A Diamond in the Midwest

Steady growth made IU School of Medicine the nation’s largest medical school, but an overhauled curriculum, metric-driven decisions, expanded student services, and new residency programs aim to make it among the best.

IU School of Medicine students participate in a white coat ceremony before starting their clinical years.

THE FIRST TIME Dean Hess met Paul Wallach, MD, the circumstances weren’t ideal. In early 2017, IU School of Medicine was gearing up for a stressful rite: reaccreditation. To have it renewed, the school would host a visit by officials from the Liaison Committee on Medical Education. To prepare, the school staged dry runs.

“We were struggling,” Hess said.

They were the latest in a series of growing pains Hess encountered early in his tenure. Previously, IU had scaled up enrollment by 30 percent to address a looming physician shortage in Indiana. Doing so meant increasing head counts at eight regional campuses and shifting them from teaching two years of basic science to a full four-year curriculum.

Under LCME guidelines, a medical school requires a uniform curriculum which must be deployed in a comparable way at schools with regional campuses—the opposite of IU’s system at the time. From their inception, most regional campuses operated with considerable independence. When the school adopted a new common curriculum, faculty who had long taught courses they created now used materials prepared by others and taught as part of a team.

“There was a small number of people who just couldn’t go along with it,” Hess recalled.
Meanwhile, the school had to sway potentially skeptical LCME officials that the school’s education was comparable across its nine campuses. Hess hired consultants. The process included a simulated or “mock” site visit. One member of the trio was Wallach, then-vice dean of academic affairs at the Medical College of Georgia.

Over several days, Wallach made a lasting impression on Hess. After the school’s credentials were renewed, Hess wooed him to Indianapolis. “It was clear to me Paul had this incredible knowledge base,” Hess said. “I worked to get Paul here so we would have someone of that caliber.”

 

Medical students work together during an anatomy lab at IU School of Medicine—West Lafayette, one of eight regional campuses that collectively saw enrollment jump by 40 percent in the past 10 years.

NOW, THOSE EARLY strains have proven to be worth the effort.

With more than 1,400 students (approximately 40 percent are based at regional campuses) IU remains the nation’s largest medical school. Each regional campus has carved out a distinct niche. Three of them have relocated to newly constructed facilities. And the school has made marked improvements in preparing graduates to excel once they leave IU behind and begin residency.

From his sixth-floor office at Fairbanks Hall, Wallach recalled the ambition he and Hess share. “When I was being recruited, we spoke about the development of a preeminent medical education program,” said Wallach, executive associate dean for educational affairs. “This was a place that could become absolutely spectacular.”

By the time Wallach arrived in 2018, enrollment was cresting, and the new curriculum had been rolled out. His task was to do more than keep it all humming. “It’s the biggest sandbox to play in,” he said.

The new curriculum streamlines a student’s first two years, shaving off several months and getting students to clerkships earlier. A series of brief courses were created to manage the three critical transitions in medical school: getting started, moving to the clinical years, getting ready to be a resident. Short intercessions impart skills in behavioral health, communications, and ethics.

By their fourth year, IU students focus on professional development, career exploration, and residency preparation. Outside of three advanced clerkships (emergency medicine, sub-internship, critical care), they load up on electives like bench research, and rotate among subspecialties across the state.

Along the way, faculty offered input that helped tweak the structure in ways that better prepare students and assess readiness. The context and environment in which education is delivered is important. The student affairs office helps create that positive environment and has expanded services to support student success.

The school also launched 17 scholarly concentrations across the state, drawing on each campus’s faculty, expertise, and character. The programs involve electives, a research project, and targeted mentoring. Unlike traditional certificates, there’s no added time or cost. Most students can complete the entire concentration prior to graduation.

“The concentrations allow a student to focus their education on topics such as health disparities and urban health care, rural health, biomedical engineering, or the business of health care. They also enable campuses to claim an area of excellence,” Wallach said.

 

The success of students matching into residency programs is a crucial indicator for school officials. In 2023, 99.7 percent of fourth-year students secured a slot.

ALMOST EVERY OBJECTIVE metric shows the plan is working.

Students scored above the national average on all exams given at the end of their clerkships. This spring, the Class of 2023 had a match rate of 99.7 percent, sending graduates to New York University, Johns Hopkins, Stanford, and Yale, to name a few. A survey of residency program directors found that almost 98 percent reported IU graduates were equal to or above the expected competency level.

To Wallach, it reflects that the school is upholding its duty.

“We don’t just teach medical knowledge for the sake of it,” he said. “The people who graduate from these programs are entrusted to care for me, you, our families, and our communities. There’s a sacred trust involved in educating doctors. It’s critical that our graduates are extremely capable.”

To make it easier for Hoosiers to access care, there’s not only a need to graduate more doctors but also to create more residency slots in Indiana. In the last five years, the School of Medicine has expanded residency slots at IU Health Arnett in Lafayette and partnered with four hospital systems to launch primary residencies in Evansville.

 

We don’t just teach medical knowledge for the sake of it,” he said. “The people who graduate from these programs are entrusted to care for me, you, our families, and our communities. There’s a sacred trust involved in educating doctors. It’s critical that our graduates are extremely capable.

Paul Wallach, MD

Executive Associate Dean for Educational Affairs and Institutional Improvement

The labs will focus on Alzheimer’s disease and related dementias, but researchers there will also seek answers for Parkinson’s and Huntington’s diseases, and ALS, also known as Lou Gehrig’s disease.

Part of the purpose of the new building is to provide much-needed research space for the School of Medicine, which has seen its National Institutes of Health research grants double in the last decade. Grants pay for research, but not the spaces where it’s done. And lab space is now at a premium, especially in neuroscience.

The Roberts gift is expected to support equipping lab space for 42 researchers, faculty and lab support spaces, precision tools for research, and specialty areas such as brain and tissue banks.

“We are so grateful for this generous gift from Dave and Susan,” said IU School of Medicine Dean Jay L. Hess, MD, PHD, MHSA. “Their support of our neuroscience research has been nothing short of extraordinary. This gift comes at a crucial time, giving us room to expand our work, attract new talent, and make important discoveries.”

The Roberts have previously supported brain imaging research and drug discovery projects, fellowships for young researchers, and a powerful PET-MRI scanner that’s one of a few of its kind in the world. They also funded the creation of a new faculty chair used to recruit Bruce Lamb, PhD, from the Cleveland Clinic.

 

 

Lamb—the Roberts Family Professor of Alzheimer’s Disease Research—is an internationally-recognized expert in Alzheimer’s disease research and Executive Director of the Stark Neurosciences Research Institute at IU.

Since his arrival in 2015, Lamb has come to know Dave and Susan well. He’s discussed with them where Alzheimer’s research is headed and has been impressed not only by their generosity but also their grasp of what he and others are trying to do.

“Dave and Susan have not only been tremendous partners in our work, but they’re also just good people,” Lamb said. “They ask great questions and they have a heartfelt interest in sparing future generations from the devastating effects of neurodegenerative disease. There is no question that their ongoing support has helped speed our efforts. We’re so thankful for their support.”

Dave had a lengthy career in business. And he’s sponsored, collected and driven race cars—so he appreciates the importance of going fast. But he also understands the years of work that go into building a strong business or a fast car. He says, when it comes to neurodegenerative diseases, he knows the returns on his investments could take years or even decades.

“Would we like to see something immediately? Of course. But we recognize that research is going to take a long time,” Dave said. “So, we recognize it is a long-term fight to get there, but we’re OK with that.”

Learn more about the new medical education and research building.

The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
Author

Matthew Harris

Matthew Harris is a communications specialist in the Office of Gift Development. Before joining the School of Medicine in 2015, he was a reporter at newspapers in Pennsylvania, Arkansas, and Louisiana. He currently lives in Indianapolis with his wife and two basset hounds.