The 1990s have been very kind to Duke's School of Medicine.
Seventy-two years after its opening, Duke finds itself among the elite of U.S. medical schools and has every intention of remaining there. Rather than radical change, the path to the upper echelons in the past decade has largely been one of steady and determined growth and of plans for the future that embrace a similar dedication to existing strengths and developing technologies.
"We are quite pleased with our lofty national rankings," said Dr. Sandy Williams, dean of the School of Medicine. "We want to stay there. We have a sound strategic plan.... I would be shocked and surprised if we changed the fundamental nature of our curriculum in terms of unique experiences."
One facet of this strategic plan is a major initiative to incorporate computer technology in the classroom. "They're trying to change the curriculum to more computer-aided programs, simulation and that sort of thing," said Prithu Mettu, a second-year student in the School of Medicine. "The challenge is to try and integrate an evolving role for technologies." Mettu points to recent applications like Harvey, a computer-based, clinical simulator that gives students experience with finding symptoms and making diagnoses.
Russel Kaufman, vice dean for education and academic affairs, noted that technology is beginning to pervade nearly every aspect of medical instruction, from the development of e-mail as the accepted mode of communication to computer simulation in basic science instruction and the use of palm pilots as information databases. David Yoo, a doctoral candidate in the cancer biology program, said none of these technologies were used when he entered the school in 1993.
A great strength of the School of Medicine has been its intimate connection with the nationally-renowned Duke University Medical Center, and the center's recent growth into an expansive health care system partnered with area hospitals and clinics.
With this emphasis on patient care in the Medical Center, clinical research has been a major strength for the School of Medicine throughout the 1990s, and administrators are planning an ambitious increase of its role in education.
In comparison with the 1980s and before, the school is "more open, diverse and patient-oriented," said Dr. Ralph Snyderman, chancellor for health affairs and executive dean of the School of Medicine, who in 1991 officially instituted a mission for the school "to deliver to society the good that the academic cores have to show."
"We can't get so enamored with the technology that we lose the focus away from the patient-physician relationship because that's what got us here," said Snyderman, also CEO of Duke University Health System.
Experience with patient care settings has long been stressed within the School of Medicine. "There is definitely an emphasis on getting students familiar with a clinical setting," Yoo said.
Perhaps the school's defining characteristic is the great flexibility allowed to students by its unique curriculum.
After finishing basic science requirements in one year, compared with two at most other medical schools, Duke students gain experience with patient care their second year and are then given a variety of options for further study.
An increasing number of students are taking this time to pursue master's degrees in business, clinical research, public health and public policy. The boom in science-related technologies and the increasing bureaucracy within medicine during the 1990s has led many students to seek a profession, such as consultation, to fall back on, Yoo explained.
By emphasizing its unique strengths and remaining on the cutting-edge of research and technology, the School of Medicine aims to stay among the very best medical schools.
"We have excellent people. We have a strong plan for the future. I wouldn't bet against us," Williams said.
Jennifer Song and Matt Brumm contributed to this story.
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