A lot has happened at the Alabama College of Osteopathic Medicine since the school’s first students started classes in August 2013.
The school received full accreditation. It opened centers for research and team-based learning. A stand-alone four-unit simulation center also opened on the campus.
And those students who arrived in 2013 graduated in 2017. The school’s second class graduated earlier this year. The graduates from those two classes have started their residencies – the Alabama College of Osteopathic Medicine, or ACOM as its known, had a 100 percent residency placement for its first graduating class and a 98 percent residency placement for its 2018 class.
“That’s the real fruit,” said Dr. Craig Lenz, the school’s dean and senior vice president. “When you’re building the medical school, the biggest goal is getting to graduation and getting them out into residencies. That goal couldn’t be realized until May of 2017 – last year.”
Lenz arrived in Dothan in 2010 to open the new school created by the Houston County Health Care Authority, a volunteer board that governs Southeast Alabama Medical Center (which is to be rebranded as Southeast Health Oct. 1).
There was no building, no faculty and no students. But there was a need for primary care physicians throughout the state, and that need eventually led to the establishment of a college of osteopathic medicine in Dothan. And, of course, there were challenges recruiting both faculty and students.
“The first class accepted coming here and depositing before we’d even finished the building,” Lenz said.
Recruiting faculty and administration was a challenge since many weren’t familiar with Dothan, Lenz said. And, he said, there were plenty of naysayers who questioned how ACOM would attract qualified faculty to a new school. But, the school’s faculty today includes both PhD faculty and clinical faculty with MD and DO degrees and a range of medical experience.
Lenz said he knows faculty members took a risk coming to ACOM. There’s no tenure but the school gives contracts in three-year increments. And Lenz made a promise to the new faculty that the school would keep adapting to a rapidly changing medical world.
“I gave them a promise that we could change curriculum and innovate quickly,” Lenz said. “… They knew when they came here that they can work here as long as they want as long as they are accountable and fit in with our mission and vision of professionalism and innovation. We re-evaluate every course as soon as it’s finished and if there are changes to be made it’s changed by the next time it’s run within a year. Not many schools, whether medical schools or universities, can really accomplish that. So we’re small enough to be nimble innovators.”
And of course there was the challenge of making people understand how an osteopathic doctor, referred to as a DO, differs from a medical doctor, or MD (sometimes called allopathic medicine). Basically, osteopathic doctors use their hands as medical instruments through what is called Osteopathic Manipulative Treatment, which is performed for diagnosis and treatment for pain and other ailments. The goal is to improve nerve function and joint motion, promote blood flow, and increase diminished immune function. Otherwise, training for a DO is similar to that of an MD.
Students at ACOM spend their first two years in classroom settings. In the third and fourth years they go through medical rotations in behavioral medicine, internal medicine, general surgery, obstetrics and gynecology, pediatrics, family medicine and even hospice.
ACOM uses a community-based education approach for years three and four. ACOM uses 24 sites around Alabama and the Florida Panhandle where students go out into communities to work directly with physicians. Lenz said the students get a better clinical training experience and see a variety of patient cases, helping prepare medical students for their residencies after graduation.
“I’ve been a believer for a long time in community-based education for years three and four,” he said. “They are better off getting out into these communities.”
ACOM is a private, tuition-based college that does not receive state funding. While described as not-for-profit, the school has to make some profit to keep investing in programs, Lenz said. But, he thinks the school has used tuition dollars efficiently, matching them with grant money. The research center, for example, is a shared space with shared equipment rather than each research team having its own space and equipment – which saved more than $1 million.
There are ongoing challenges that ACOM and other medical colleges, whether osteopathic or allopathic, have to deal with. For example, the number of medical schools and students applying to those schools keeps climbing. Osteopathic colleges around the country have also opened more branch campuses around the country in recent years.
There are 34 colleges of osteopathic medicine accredited by the American Osteopathic Association’s Commission on Osteopathic College Accreditation. Those schools have 51 locations in 32 states. About six months after ACOM opened in Dothan, the Edward Via College of Osteopathic Medicine (VCOM) broke ground on a branch on the campus of Auburn University. Also, the Philadelphia College of Osteopathic Medicine, which has had a Georgia campus in Suwanee since 2009, plans to open a South Georgia campus in Moultrie in the fall of 2019, according to American Osteopathic Association’s website.
However, the number of residency programs around the country for medical school graduates has not kept up pace with the number of schools and students.
“The competition for residencies and the possibilities that people graduating won’t have a residency when they finish is probably the biggest challenge,” Lenz said.
ACOM has worked with hospitals, including Southeast Alabama Medical Center, to create residency programs. The medical center recently created a three-year internal medicine residency program with 13 resident physician slots.
ACOM is already doing admission interviews for the class that will start in 2019. The school received 4,000 applications for 162 slots and will interview 650 potential students. ACOM’s students come primarily from Florida and Alabama followed by Texas, California and Michigan although it is seeing more applicants from the Northeast.
Of the graduates from its first two classes, nearly 300 are in residency programs around the country while 32 entered residencies in Alabama. Twenty-five percent of ACOM’s graduates have gone into family practice. Sixty percent have gone into primary care – a category that actually includes family practice, general internal medicine and pediatrics.
With a 200-acre campus, ACOM has room to grow, but Lenz said how the college evolves will be up to its board of directors. The college’s vision has been to add other health science programs like those for physician’s assistants or physical therapists and become a health science university. Those additions would require regional accreditation through the Southern Association of Colleges and Schools.
Lenz said he’s proud of the milestones ACOM has reached, but the school has to stay focused on educating doctors and helping them develop the medical skills, professionalism and compassion to work out in the world.
“The ultimate mission and vision is for the benefit of the future patients and that they are going to be taken care of,” Lenz said. “And if you keep that in mind, it’s not that hard to maintain your standards and expectations for the students.”