First for-profit med school nears approval

With Rocky Vista University College of Osteopathic Medicine in Parker, Colo., one step closer to becoming the only for-profit, accredited medical school in the United States, it is generating controversy in the medical community.

In August, the Commission on Osteopathic College Accreditation awarded the school provisional accreditation. Once fully accredited, it will join the ranks of 149 public and private medical schools in the U.S. All those institutions are nonprofits.

Critics say a for-profit school will be beholden to investors and will scrimp on educational mission. Supporters assert that Rocky Vista must meet the same accreditation standards of other osteopathic schools. They also say the school's educational outcomes will be the same as nonprofit schools.

"People are paying a lot of attention to this. There's been a lot of discussion, and there are some very vocal people against it," said Stephen C. Shannon, DO, MPH, president and CEO of the American Assn. of Colleges of Osteopathic Medicine.

The phrase "for-profit school" triggers a negative picture of a business making money from tuition while skimping on education, he said. Medical educators from DO and MD schools alike are watching to see if Rocky Vista transcends that image.

Dr. Shannon is betting on Rocky Vista's success, at least as an educational venture. "It remains to be seen if this is the beginning of a trend or not," Dr. Shannon said. "That's not beyond the realm of possibilities."

He said Rocky Vista represents a change in how osteopathic medical education is structured, not a change in curriculum, clinical training, research or focus on primary care.

"The key is to be sure that the development of any college of osteopathic medicine, like allopathic medicine, is following national standards and focusing on quality education that relates to the needs of our health care system," Dr. Shannon said.

Ronnie Martin, DO, RPh, dean and chief academic officer of Rocky Vista, said the school board's independence convinced him to join the staff.

He said the board is free to determine the school's mission and budget, without interference from the school's chancellor and chief investor, Coral Gables, Fla.-businessman Yife Tien, who is not on the board. Tien is involved in managing the American University of the Caribbean School of Medicine on Montserrat, according to the Rocky Vista Web site.

Dr. Martin said he was not given guidelines on what profits the school is expected to generate.

Neither Tien or Rocky Vista's public relations representative returned phone calls. But according to Dr. Martin, the school's auditing firm projected that there will be no return on the $100 million investment for the first two to three years. The firm predicts that it will take 17 years to break even.

George Mychaskiw II, DO, chief of anesthesia at the Blair E. Batson Children's Hospital in Jackson, Miss., said he does not believe that accreditation standards are enough to ensure that a school with private investors will give students a high-quality education.

Dr. Mychaskiw said he believes a for-profit school within the osteopathic profession's ranks erodes creditability. "This is a very unsavory situation," said Dr. Mychaskiw, who also is a professor at the University of Mississippi School of Medicine.

Richard A. Cooper, MD, a physician work force expert and senior fellow at the University of Pennsylvania's Leonard Davis Institute of Health Economics in Philadelphia, said the entry of a for-profit medical school is one of several factors muddying medical education's waters.

An increasing number of schools have moved away from the traditional model where students are immersed in an academic medical campus and culture in which there is a medical school and teaching hospital with clinical staff committed to education, patient care and research.

Instead, he said, new schools without ties to a neighboring tertiary hospital are shipping their students out for their third- and fourth-year clerkships to hospitals without strong teaching or research backgrounds.

"You learn a lot in medical school besides how to pass the exam [U.S. Medical Licensing Examination]," Dr. Cooper said. "You learn professionalism, leadership, responsibility. You are immersed in the experience."

It is a very special educational environment, he said, one that for-profit schools might not be able to capture.