Percentage of PLMEs in Med School declining

Thursday, September 18, 2008

With lingering questions among University officials over the Program in Liberal Medical Education’s rigor, the proportion of PLME students in the Alpert Medical School is trending downwards. Enrollment numbers indicate that while the current first-year Med School class is 68 percent PLME, as the Med School grows, that proportion could drop as much as 20 percentage points over the next four years.

Since 2006, each incoming PLME class has been capped at about 50 students. The program had previously aimed to matriculate 60 to 65 students, said Associate Dean of Medicine Julianne Ip ’75 MD’78. The undergraduate class of 2008 had as many as 67 PLME students, according to an e-mail Ip sent to The Herald, and those students compose about 68 percent of the current Med School freshman class. However, there are only 51 PLME students in the undergrad class of 2012, which will graduate medical school in 2016.

Meanwhile, because of a recent $100 million gift from the Warren Alpert Foundation, the Med School continues to expand. With a new medical building slated for completion in four years, the average Med School class size will probably rise from its current size of under 100 students to between 110 and 120 students, Associate Dean of Medicine Philip Gruppuso said.

PLME students would then compose less than half of the Med School’s class of 2016.The gradual decline in enrolled students was not entirely unexpected, Ip said, as the Med School has been taking a new direction for several years.

The enrollment statistics are approximate and do not account for factors like attrition or leave-taking, but they nonetheless indicate a downward trend in the proportion of PLMEs in the Med School.

The decision to decrease the size of PLME may date back to a 2004 Corporation meeting, Gruppuso said, when it decided to enlarge the Med School and its resources.

The Corporation decided at that time to try to raise the Med School’s profile. The changes that followed included establishing a standard route of admission for the Med School and reducing the size of the PLME class over time in order to give outside applicants greater access to the four-year program, according to Gruppuso.

Both of these modifications increased the number of people in the medical field connected to Brown, improving the school’s reputation as a medical institution rather than an extension of the undergraduate PLME program, Gruppuso said. In the past, “if you went around to other universities and said you were from Brown, people would say, ‘Gee, I didn’t know Brown had a medical school,'” Gruppuso said.

The Corporation’s desire to “promote (the Med School’s) visibility” was also shared by both University and Med School administrators, Gruppuso said. “The question of if PLME should continue was (first) raised” with the arrival of former Provost Robert Zimmer, he added.

“The Med School doesn’t certify its students like other medical schools,” Gruppuso said. There is no requirement for PLME students to take the MCATs, attain a certain GPA or fulfill certain requirements – such as a complete year of organic chemistry – that are necessary for admission to other medical schools.

Ip said this freedom is exactly what makes PLME so valuable. Students can “savor” the Brown undergraduate experience and there is “decreased stress and an emphasis on being a well-trained physician,” she added.

“From the minute (former Dean of Medicine and Biological Sciences Eli) Adashi and Dean Gruppuso came aboard … it was clear that there would be changes,” Ip said. Many of the tenets of PLME were called into question, she said, and ” ‘rigorous’ was a word that was thrown around a lot.”

Ip added that she thought the changes were motivated by concerns over the Med School’s ranking among medical schools by Wing, Adashi and President Ruth Simmons.

But improving the Med School’s reputation is not the only benefit of accepting more outside students, Gruppuso said. It “provided us with a chance to really diversify the student body,” he said, in a way PLME alone cannot, since almost all PLME students are about the same age and come from a similar undergrad experience.

PLME students had mixed feelings about the class size gradually being reduced. Mike Bohl ’11, a PLME student, said he had heard rumors that the program was going to be abolished entirely, which worried him. But he said he thought a smaller program might make it easier to focus on advising each individual student, building a stronger PLME community.

Emma Anselin ’11, also in PLME, said she appreciated the need for diversity at the Med School but wished students had been consulted more before adjusting the program. Making the decision without student input was “uncharacteristic of Brown,” Anselin added.

Ip said she shared those concerns. “The faculty and students have always had a phenomenally close relationship with the administration,” she said, and it would be a shame to see that connection erode.

Ip said she had not been consulted, though she has worked with PLME since its inception in 1985. “I would have liked to been able to dispel some of the anti-PLME sentiment,” she added.

Despite these concerns, Ip said she believes that the program is safe and will not face further reduction in size.

The Med School has reached a “stability point,” Gruppuso said. He added that Brown will retain its unique status as the only medical school having an “eight-year continuum program of this type.”

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