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Medical school and Hospital District in serious lease talks

Top administrators from the Edward Via College of Osteopathic Medicine (VCOM) traveled to Vero Beach again on Nov. 29 to visit with medical students training at Cleveland Clinic Indian River Hospital, and to discuss terms of a long-term lease of a building and land with key personnel from the Indian River County Hospital District.

VCOM President and Provost Dr. Dixie Tooke-Rawlins and Senior Dean Dr. Matthew Cannon met with Hospital District Chair Marybeth Cunningham and Executive Director Frank Isele to address what had been a major sticking point in the negotiations – VCOM’s reticence to invest resources into building a new clinical campus of the medical school on leased property.

The state-of-the-art Medical Simulation Center VCOM aims to eventually build would cost millions of dollars, and the three-story building the Hospital District hopes to lease to VCOM is nearly 40 years old and would require major renovations and upgrades to serve as a medical training facility long-term.

After the Vero visit, and the 90-minute meeting with Hospital District officials, Tooke-Rawlins said, “We are developing an agreement with the hospital district for a lease that accounts for such improvements to be considered and with the option to purchase.”

The building, which for decades housed the Visiting Nurse Association offices, and the 5 acres on which it sits are prime real estate adjacent to Cleveland Clinic Indian River Hospital, so of course the Hospital District wants to make sure VCOM intends to operate a medical school in Vero for generations.

Cunningham said, based upon the latest round of talks after Thanksgiving, that she’s optimistic a deal can be negotiated that allays concerns on both sides and gives both VCOM and the Hospital District the assurances they need to move forward.

“A date to establish a VCOM medical school campus with Indian River State College and Cleveland Clinic has not been set. The responsible way to establish any new medical school begins with assuring the clinical education for the third and fourth years and the growth of the new residency programs,” Tooke-Rawlins said.

“The development of these programs is in progress and will use the facility. The clinical training positions and residency positions will help to determine the size of any new class.

If the growth of these are successful, we would hope to matriculate between 100 to 150 students in the first class,” Tooke-Rawlins added.

It’s a model VCOM has followed successfully, and learned from, over the past 20 years since opening its first medical school building in Blacksburg, Va. – a partnership with Virginia Tech – in 2003.

In 2008, VCOM was approached by the City of Spartanburg and Spartanburg Regional Hospital about opening a South Carolina Campus. The VCOM- Carolinas campus opened in 2011. Then in 2012, VCOM collaborated with Auburn University and the Auburn Research and Technology Foundation to open its Auburn campus, admitting its inaugural class of first-year students in 2015.

In 2017, VCOM began meeting with University of Louisiana officials about opening a medical school in Monroe, in northern Louisiana. Construction began on the University of Louisiana-Monroe campus in 2018 and the first-year medical students began classes in 2020.

Cunningham said she understands it could take eight to 10 years to lay all the groundwork needed to establish a four-year accredited medical school in Vero Beach.

She said the Hospital District could include language in the lease that, if after a reasonable amount of time, VCOM has not established a medical school on the property, or has decided against it, the land and building would revert back. That way the trustees and the taxpayer-owned asset would be protected. “They (VCOM) will need to let us know what that timeframe would be,” Cunningham said.

Tooke-Rawlins said VCOM needs to build the local residency program, and expand local opportunities for clinical rotations for third- and fourth-year medical students to train in Vero and in St. Lucie County, before branching out to accept first-year medical students.

VCOM is also working with Indian River State College to provide a way for students to better prepare for the rigors of medical school.

“We are also planning on seeking approvals by the appropriate educational and governmental accrediting bodies to work with Indian River State College to offer a Master of Arts in Biomedical Sciences (MABS) program on their campus that will provide additional education to help students or healthcare personnel who may not have all the requirements for medical school to enhance their qualifications to enter medical school or other healthcare and research programs,” Tooke-Rawlins said.

Through the MABS program, VCOM would set aside 10 interview slots per year for Indian River State College graduates who meet all the other entrance criteria for admission to medical school.

As it has done prior to opening its campuses in Spartanburg, S.C., Auburn, Ala., and Monroe, La., VCOM conducted a needs assessment for the Vero Beach area, as well as the Treasure Coast region and the entire state of Florida.

Since VCOM’s focus is training primary care physicians to work in rural communities, and in areas with a shortage of doctors who practice family medicine and pediatrics, the college’s team had to determine that VCOM’s mission was a good fit for Vero, and that the campus would attract the high-caliber students needed to sustain not only a medical school, but also the residency programs.

Each year, VCOM receives more than 9,000 applicants for 650 first-year medical student slots across the Virginia, South Carolina, Alabama and Louisiana campuses. More than 250 students from Florida are enrolled at one of VCOM’s campuses, the majority of whom attend classes in Alabama or South Carolina.

“As there are two medical schools opening in the state in the next three years, analyzing the needs and the resources has been a significant part of our research. These are also the reasons for us to move forward first with the clinical campus for the third- and fourth-year training and with residency development for the graduates,” Tooke-Rawlins said. “These are significant steps in assuring a quality education and for retaining graduates.

“The need for more physicians, especially in primary care, is evident. VCOM currently has between 40 and 50 students from Florida on our Carolinas and Auburn campuses who will return to the area for clinical training so we can begin to address the need now in the region,” she said.

The medical school’s website says 65 percent to 70 percent of VCOM graduates end up in primary care practice, which encompasses family medicine, internal medicine, pediatrics and obstetrics-gynecology.

When VCOM opens a new medical school campus, the students take an active role in the community, way beyond training in the local hospitals and clinics. At all four VCOM campuses, students participate in charitable events, fundraising 5K runs, food drives, fairs with free health screenings, flu and Covid booster shot clinics and breast cancer awareness events.

Medical students and staff attend training with local first responders and nurses, and VCOM students volunteer to provide first aid at school and community athletic events.

Student service days include serving the homeless, building Habitat for Humanity housing, assisting military families, and providing medical care to Hurricane Ida evacuees in shelters. The medical school hosts open house days and gives tours to civic groups and local residents.

Members of the Hospital District Board of Trustees want VCOM students and faculty to operate a primary care clinic on the ground floor of the leased building, possibly in partnership with Cleveland Clinic. Those details have yet to be worked out.

On a national level, each summer the college hosts the VCOM National Rural Medicine Conference, bringing rural physicians together for three days for on-site hands-on training or virtual training, as well as venues for highlighting research and best practices.

Internationally, VCOM students and faculty embark upon mission trips to provide medical care to people in remote villages and in developing countries. Last month, the Hispanic Community Medical Outreach student organizations collected donations, food and clothing for needy children in El Salvador and the Dominican Republic for Christmas.

VCOM is a private, nonprofit medical school that would not receive state funding, so at some point as the plans for a Vero campus become a reality, Vero Beach residents would have the chance to help purchase equipment or even to underwrite some of the needed building improvements.

“We have not started a capital campaign, but as we make definite plans for the future, we hope to receive such support. Naming opportunities for the simulation center, medical library or classrooms will exist in the current facility once we complete negotiations with the hospital district,” Tooke-Rawlins said.

“We wish to build out the facility to house the third- and fourth-year students and the medical residents for the next years. The simulation center could also support nursing, paramedic, and other allied health program education. So, while a capital campaign is not planned for the current phase of development, we will certainly announce this in future plans as progress moves forward.”

Ongoing negotiations with VCOM will likely be on the Hospital District Board of Trustees’ agenda next week when it convenes for its Chairman’s Meeting on Wednesday, followed by the monthly business meeting on Dec. 20.

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