JANUARY / FEBRUARY 2003
HARVARD MACY INSTITUTE
A medical educator’s dilemma leads to innovation in Florida
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| Dr. Myra Hurt |
In his influential book The Innovator’s Dilemma, Harvard Business School professor Clayton Christensen argues that well established, industry-leading companies struggle to adapt their businesses to new technologies or business practices because they are wedded to proven methods for bringing about success. While big businesses focus on the needs of their current customers, the innovations that move industries forward are introduced to the market by upstarts who are unfettered by the burdens of tradition or the stifling expectations that accompany industry leadership. Dr. Myra Hurt, an alumnus of Harvard Macy Institute’s Physician Educators program, has been instrumental in helping just such an upstart bring about radical changes in medical education in the state of Florida.
The Florida State University College of Medicine was still a gleam in the eye of Hurt and other medical educators in Florida when she attended the summer 1999 session of the Physician Educators program, where Christensen spoke about the difficulty of effecting radical change in industries with long-standing traditions. Hurt, at the time the director of FSU’s one-year Program in Medical Sciences (PIMS), had been involved since 1998 with efforts to establish a new allopathic medical school. She calls hearing Christensen’s presentation one of the transforming events of her life.
"It was a real epiphany because I realized that we could make this happen. We had the ideal incubator for a non-traditional medical school because we weren’t restricted by the same things that prevent older medical schools from making radical curriculum changes,” said Hurt.
A chance to create new traditions
The key restriction that Hurt and others working to make the FSU medical
school a reality wanted to avoid was the financial burden that comes with
owning a teaching hospital, where medical educators often find themselves
struggling to prioritize student growth and instruction over the stresses
of hospital administration.
“At Florida State we aren’t handicapped by the past except in the sense that the faculty was trained in traditional medical schools,” said Hurt. “At a state university medical school that’s been around for a while, it’s almost impossible to do anything radical in terms of curriculum.”
In June of 2000, Florida State University became home to the first new medical school in nearly 20 years. 2001 saw the enrollment of the first class of FSU medical students that will not have to look to Gainesville to complete their education at the University of Florida. For thirty years, FSU had operated PIMS, which was affiliated and accredited through the University of Florida’s medical school. After the first year, those students were gone.
FSU’s non-traditional mission relies on a model that is fundamentally different from the community-based medical school, yet focuses on the health care community, and many of the more neglected consumer groups within that community, like no other school in the state. “Our students will be trained on the front lines,” said Hurt, who noted that clinical training will be completed in ambulatory settingsæincluding the physician’s clinics, HMOs, and chronic care facilities that serve elderly and minority communities as well as rural and underserved areas.
Currently, fewer than half of the 500 medical students who graduate annually from other medical schools in Florida remain in the state, primarily because the demand for medical education outpaces the supply of residency positions in the state’s teaching hospitals. Hurt and FSU are hoping to raise that percentage.
Moving forward
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| Hurt teaches a class in microbiology at FSU. |
`With the difficult work of building support for the medical school behind her, Hurt, who serves as associate dean of the college, is back in the classroom, teaching microbiology. She is scheduled to return to Boston in January to share with a new class of Macy physician educators her perspectives on the challenges of creating a new medical school. Today, Christensen’s hypothesis that “disruptive technologies”æoften introduced by the new kids on the blockæchallenge the forces of corporate culture that often prevent radical change applies to the achievements of Hurt and everyone who supported the creation of the FSU medical school. While other Florida medical schools continue to direct their curriculum toward serving the traditional consumer of medical services, FSU is poised to prepare a new generation of doctors to deliver medical care to the often underserved constituencies.
“My experience at the Harvard Macy Institute validated a lot of the ideas we were working on while trying to establish the new medical school,” said Hurt. Ultimately, making the argument for a new medical school in a state that already had three allopathic schools was, like the creation of any new business, a matter of dollars and sense. Like an upstart in another industry, such as telecommunications or manufacturing, FSU’s College of Medicine has made the case that it is bringing a fresh perspective to the market of medical education. “I just happened to be working in the trenches,” said Hurt. For now, as the first ever class of second-year FSU medical students casts an eye toward clinical training, it looks as if the first battle to bring innovation to medical education in Florida has been waged and won.
Copyright 2003 Harvard Medical International • http://hmiworld.org/
