On vast acreage left vacant when the pharmaceutical Hoffman-La Roche pulled up stakes, Seton Hall University is building a new medical school in partnership with Hackensack University Medical Center. It will be the state’s fifth teaching hospital and the only private nonprofit one. And a pediatrician who’s expert in international epidemiology is its founding dean. NJTV News Anchor Mary Alice Williams recently asked Dr. Bonita Stanton whether its focus will be on basic research or clinical outreach or both.
Williams: Medical school certainly can’t be all things to all people. Is it going to be primarily a research hospital, primarily a clinical hospital? What is your vision?
Stanton: My vision is that in some ways it will be all things to all people and that’s because we’re going to make a big impact on the health care of the United States. We’re going to start with the impact on the health care people that are in New Jersey, that are in the area that we’re serving, and our students are going to understand that it is their responsibility to continually get new knowledge so that they’re able to improve the health of every person as they mature through their health care career. So we will be educators, we will be researchers and we will be giving top quality care.
Williams: What an opportunity you have to create a curriculum from the ground up. What is the most significant change you’re applying?
Stanton: The most significant change is going to be recognizing that we need to reach out to people who currently are not benefiting from the knowledge that we have in the United States. That it’s our responsibility to make sure that everyone in the United States, and in this case in New Jersey, is getting first-rate health care. So we’re going to be teaching our students a lot about, in addition to the biological causes of health and illness, the social determinants and we’re going to be utilizing everything that we have at our disposal including modern technology, how to reach out to these people and get them to be able to be partners.
Williams: To what extent can you get people, not just the under-served, but normal people who have health insurance, to get into the system and get routine exams?
Stanton: Again, so much of that is because we have made it difficult for them to access us. Instead of working on their schedules and their domain and their geography, instead of using technology to go into their household for things, they don’t have to come to us. And this is what we have to teach our physicians and their partners across the health care system, not just physicians, to be able to be thinking about what are alternatives that are going to allow people to access what we have to offer.
Williams: Let me ask some just medical school questions. I understand that you are no longer going to have gross anatomy even though they still have to take, what’s the other one everyone hates, organic chemistry. But really, you’re not cutting up cadavers any more?
Stanton: Well, that actually isn’t completely true and organic chemistry is the prerequisite to medical school. Anatomy, gross anatomy, it is probably true that we will not be having the full human body, the so-called cadaver, but we’re exploring whether or not we want to use total 3D or whether we will in some cases have some body parts and/or whether in the fourth year those persons who are going into a surgical specialty might want to do some work directly with a human body, with a cadaver.
Williams: You’ve been committed to making sure that socioeconomic status aren’t barriers, but how do you embed that into your training to students?
Stanton: You’d begin at the beginning in year one constantly returning them to the site where people live.
Williams: So you’re going to start clinical practice in year one until waiting until you’re a third year medical student?
Stanton: As many of the new medical schools and an increasing number of the established medical schools are doing, that’s exactly what we’ll do, yes. But we’ll also be framing it around what’s happening in those areas and what’s missing. If they’re no grocery stores in the area how do we expect them to be eating healthy and what can we do to work with local governments to get grocery stores, as an example.
Williams: There’s been a move towards what’s been called evidence-based health care which aims to keep people from spinning back through, cycling through hospitals and emergency departments. How do you embed that in a medial school curriculum?
Stanton: It’s a great question because what we need people to be doing is constantly updating themselves throughout their medical career to take the best knowledge. We need them to get used to the one hand relying on a solid base but constantly seeking new knowledge and applying the latest finding to it and that will come with training, that will come with the way we teach them which will no longer be lectures that they’re expected to memorize but rather there will be discussions and they will have to go out and find that information and bring it to an individual patient in situations.
Williams: You have almost unique experience as a physician both in a standard medical school, Wayne State, and in Bangladesh working for the World Health Organization in epidemiology, is that accurate?
Williams: How do you bring those two experiences together?
Stanton: My work in Bangladesh was in the communities in Dacca. I was delivering initially treatment through oral re-hydration solution to patients with diarrhea. That happened out in the community, in the slums, and that was a very moving experience for me and one that I realized when you’re out there, when you see what this disease is doing, when you see how limited their options are, that’s when you begin to be able to work with these communities to figure out how to come above it, how to make it happen. So that’s exactly what we do here. Now when I was in Baltimore, I worked in the housing developments in order to understand what they were up against in terms in that case a lot of it was HIV prevention, but other pediatric diseases. Communities are where disease and health happens. We have to get our students out into the communities.
Williams: Last question. If you had a magic wand, how would you change the health care system in America?
Stanton: I would try to get it that we have much more emphasis on primary and secondary prevention, that we continue to make advances in tertiary and quaternary care absolutely, but that we’re using the full spectrum of health care in which case we’re going to end up with an equalizing of our health outcomes by bringing the bottom up. Not by in any way undermining the excellent health care that we have in some areas.