, convenience to sites where clinical training will take place – hospitals and outpatient facilities. We’ve really tossed that around a lot. We’re trying to come up with a specific site that will be eligible.

REW: We don’t want to run a hospital. We really want to be involved with as many hospitals as are important for the education of medical students. We’re talking about a distributed type of model, where students will learn in a number of institutions. Clearly the four institutions that are represented on the Medical Education Development Consortium’s board would be involved. We hope to expand that to other institutions in the region that haven’t yet been involved, and we also hope to see a lot of the medical education take place in ambulatory centers that are not necessarily institutionally-based. We have until 2011 to define the clinical training sites – because the first two years of medical schools are pre-clinical – but those are clearly things we’ll be talking about, and the dean we hope to hire by the spring will be involved. The opportunities for medical educators to relate to community needs are profound and I think that there are some great opportunities for this region.

REW: I haven’t given any thought to that.

REW: I don’t think there’s going to be a significant impact – given the number of applicants who don’t get into medical school and the number that come from Pennsylvania. We would be most interested in any opportunity for synergy. You don’t want to waste the time and energy on competitive types of strategies. There are all kinds of research opportunities that could be collaborative. For example, we send our residents down to Drexel for certain kinds of clinical training, where they have standardized patients and that kind of thing. I think there can be many types of collaborative studies, epidemiology studies. Scranton has a very stable population compared to larger cities, and that’s a good opportunity to look at epidemiology. I think there’s lots of reasons to think that this would be a positive addition rather than a threat.

REW: The regional reaction has been extremely positive. The four hospitals in our region support it and gave us $50,000 apiece to help us get started. I gave a talk at Moses Taylor Hospital to about 50 doctors that was very positively received. They are very worried about manpower renewal. It’s hard for a primary care doctor to get their patients in to be seen by a specialist. They’re overworked and tired. They’re looking forward to more physicians in the area and to the opportunity to refresh themselves by having students around and teaching them.

REW: Very significant. The projected business volume impact by 2015 of the proposed medical school is $71.3 million on the state and $45.6 million on the region. Business volume impact takes the form of expansion of existing businesses in multiple sectors of the economy – government, technology, service, etc. – and the creation of new businesses developed to meet the needs of the proposed medical college and related populations.

REW: There were one or two articles in the paper by physicians who thought it was overwhelming and who questioned how we could possibly pull this all together. Money is the big thing, but that’s about it. The hospitals are for it. The doctors are for it. The politicians are soundly behind it.