Blog Post August 18, 2021 Regional Medical Campuses: A Partnership Opportunity for Medical Schools and Health Systems Authors Clay Tellers Mike De Castro As a means of addressing the expected physician shortage over the next decade in the US, a flurry of medical school expansion has occurred in the form of increased enrollment on existing campuses, the creation of new schools of medicine (SOMs), and the development of regional medical campuses (RMCs). RMCs have evolved beyond simply serving as a vehicle for institutions interested in expanded enrollment and may offer strategic advantages to SOMs and health systems looking to establish or deepen a partnership. Given the competitive academic and clinical landscapes these organizations face, medical schools and health systems would benefit from analyzing this model and determining if it is right for them. This blog post explores RMCs, including their characteristics and types, the rationale for SOMs and health systems to pursue such models, and the key considerations that must be explored by organizations interested in RMC development. RMC BackgroundRMCs, historically referred to as branch campuses, first appeared in the US after World War II, in conjunction with a wave of medical school expansion. This growth was driven by various factors, including: Recognition that the physician workforce was inadequate for the growing population. GI Bill that fueled college enrollment. Growth of science stimulated by the National Institutes of Health. Shift toward specialized practice.RMC development was gradual in the decades that followed. But since the mid‑2000s, when the Association of American Medical Colleges (AAMC) called on medical schools to increase first-year enrollment to address projected US physician shortages, the number of RMCs has grown rapidly. Today in the US, there are about 130 RMCs that deliver some or all of the medical school curriculum to students. The Liaison Committee on Medical Education (LCME) and the Commission on Osteopathic College Accreditation (COCA), the two accrediting bodies for medical education programs in the US granting the MD and DO degrees, respectively, offer unique but similar definitions of an RMC, as highlighted in table 1. Allopathic versus Osteopathic RMCsAllopathicOsteopathicDefinition An instructional site that is distinct from the central/administrative campus of the medical school and at which some students spend one or more complete curricular years A site that is geographically apart from the COM and is: Permanent in natureOffers courses in educational programs leading to a DO degree Has its own faculty and administrative bodyHas its own budgetary and hiring authority Accreditation Included in the accreditation process for the parent institution, from the LCME Included in the accreditation process for the parent institution, from the COCA Number of Medical Schools with at Least One RMC 514Total Number of RMCs 120+6The AAMC classification of RMCs encompasses four models, based on medical student class years on campus and a description of the type of education. Each model is highlighted in figure 1. Figure 1: RMC ModelsThe most popular of these models is the clinical model, with approximately 60% of RMCs having adopted this approach, followed by the combined model offering all four years of instruction, representing approximately 15% of the total, including all existing osteopathic RMCs. The Case for RMC DevelopmentFor SOMsIn response to the calls for more medical school matriculants, many SOMs chose to expand class sizes within their existing campuses and nearby facilities. However, physical space and other capacity and/or resource limitations have restricted some in their ability to grow. In such cases, an RMC affords an institution the capability to expand in an efficient and cost-effective manner. Various constraints to expansion in place notwithstanding, many SOMs have looked to RMCs as an opportunity to develop unique experiences for learners. While the traditional medical school is anchored by the AMC framework, most of the care in the US is delivered in community settings. As such, many RMCs are structured to focus on community-based clinical education across a variety of patient care settings and environments. Additionally, rural and longitudinal programs are focus areas for a number of campuses. These aspects, coupled with typically smaller class sizes compared to those at the primary campus, which may allow for a more personalized educational experience, are attractive to some and may serve as a notable differentiator for the SOM. Another outcome from RMC development is the broadening of the geographic presence and recognition of the SOM. Medical schools and teaching hospitals typically hold a high favorability rating with the general public; expanding brand recognition across a wider region through an RMC may benefit the SOM as a whole. For Health SystemsWhile most RMC development is driven by SOM expansion efforts, many hospitals and health systems have recognized the opportunities that RMCs represent and have explored this option. For many provider organizations, the initial interest in stand-alone SOM or RMC development is focused on securing or bolstering its physician workforce. An RMC opens the door to a more closely aligned pipeline of residents/fellows, many of whom may ultimately join the organization’s physician workforce and are already oriented to the health system’s culture and processes. RMCs can also have a beneficial impact on a health system’s culture. The presence of medical students and residents/fellows can promote an environment of inquiry, learning, and mentorship. In parallel, this reinforces a cycle whereby providers who are interested in academics are recruited and retained. With this comes the potential for clinical innovation and improved health outcomes due to increased participation in education and research. As discussed previously, medical schools and teaching hospitals are looked upon favorably among the general public. Many individuals recognize added value in receiving care from a teaching hospital. By partnering with an SOM to create an RMC, a health system can make strategic use of the academic brand while establishing the infrastructure needed to become a teaching hospital. This may serve as a means of differentiating the system in its market. Additionally, it opens the possibility for enhanced philanthropic and other funding opportunities that are associated with an SOM. How to Determine Whether RMC Development Is AppropriateWhile there are clear and tangible benefits for both SOMs and health systems in jointly developing an RMC, such a decision requires a great deal of deliberation. Medical schools and health systems need to conduct several key planning activities to determine whether RMC creation is the right idea: Evaluate current and anticipated medical student enrollees within the state, along with existing local and state provider supply, to understand the market need for an RMC.Articulate the institution’s reason for developing an RMC and how it aligns with the organization’s mission and vision.Assess the institution’s current position, ability, and readiness relative to various considerations (summarized in figure 2).FIGURE 2: RMC Development ConsiderationsRMCs represent a possible solution for both SOMs and health systems looking to address key needs across the academic and clinical missions. For organizations that determine that RMC development makes sense, a partnership may reduce the risk and financial and other resource requirements for a medical school and health system that pursue such an endeavor. SOMs and health systems should proceed in a thoughtful manner to decide whether an RMC is the best path forward and identify the right partner. A contemporary AMC needs a modern financial arrangement. Learn more about developing an arrangement for your AMC, and why you need it. Learn More Footnotes 1. L. Smith, “New Medical Schools in the United States: Forces of Change Past and Present” (Trans Am Clin Climatol Assoc., 120;2009; 227–238). 2. Annual LCME Medical School Questionnaire Part II, 2011–2012 through 2019–2020, https://www.aamc.org/data-reports/curriculum-reports/interactive-data/regional-campuses-us-medical-schools. 3. COCA, “Accreditation of Colleges of Osteopathic Medicine: COM New & Developing Accreditation Standards,” https://osteopathic.org/accreditation/standards. 4. AAMC, “Public Opinion Research: What Americans Are Saying about Medical Schools and Teaching Hospitals,” https://www.aamc.org/data-reports/faculty-institutions/report/public-opinion-research.