State of the School 2019 - 2020

State

of the

School 2019 – 2020

Steven J. Scheinman, MD President and Dean, Geisinger Commonwealth School of Medicine Executive Vice President and Chief Academic Officer, Geisinger

Table of contents Introduction............................................................................................................ 2 MD curricular renewal........................................................................................... 5 Optimizing clinical learning venues.................................................................... 7 GME expansion...................................................................................................... 9 New graduate degrees......................................................................................... 10 Expanding educational partnerships and programming................................. 12 Diversifying the healthcare workforce .............................................................. 14 Alleviating student debt....................................................................................... 16 Community health equity..................................................................................... 18 Student, faculty, staff wellbeing.......................................................................... 20 Expanding alumni engagement.......................................................................... 22 Conclusion.............................................................................................................. 25

State

of the

School 2019 – 2020

Jan. 22, 2019 – This is our 10th year since students first arrived.

A milestone like this is an opportunity to reflect on all the school has accomplished. We have graduated 440 medical doctors who have done superbly well in the Match and in residency, and who are now starting to return to the region to practice. Our Master of Biomedical Sciences (MBS) program has grown in size and excellence, with many of those graduates in our medical school.

“ We will educate the healthcare workforce of the future, leveraging our unique strengths to be regionally engaged and nationally relevant.”

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Introduction This month we are entering our third year as Geisinger Commonwealth School of Medicine. Our integration with Geisinger has of course secured the future of our school — “in perpetuity!” — but it has also done much more than that. It is strengthening our ability to keep our alumni in our region to practice. It has changed our context and enabled us to expand our view of health sciences education to include care delivery and health insurance. As part of Geisinger, we now straddle three industries: healthcare, health insurance and education, each of which individually creates rich opportunities for research and innovation. Together, the merging of these arenas makes us distinctive. We no longer think of the school as an independent entity; it is the flagship of a larger enterprise we call “Education at Geisinger.” 1

The Context for Strategic Planning: Industry Integration & Value Creation Strategic Planning Working Themes – Community, Wellbeing & Innovation

Healthcare

Insurance Education at Geisinger

Workforce & Talent Development – A Systems Thinking Approach

Education & Research

Innovation – Partnerships and Adjacencies

Our integration with Geisinger has opened whole new opportunities for developing programs, enriching curriculum, expanding experiences for our students, starting new residencies and much more. Education at Geisinger encompasses a spectrum of education spanning medicine, nursing, pharmacy and graduate medical education, as well as a graduate school with the prospect it offers of non-clinician career paths.

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One thing integration has not done is to change our mission, which remains: . . . to educate aspiring physicians and scientists to serve society using a community-based, patient-centered, interprofessional and evidence-based model of education that is committed to inclusion, promotes discovery and uses innovative techniques.

We remain This Community’s Medical College, though our definition of “community” is now broader. Our students still learn in Scranton and Wilkes-Barre and Sayre and Honesdale and Hazleton and Danville and Doylestown and Lewisburg and Harrisburg — and later this year in Atlantic City, as well. And since

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our perspective on education now encompasses other health professions and residencies and fellowships, we can also say that we have learners in places such as Lewistown and Bloomsburg.

This spring, as we finalize our new three-year strategic plan, we will continue to be guided by this mission. And the planning process has also clarified our strategic intent, as expressed in our vision statement: We will educate the healthcare workforce of the future, leveraging our unique strengths to be regionally engaged and nationally relevant.

This intent is of course not new; its themes have always been ours but becoming Geisinger has given them strength and substance.

We will educate the healthcare workforce of the future2 – The future will see the best care delivered by teams, with doctors and pharmacists and nurses, and patient navigators and other professions we can’t yet envision, each playing important roles, and delivering care that is coordinated and not fragmented.

Leveraging our unique strengths – This includes our historic strength of relationship with the community, and Geisinger’s unique strengths in research and systems. We don’t want to create programs that merely mimic what others are already doing well; we will create new programs and paradigms that will make us regionally engaged and nationally relevant.

To achieve this vision, 10 strategic initiatives emerged from a strategic planning retreat this past summer. As I enumerate them you will see among them strategic priorities that we’ve been discussing and pursuing, and some that are already well underway. Each has a champion in leadership, whom I’ll identify. These initiatives all interrelate under the larger themes of community, wellbeing and innovation.

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MD curricular renewal Bill Iobst, MD, is leading this effort, which I discussed in last year’s State of the School address, and in fact has been a yearly strategic initiative since the integration with Geisinger. This will

William F. Iobst, MD

take several years to bring fully to fruition. The

Vice President for Academic &

goal will build upon our fundamental innovations

Clinical Affairs and Vice Dean for

in active learning, community engagement and

Medical Education

longitudinal experiences, and will incorporate a range of new content, including (quoting from last year’s address) “medical informatics, genomics, population health, health policy, the cost of care, social determinants, healthcare economics, patient experience, resilience, the humanities, healthcare quality and safety, health systems engineering, and leadership training. I challenge anyone to identify anything on this list that will not be necessary for the physician of the future, or any of these that medical schools cover adequately now.”

The curriculum should be designed to incorporate such themes integrally and not piecemeal. So the goal is a curriculum that is fully integrated horizontally — meaning that clinical and fundamental sciences are not separately compartmentalized within portions of the curriculum, but are seamlessly integrated across all four years — and vertically — meaning that content is integrated across multiple disciplines. I can envision developmentally appropriate clinical experiences beginning at the start of the first year, as is already happening at other schools. This could include structured community experiences, bringing the community engagement requirement more meaningfully into the curriculum and promoting service learning.

The faculty have just completed a comprehensive five-year curriculum review.

They worked together with Dr. Iobst on merging our two departments into a single Department of Medical Education. Thus, with the faculty we have assessed our curriculum critically and eliminated artificial educational silos, and we are bringing all faculty together into a single culture. And although as dean I am responsible for oversight and coordination of the curriculum, it is the faculty who develop and deliver it, so this is a true partnership.

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The critical goal of medical education is not merely conveying scientific knowledge.

It is to develop the professional identities of these future caregivers, which includes expertise and technical competency, of course, but more than that; it includes compassion, professional responsibility and a sense of moral responsibility for their shared ownership with the patient of health and wellbeing. Professional identity formation will be the compass for our new curriculum.

When the third leading cause of death in the United States is medical error, it is imperative that we incorporate quality and safety into the curriculum. Through its strategic planning process, Geisinger has added safety to its values of learning, innovation, kindness and excellence. For two years we have been working with the Patient Safety Movement Foundation, a national organization with the goal of achieving zero preventable medical errors. Peggy Shoemaker, MD, and I co-chair a task force of that foundation that has developed a patient safety curriculum for all health professionals. Last week at the Patient Safety Movement Foundation’s annual national summit in California I announced the launch of that new curriculum. It builds upon curricula developed by the Institute for Healthcare Improvement, the World Health Organization and others, but differs in that it is modular and adaptable to a range of health settings, the full range of health professions and the developmental spectrum, from novice learner to expert practitioner. You will be hearing throughout the coming year of our efforts to incorporate patient safety into the MD curriculum, but also into our graduate degrees, residency curricula, CME and continuing professional development in the clinical system.

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Optimizing clinical learning venues This established initiative is also overseen by Dr. Iobst. It includes the strategic goal, since becoming Geisinger, of giving our students experiences in high-functioning integrated care delivery systems.

We are embedding our students throughout Geisinger and are now at the point where our clinical learning venues are nearly all at Geisinger or Guthrie, another high-functioning system. Geisinger’s

commitment to education, coupled with my role as chief academic officer of the system, allows me to control access to Geisinger sites by all learners, ensuring that our medical students have priority and that the experience of all learners is of the highest quality. And our close relationship with Guthrie will be made secure by a long-term contract.

One of Dr. Iobst’s goals for this initiative is to optimize learning opportunities for our students at all sites and guarantee consistency and comparability. Expanding to places like Geisinger Holy Spirit and AtlantiCare, a member of Geisinger, serves this goal, as do the recent enhancements of our education space at Geisinger South Wilkes-Barre to give our South Campus students a home. We have no plans to expand our medical school class size beyond its current level of 110 students. We are simply investing to make sure our students have the best experience and access.

And we continue to value the teaching and mentoring that is still being done by many volunteer faculty members in the community.

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Optimizing learning venues also means creating spaces that enrich the student experiences beyond clinical spaces. Thus, this past year we have made improvements to the Medical Sciences Building in Scranton to enhance the student experience. Our lab and research space have been aligned with Geisinger’s focus on translational and “dry-lab” research. We have created an active recreation space on the west wing’s fourth floor, and are planning to accommodate a student suggestion for a meditation room. And this year we will begin renovations of the Manual Arts Building to create Halpin Hall.

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GME expansion We are eager to expand residency opportunities. If we are to serve our founders’ goal to address the physician workforce needs of this region, Michelle Thompson, MD

the most important thing we can do will be to develop residency programs here.

Associate Dean for Graduate

Michelle Thompson, MD, associate dean for

Medical Education and Designated

Graduate Medical Education (GME) is overseeing

Institutional Officer

an effort to launch a range of new residency programs. This has been guided by a value analysis of residency programs that we commissioned and was completed this year. A new family medicine residency opened at Geisinger Lewistown Hospital this year, and two new programs (Physical Medicine & Rehabilitation and Transitional) are set to open at Geisinger Bloomsburg Hospital this July.

We have supported The Wright Center’s new psychiatry residency, which this year will enter its third year. A new Addiction Medicine fellowship based at Geisinger Marworth has received ACGME accreditation. And we have an exciting opportunity to establish new programs based in the northeast by taking advantage of the federal designation of Geisinger Community Medical Center and Geisinger Wyoming Valley Medical Center as “rural” hospitals, which makes them eligible for new Medicare funding for the indirect costs of residencies.

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Dr. Thompson is leading efforts to develop several new residency programs based in Wilkes-Barre which, pending approvals, would open in July 2020.

Through all of Geisinger’s many residencies and fellowships, we will be working to expand curriculum around themes similar to our goals for the MD curriculum — from informatics to patient safety to resilience — to establish and strengthen a curricular continuum, and to enhance the reputation of programs through incorporation of unique curricular content.

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New graduate degrees The Graduate School team, led by Scott Koerwer, EdD, has implemented a highly successful redesign of the MBS Venard Scott Koerwer, EdD

program that more effectively serves the goals of the program — multiple paths to

Vice President for Strategy, Planning

success for careers in healthcare — and our

& Communication and Vice Dean for

students, and positions us well for expansion

Graduate Education

of degree offerings in which courses and content will be modular and can serve multiple degrees. The MBS class is now

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nearly 100 students in Scranton and Doylestown. Our second master’s degree, the Master of Professional Science, has just received approval from Middle States and will be ready for launch in the fall in partnership with our colleagues at the Doylestown Biotechnology Park.

“Leveraging our unique strengths” includes building new degree programs around biomedical informatics, genomic informatics and pharmacy system science. These are in varying stages of development in partnership with the University of the Sciences, a school in Philadelphia that many of you know well and that aligns closely with our strategic intentions.3 They will also be built in a modular way, including a core of fundamental content that is common to all Geisinger Commonwealth degrees. And the expertise that we enlist for such programs will also inform the new content we develop for the MD curriculum, residency and fellowship curricula, continuing professional development and programs in other health professions as they emerge.

Perhaps the most important feature of the new programs under development is the manner in which they will open new frontiers for education at Geisinger. Unlike medical education, graduate education doesn’t necessarily require physical space.

In fact, many successful graduate degree programs are delivered online. The new degree programs we are planning to launch will be multimodal in delivery, moving into cyberspace while also taking advantage of distinct learning settings such as the Doylestown Biotechnology Park or the Genomics Institute in Forty Fort or here in Scranton. The combination of these modes of delivery will provide access to a whole new marketplace of learners, in our region, coast to coast and someday globally.

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Expand educational partnerships and programming One reality we face in developing new programs is our very narrow bandwidth. We have gotten this far, and done this well, with a bare-bones team. Our ability to build new graduate degrees and other programs that contribute to the workforce will be greatly enhanced through strong partnerships with other educational institutions.

Dr. Koerwer has led a range of discussions to develop such partnerships.

One concrete manifestation of this was our incredibly successful “10,000 Meals” event in August. The event took an institutional priority of Geisinger’s — food insecurity, being addressed under its Springboard Healthy Scranton initiative — and joined it to educational priorities at Lackawanna College, Keystone College and the University of the Sciences. The result was a day that merged learning with real-world action. (And all of the event’s costs were supported by a generous donor from the community.) This event was just the beginning of an ongoing program. Students who took the lead on this first event are now brainstorming some very intriguing ideas, in partnership with Geisinger’s Fresh Food Farmacy®, for ways to translate education into effective action.

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Creating the healthcare teams of the future will also involve the Talent Management and Organizational Development teams at Geisinger, as well as other members of our education continuum who are developing — or working with partners to develop — programs that prepare learners for the careers of the future. With Geisinger’s nursing leadership we have spent a great deal of time meeting with all the nursing training programs in the region. Bloomsburg University is our largest nursing partner, and this year we have expanded from 120 to 140 the number of Bloomsburg nursing students we host at Geisinger Medical Center. In discussions with nursing partners, Dr. Koerwer has emphasized our eagerness to develop joint curricula themed around the care teams of the future, to create pathways and incentives for employment at Geisinger, and to acknowledge the value of Geisinger’s clinical venues while working on and learning about the healthcare challenges in our communities. I look forward to expanding these partnerships in the coming year.4 But workforce needs go well beyond physician and nurse staffing. Lackawanna College has a great track record in creating programs that offer career opportunities through certificate or associate-level degrees. With the hospitals in Scranton and Wilkes-Barre we have begun exploring such opportunities in healthcare. Other schools may join in this effort.5 We have been partnering with the University of the Sciences to help deliver our MBS program in Doylestown, where their faculty, with adjunct appointments at Geisinger Commonwealth, are teaching MBS classes. We look forward to deepening this collaboration to help us develop the new master’s degrees I just described. The University of the Sciences can also be a valuable partner as we generate the capacity to deliver curriculum content online.

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Diversify the healthcare workforce The Federal Health Resources Service Administration (HRSA) award Ida L. Castro, JD

that Ida Castro, JD, garnered last year provides $3.4 million over 4 years

Vice President for Community

to develop programs within a Center of

Engagement and Chief Diversity Officer

Excellence (COE) that will promote a more diverse healthcare workforce in the region.

Ours is the only HRSA-funded COE in Pennsylvania. This builds upon our established success in providing opportunity for underprivileged youth through the REACH-HEI program, but also goes beyond that. With the support of Jaewon Ryu, MD, JD, interim Geisinger president and CEO, a Health Equity Group of Geisinger physicians from underrepresented minorities (URM) has been established and now serve as mentors to our URM medical students. Geisinger’s Talent Management team is working with Dr. Castro to expand opportunities for careers other than physicians. These efforts will also entail partnerships with local colleges for training opportunities.

The REACH-HEI program continues its work to build a seamless pipeline for local students from disadvantaged backgrounds. Since 2011, 1,048 students have participated in REACH-HEI longitudinal programs. This year REACH-HEI added new programming, in addition to its existing middle school, high school and pre-matriculate programs. It sponsored the first Girls in Science symposium to promote interest among high school girls. In partnership with Lackawanna College, the Scranton School District, the Equal Employment Opportunity Commission and Geisinger Community Medical Center, REACH-HEI presented an Allied Health Program that allowed high school students to explore careers as assistants in occupational therapy, physical therapy, sonography, surgical technology, emergency medical services and prenursing. This is another program strongly supported by the community. During the Campaign for Scholarships and Innovation, REACH-HEI received over $470,000 of support from donors.

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Alleviate student debt I’m sure I don’t need to recite (again) the data showing that a higher percentage of our students graduate with debt, Anna Arvay, CPA, MBA

and that their debt is much higher than the already very high national figures. Our

Vice President for Finance &

CFO, Ann Arvay, leads this effort to alleviate

Administration and Chief Financial Officer

debt, which has been a priority since our founders created half-tuition scholarships for the entire charter class.

We have taken substantial steps on four fronts. First, we have significantly increased the amount we spend from operations for scholarships. We have more than tripled that amount since I arrived in the fall of 2012; in this budget year it amounts to nearly $2 million, and we are planning further increases in the coming years.

Second, for the past 3 years we have held tuition increases to 2 percent per year, below that of many other schools, and well below some of the large annual increases the school imposed in our early years.

Third, we have very successfully concluded our Campaign for Scholarships and Innovation. It was launched in October 2015 with an announced goal of $15 million, and closed 3 years later at $25.3 million, nearly $13 million of which was committed to scholarships. This included our largest scholarship gift ever, from the Northeast Pennsylvania Healthcare Foundation, which provided $3.2 million to support most of the tuition for all 4 years for 2 students in each of 10 successive classes. We remain deeply grateful to them and to all of our other generous donors.

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The fourth — and in many ways, most innovative — approach is our creation this year of the Abigail Geisinger Scholars Program, which will support full tuition in exchange for a commitment from the recipient to work at Geisinger upon completion of residency: one year of service for each year of support. The first cohort of 10 Abigail Scholars was selected from among current first- and second-year students.

Starting this year, at least 10 recipients will be selected from each incoming class.

This program will not only help address debt, but it also represents a substantial step on our mission to have our graduates return to the region to work.

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Community health equity It has been abundantly demonstrated that health outcomes are closely linked with socioeconomic status, and that this is a significant factor in the health challenges faced in this community.

Addressing these social determinants of health is important for education, by ensuring that our students understand the context of care, and for service, as it is our mission to serve the community.

Dr. Castro’s COE provides an approach to addressing health equity. The COE has worked with faculty members including Brian Piper, PhD, to design an initial Latino Health Needs Assessment. High school students participating in REACH-HEI, together with our medical students, conducted this survey throughout neighborhoods and community centers in Scranton’s south side. When completed and analyzed, the results will help inform Geisinger’s Springboard initiative and other partners addressing community needs.

Dr. Koerwer’s “10,000 Meals” initiative was also a concrete effort to address a major community challenge, food insecurity.

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Under the leadership of Leighton Huey, MD, and Terri Lacey, RN, our Behavioral Health Initiative continues to develop programs for the benefit of the community.

The Wright Center’s psychiatry residency, on which we partner, will welcome its third cohort of residents this summer. Our certificate program in behavioral health for primary care providers will go live this spring. Dr. Huey has worked with the faculty to develop a pain management curriculum in our MD program so that our students will graduate knowing how to manage pain without opioids. And he is working with community partners on an exciting program to address resilience. This is another program strongly supported by the community. During the campaign, we received over $3.5 million in support of BHI from external sources, including the Moses Taylor Foundation and others.

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Student, faculty, staff wellbeing Student, faculty and staff wellbeing is a critically important initiative. I am directing this one myself.

Steven J. Scheinman, MD

Over-stress and burnout is not limited to medical students; it is a reality at all

President and Dean, Geisinger

levels of higher education, and in our society

Commonwealth School of Medicine

in general. We know that it affects our faculty

Executive Vice President and Chief

and staff. This initiative will seek to address the

Academic Officer, Geisinger

fundamental basis of stress here.

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We have already taken a number of steps to promote wellness. These include actions that Staff Council has advocated for, including ending core hours at 4:30 p.m. and sending routine broadcasts in the morning rather than the evening. Mindfulness sessions are being planned and we expect yoga classes will be reestablished soon.

The new on-site Student Health Service through Geisinger CareWorks has been received enthusiastically by students. In response to a strong desire by students, we have created a full-time position for a student counselor. We are in the final round of interviewing finalists and expect the new counselor to be announced soon.

The team working with me on this initiative will consider the full range of issues related to wellness, from the work environment to professional opportunities to support resources, and also ensuring that resilience is addressed adequately in program curricula. The team will have broad representation; we welcome working with staff and faculty councils on this important issue.

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Expanding alumni engagement This initiative is led by our vice president for Institutional Advancement, Marise Garofalo. Two years Marise Garofalo

ago, we passed the milestone when we had more alumni than active students.

Vice President for

The sense of community within this school

Institutional Advancement

shared by staff and faculty creates a culture in which the students feel welcomed and supported. Since our charter class was graduated we have maintained contact with individual alumni, through former advisors and mentors and organized by an alumni relations committee chaired by Michael Ferraro, MD. This year we hosted our first alumni reunion. More than half of the charter Class of 2013 returned this fall for their 5-year reunion. Though alumni engagement is housed within Development, our interest in our alumni goes well beyond their support of the school. It is important to us to recruit them to return here to practice, which is the focus of Dr. Ferraro’s committee. We now have 10 of our alumni practicing in our region, with others actively interested in returning when they complete their residencies. And we have 10 of our graduates currently in residencies at Geisinger and another 10 training at either The Wright Center or Guthrie.

Engagement of our alumni includes offering them the opportunity to mentor our current students. We’ve been encouraging alumni to act as advisors to students as they decide on specialty and preparing for residency interviews, and we invite students to regional alumni get-togethers to make these contacts.

And when we became Geisinger, thousands of alumni of Geisinger residency programs over the years became, in a sense, the school’s alumni as well. Anthony Cernera, who until recently was our director of Alumni Relations, has now moved up within system development and, among other responsibilities, is responsible for relations with those thousands of Geisinger alumni.

While not called out by the strategic planning effort as a separate initiative, space planning is critical to being able to support and develop these initiatives. We all

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know that space is currently tight and we can’t accommodate all requests. But we are thrilled to know that we have the funding and are on track to begin construction this summer on the renovations to what we now call the Manual Arts Building, which will be named Halpin Hall in honor of the $5 million bequest from Mr. Jerry Halpin.

Halpin Hall will be devoted to student support services. These will include Student Affairs, Financial Aid, Admissions, the Bursar and Registrar, Student Health, the REACH-HEI pipeline programs and the Center of Excellence. It will be contiguous with this building through a bridge across the alley connecting with the Medical Sciences Building near the second-floor west elevators. Shifting those services to Halpin Hall will give them more space that is more functional and will free up space in the MSB for needed faculty and other functions.

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Halpin Hall is funded by Mr. Halpin’s gift, by the state RACP award that Governor Tom Wolf announced here in the fall, and by a $600,000 bequest from Gov. and Mrs. Scranton, as well as nearly $2 million from Geisinger itself. We continue to seek to identify funds to renovate the fourth floor of the west wing, which would create much-needed space for expanded classrooms and a student lounge. I am very grateful to Ann Arvay and her teams in Finance and Facilities and the members of the Space Planning Committee for their support of the planning and financing of the space, and of course to Marise and her team in Development.

Taking all of this in, it should be abundantly clear that this has been an eventful and productive year for this school and our students. Beyond the progress we have made in maturing the integration with Geisinger and in all of the achievements I’ve just outlined, it’s been significant for our planning process and identification of the initiatives that will define our path for the next three years. The teams will be working through the spring to finalize the strategic plan. And I will be updating you throughout the year on our progress with these initiatives, and surely other exciting developments as well.

I’ve listed a lot of accomplishments and an ambitious set of plans. So I want sincerely to thank all of you for your stalwart commitment to this these initiatives, this school and our students. Our school’s greatest asset is the support we see consistently from our staff, our faculty, our community — who brought our campaign to over $25 million! — and now from Geisinger.

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Conclusion I continue to be excited about our trajectory. As you’ve heard me say more than once, this is a very special place. As you’ve heard Dr. Koerwer say more than once, there is fun ahead! I am certainly continuing to have fun, and our goal is that you will as well. So buckle your seat belts as we continue on this trajectory to create the healthcare teams of the future, leveraging our unique strengths to be regionally engaged and nationally relevant.

Thank you.

1 Education at Geisinger includes all learners whether GCSOM delivers a traditional program, an online program or serves as host with collaborative partners.

2 From its core of medical education, education at Geisinger has grown to include an expanding Graduate School and graduate medical education, as well as continuing professional development and new educational partnerships.

3 Education at Geisinger encompasses programs delivered with academic partners.

4 Joint curricula are a good example of the expansive scope of education at Geisinger.

5 Educational partnerships with local institutions are an important component of education at Geisinger’s goal of building the healthcare teams of the future.

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570-504-7000 geisinger.edu/gcsom