Q&A: Dr. Stephen Spann, Founding Dean of the University of Houston College of Medicine

Dr. Stephen Spann is the Founding Dean of the University of Houston College of Medicine. Earlier this month, Texas Gov. Greg Abbott signed a bill into law that formally recognizes the new medical school, which is slated to welcome its first class of students in Fall 2020.

The University is launching the school with the goal to build the primary care workforce in Texas, along with other aspirations. Read more in the January 2018 University of Houston College of Medicine Report.

Spann joined State of Reform to check in on the significance of the recent legislative milestone and what’s in store for the college moving forward.

 

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Sara Gentzler: What does this formal recognition from the state via House Bill 826 signify, in the big picture of bringing the school to fruition?

Dr. Stephen Spann: Well, it means that the Legislature has recognized our medical school as a state university medical school. And it formalizes that in statute, so to speak.

It formalizes the fact that we will have access to formula funding through the Higher Education Coordinating Board. It does not commit any additional funds, but I think it may be of help to us, as we have requested a $20 million appropriation, this biennium, for the start-up costs of the medical school. That is in the House budget. And so, hopefully the fact that this was approved by both the House and the Senate will be a stimulus for the State Legislature to approve our appropriation request in the budget.

SG: With that step taken, and with the application in to the LCME, what’s the next step in planning?

SS: We’re very busy working on the granular curriculum. We have the curriculum planned in broad strokes, but now we have to get very specific curricular objectives, start developing learning materials — so that’s a lot of work.

We’ve been busy recruiting faculty. We’ve recruited a number of faculty, just a few more to go to meet our goal for faculty we want to have here by this summer. Then, we’ll start recruiting some additional faculty that will be on board by the following summer to help [with] the first class.

We’re also beginning to plan a permanent building. We have an architectural firm and a construction firm hired. So, the permanent medical education building is in the early stages of planning. That’s a lot of work, too.

SG: You mentioned recruiting faculty. The initial class of 30 students is slated to enter in Fall 2020, pending LCME accreditation. Do you know yet when recruiting would begin and what it would look like for that first class?

SS: By LCME rules, we cannot begin to recruit until we’re formally accredited.

Now, our accreditation process will take place through the Texas Medical and Dental [Schools] Application Service. So, we will have everything in place with them, so that when we get notice of accreditation we can trigger that process. That’s the way it’ll take place.

SG: And that would start when? This fall?

SS: It will start when we receive notice of accreditation. And we think that, probably, is unlikely to happen before next February.

SG: Obviously, there’s a lot going on — to bring it to the bigger picture: In 2014, Chancellor Khator said the new school would “not duplicate anything currently available in Houston, but…build upon it and focus entirely on community-based research and training.” There are some pretty specific goals, I know, as far as building the primary care workforce and serving these underserved areas. How do you see that vision playing out now, in the planning process?

SS: We’re very, very actively involved in trying to develop connections with communities, particularly those that have major health disparities.

The curriculum, at a high level, is already designed, and it will be very primary care focused. Every medical student will spend one half-day a week, for the four years of medical school, in a primary care setting — mostly in community-based, federally qualified health centers. So, we have a number of relationships established with local and federally qualified health centers, where students will do that half-day a week.

Part of the curriculum involves an experience we’re calling ‘household-centered care,’ where the students will be part of inter-professional student teams with nursing, pharmacy, social work students — maybe law students, maybe education students — a potential variety of students. And, each team will be assigned a family in an underserved community, a family that has complex medical and social problems. They’ll follow that family longitudinally, on a monthly basis, over the four years of medical school. They won’t necessarily provide health care for the family, but they will work with them to help coordinate their care, to help navigate the health care system, to teach them about health and healthy living, and so forth. We’re actively working on beginning to identify some communities and some families we’ll invite to do that.

Over the long term, we hope to partner with some of these communities to work together to improve health in a number of ways. We’re beginning to establish those community connections. I think our research will complement what the traditional medical schools are doing. Ours will be much less disease-focused and much more health and health care-focused, much less focused on discovering new molecules and genes and drugs, and much more focused on innovation in the way health care is delivered. We’re doing a lot of thinking about that.

SG: Is that in communication or in collaboration with the other medical schools in the area?

SS: We are in close communication with them. In fact, we have a collaborative agreement with Baylor College of Medicine and are actively talking with them about how we might partner together to improve health in Houston — to collaborate in both research and medical education.

We didn’t intend to be a threat to the other medical schools, but a complement to them. There are plenty of medical school applicants to go around. We’re not going to develop a big, private practice enterprise, and our research is medical and is, in many ways, going to [complement them.]

I think the chancellor was right: We’re going to add value to the great medical schools we already have in our area.

SG: In the end, how do you think you’ll measure success for the school in approaching all these goals?

SS: One important measure– but it’s going to take a while to be able to measure, I think — is to see some improvement in the health of some of these communities that have major health disparities. That takes time, that’s complicated. But we hope, over time, we will see improvement in health and the health care in our communities in the Houston area.

One measure of success is going to be whether or not half of our graduates enter primary care practice and what percent of those are practicing in underserved urban or rural areas. Those will be important measures.

SG: I’m guessing this is already in your plans, and it’s probably in the work plan, even, from last year. But, do you have pipelines in place to try to keep graduates in the community?

SS: Well, we’re working on pipelines to attract students from underserved areas and underserved populations. There are a number of federal and state programs that provide for loan forgiveness if students practice in underserved areas in primary care.

We also are working on developing scholarships. We have an anonymous donor that gave us enough money to provide full, four-year tuition and fee scholarships to our first class of 30 students, which is a great thing.

So yes, we’re thinking a lot about how to ensure that these students will want to practice primary care and want to practice in underserved areas. I think part of that is just to expose it to them in their training.

SG: And it sounds like that’s absolutely in place already. Those are the questions I had — is there anything else you’d like to talk about or share about the planning process?

SS: I think we’re making good progress, and we think that if all goes well this will make a difference in the health and health care of Houston and Texas, and that’s our goal.

This interview has been edited for length and clarity.