Lessons we learned in creating the Hackensack Meridian School of Medicine

A decade ago, at a backyard cookout, we kicked around the bold idea of starting a medical school, one that would change the way future physicians practice medicine. We realized that you can’t make all improvements necessary to remodel a flawed American healthcare system at the point of care. You have to instill a new way of learning with a far more expansive view of health and healthcare and teach future physicians to become lifelong learners.

Recently, we marked a major milestone on this momentous journey. The Hackensack Meridian School of Medicine received full accreditation by the Liaison Committee on Medical Education (LCME), capping a rigorous seven-year process that affirms the highest standards in the training of future physicians in the U.S. and Canada.

We have graduated two classes and sent residents to our network hospitals as well as other fine institutions including the Mayo Clinic and Mt. Sinai Health System. We have grown dramatically with 6,000 applicants for 160 slots in the most recent class. Our innovative curriculum has received national recognition and includes a three-year path to residency and a foundational focus on the social determinants of health. 

We would like to share a few lessons from this epic gamble which has surpassed our dreams and will continue to have a profound impact on future doctors, their patients and the healthcare system at large.

First, when you need to make sweeping changes, it’s often best to start from scratch. Our school is founded on the cornerstone of improving value in healthcare, of correcting inequalities and teaching in a new way that creates critical thinkers, lifelong learners and change agents for community advocacy with an innate understanding of the importance of the social determinants of health. These are the nonmedical issues like safe housing and access to healthy food that greatly impacts health. Our program has been prescient - emerging research tells us that social factors can determine up to 80 percent of a person’s health. Translation: our students are paying a lot more attention to what’s not in a medical record to tackle the tsunami of preventable chronic illness and premature death, especially in communities of color. This approach is front-burner and is driving new strategic priorities at all major health systems and transforming curricula at medical schools throughout the nation.

Second, embrace risk wholeheartedly. When we first had this conversation, it was clear that education certainly is not a core business for a health network. Does this kind of undertaking make any business sense? No. Why in the world would you take this kind of downside risk to build a new school of medicine? We asked ourselves how does this network define return on investment? How bold is it to define return on investment not in dollar terms but rather the yield from producing new physicians who will not only cure and comfort patients but will give society the gift of better health and healthcare. Would you take the risk of a huge financial commitment for this school? At Hackensack Meridian the answer was an unequivocal yes. Because taking this risk has had an enormous upside in making health and healthcare better through our graduates. 

Third, pick bold thinkers with endless passion to help translate your dream into reality. Our founding dean, the late Dr. Bonita Stanton had a great research portfolio, cut her research teeth in the slums of Dhaka, Bangladesh saving countless lives, and went on to lead a children’s hospital. At age 64, Dr. Stanton was willing to risk everything to become the founding dean. Her guiding principle was this: to ensure that each person in New Jersey, and eventually the U.S., regardless of race or socioeconomic status, will enjoy the highest levels of wellness in an economically and behaviorally sustainable fashion. 

Through Dr. Stanton’s extraordinary vision, we created the Human Dimension program, which connects students with patients in underserved communities to teach them the impact of non-medical issues. Our students have helped patients lose weight, quit smoking and find better and more affordable housing. This is how we deliver more value, improve outcomes and reduce gaps based on race and ethnicity.

In this long journey, one of us, a hospital administrator, has become the CEO of Hackensack Meridian Health. The other, a pediatrician, has become the Dean of this extraordinary school of medicine. As friends and colleagues, we are humbled to be part of this grand experiment that is helping us live our mission to transform healthcare and be the leader of positive change. It’s only fitting that we close with the words of another major risk taker - a student from our first class. Haley Johnson, M.D. is serving a residency in internal medicine at an HMH hospital,  Jersey Shore University Medical Center. “I strive to be a physician who takes the time to understand my patient’s perspective and someone that I would be comfortable with taking care of my loved ones.’’

Robert C. Garrett is CEO of Edison-based Hackensack Meridian Health, New Jersey’s largest health network with 18 hospitals, more than 500 patient care locations and the Hackensack Meridian School of Medicine.

Jeffrey R. Boscamp, MD, is president and dean of the Hackensack Meridian School of Medicine.

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