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MEDICAL
EDUCATION
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design to be successful in medical school,” Dr. Peska said. “To get
into medical school, you don’t need the bachelor’s degree. You just
need the 90 credit hours.”
TCOM also agreed to waive the Medical College Admission Test
for Pathway students.
“We don’t want students to take the exam and fail because their
preparation is different, and we recognize and are fairly comfortable we have a lot of confidence in the rigor they will be facing at Midland
with the correlation with Scholastic Aptitude Test [SAT] scores,” Dr. College, and we know of no other program anywhere like this.”
Peska added. “Midland College doesn’t require either, but for this
program we ask students who want to enter to take the SAT so we
can predict how they will perform on standardized academic exams.”
Targeted Curriculum
To secure admission to the DO program, the premed students
must maintain a 3.5 grade point average — with no grades below a
B — in a prescribed curriculum that is heavy in math and science.
In the heart of oil engineering country, Midland College already
had a nationally recognized science program, says Margaret Wade,
dean of math, science, and kinesiology. In formulating what she de-
scribes as a targeted premedical curriculum, “we looked at very stan- care residency program to host the students once they graduate.
dard requirements for medical school,” which include the general
biology, anatomy, and organic chemistry courses. From there “we
pared down the first two years by giving students the option not to
take certain core courses [for an associate degree], like government
or history, and enabled them to take more science.”
A faculty member from Midland College’s biology department
spends about 10 hours a week identifying and recruiting students
to the program. “We want to look for students who’ve already
proven they know how to study, took rigorous courses in high
school, and can handle heavy loads. We won’t eliminate anyone, but
that’s our target audience,” Ms. Wade said, adding that the college
has a track record of identifying, mentoring, and transferring suc-
cessful engineering students to Texas Tech University to complete
their studies.
Dr. Peska acknowledges accelerated medical degrees — with
mixed success over the decades — are nothing new, and only time
will tell if the Pathway strategy works.
A September 2013 New England Journal of Medicine commen-
tary cautions that shortening medical education could mean short-
changing students and the public, but agreed that medical education
reforms are necessary. According to the article, in 1974, 33 medical
schools had three-year MD programs, most of which disappeared
until now as a growing number of schools across the country exper-
iment with the model. The University of Texas System, for instance,
is piloting a Transformation in Medical Education (TIME) initiative
that aims to better coordinate students’ transition from college to
medical school and shorten that total time in school by one to two
16 San Antonio Medicine • September 2016
years. The reasons for creating such programs decades ago were the
same that some schools put forth now: addressing predicted physi-
cian shortages. Nationally, the Association of American Medical Col-
leges predicts a shortfall of 90,000 physicians by 2025.
“You can get into some maturity issues when you accelerate too
quickly. But we know there have been [accelerated programs] that
do just fine, and that’s the reason accrediting bodies don’t require a
bachelor’s degree for entry into medical school, just a credit-hours
minimum,” Dr. Peska said. Nor is the program for everyone, “but
Keeping Close to home
Throughout the entire pipeline from undergraduate to medical
school, students leave their local community for only three years,
Dr. Peska explains. “We want to get them back into the community
as quickly as we can because we know the longer we take them out,
the more risk of them not coming back.”
UNTHSC also is working with the hospital to develop a primary
In addition to helping students save on education costs with a
shortened pathway, educators say the grant money provides some
enhancements to help meet community college students’ unique
needs and improve their likelihood of success. The funds primarily
support tuition scholarships, travel, stipends, and program coordi-
nation staff, in particular an advisor dedicated to coaching and en-
couraging the premed students when things get difficult.
Such support, combined with local recruitment and getting stu-
dents back to their community as quickly as possible, is key to solv-
ing some of the challenges Texas faces in getting physicians into rural
practice, Dr. Nash says.
From the get-go, rural students face several disadvantages just be-
cause they choose a particular educational pathway.
“The challenges are, like me, students don’t come from wealthy
families. Most of them have to work and pay their own way through
college, so they stay close to home. For a lot of them, that means
community college first, followed by a four-year university. And
that’s not necessarily the background most medical school admission
committees consider the strongest,” Dr. Nash said. Medical schools
also look for things like volunteer experience, “which is great. But it
takes a lot of time, and most of these kids work through school.”
That doesn’t mean their experience isn’t valuable, she says. But
another obstacle is convincing rural students that medical school is
an option in the first place.
“Nobody in my family was a doctor, and nobody from my school
had gone to medical school. I just remember since I was a little kid
wanting to be a doctor,” Dr. Nash said.