Presidential Inaugural Address
Philadelphia College of Osteopathic Medicine
Presidential Inauguration of
Matthew Schure, Ph.D.
As the Seventh President
January 25, 2002
Chairman Lotman, Vice Chancellor Finkelstein, Mr. McGloin, Members of the Board of Trustees, Administrative Colleagues, Esteemed Faculty, Members of Clergy, Distinguished Alumni, Esteemed Students, and Honored Guests:
It is with a profound sense of honor that I stand before you this afternoon, privileged to have been officially installed as the seventh president of Philadelphia College of Osteopathic Medicine. Thank you so much for coming together on this winter afternoon to share one of the most important moments in an institutional and personal lifetime.
Having been blessed with the kind of life that keeps getting better as it goes along, nostalgia is seldom known to me. But today is a day where I wish I could plant my feet and stop time. For there are few occasions in a person's life that equal this, few times when so many of the wonderful people with whom one has walked life's journey collectively gather to show their love and support. This day means so much because all of the extraordinary families that have brought me meaning and fulfillment have come to share in its celebration.
Judy, my wife, and our children, Jared and Deborah, are here. They are shining lights. And unless they write the book, no one will ever know the level of sacrifice they have made so that I could do the work I do. Thank you for all you have given. I love you beyond description!
We are blessed by the presence today of our very special aunts, cousins and our many extraordinary lifelong friends. For us, they have been family, too, and more. The love you have all given us has meant more than words can ever articulate.
The New York Institute of Technology family is here in abundance. For thirty years, we taught and learned and grew up together. At one point in our collective history, we encountered unparalleled adversity. Then all of us -- trustees, administrators, faculty, always focusing on the needs of our students, came together to rebuild financial vitality and to forge Long Island's only Tier II institution of higher learning. We did great work. I am so happy to see you, and will always love you.
There are presidential colleagues present. We have worked together to promote higher education and to build consortial activities where the whole has far exceeded the sum of our individual parts. Yet equally important, you have always been available to discuss your own approaches to administrative challenges, and to offer support and guidance. I am grateful for the mentorship and friendship you have afforded me.
The osteopathic medical family is here. How fortunate I am to be connected to this amazing profession, the tenets of which – wholism, connection, interrelationship, have brought healing to multitudes and informed all the curricular offerings of the health sciences. Thank you for taking me in.
Representatives of the psychology, physician assistant and biomedical sciences communities are here. It is wonderful to see an interdisciplinary context for teaching and research thriving on the PCOM campus. Thank you for expanding our intellectual horizons.
Representatives of the City of Philadelphia are here. Thank you for the warmth and kindness with which you have welcomed me to a city that really does love you back.
Present and former recipients of PCOM's highest honors, the O.J. Snyder and Mason W. Pressly Memorial Medals are here. They are the physicians and students who have manifested extraordinary service to this College, the community, and the osteopathic profession. Though illness has precluded his presence, it is important to recognize today's O.J. Snyder award recipient, Dr. Joseph Pellettiere. He has twice received the New York State Osteopathic Medical Society Physician of the Year Award. As an active member and former director, chair and vice chair of the American Osteopathic Board of Family Physicians, Dr. Pellettiere has shaped the practice of family medicine. He has served as a member of PCOM's alumni board since 1975. Edward Armbruster, recipient of the 2002 Pressly Award, has been a researcher, emergency room volunteer, journal author, and PCOM student representative in a host of local and national venues. My thanks to all of the Snyder and Pressly award recipients for being persons I strive to emulate.
The Temple Sinai family is represented here this afternoon. For twenty years, we have prayed and studied the Old Testament. As much as you have taught me through our discussions and analysis of text, I have learned more by witnessing you manifest courage and grace as you have responded to both joy and adversity. You have always given generously of your time and your caring. You, too, are role models, inspirations. And when we have read the Gates of Prayer, we have sometimes reviewed the following passage, my favorite:
"Days pass and the years vanish,
And we walk sightless among miracles…
Help us to see, wherever we gaze,
That the bush burns unconsumed…
And we, clay touched by God,
Will reach out and exclaim in wonder:
How filled with awe is this place, and we did not know it..."1
And that brings me to my newest family, the Philadelphia College of Osteopathic Medicine. How filled with awe is this place.
I knew before I first set foot on campus that this was a College with a passion for academic quality. And that perception was validated by the laudatory feedback from two accreditation teams during my very first week.
But what I could not know until I got here is that the people who have comprised this over century old institution have given PCOM a soul. The sense of community is incomparable, the product of a multitude of caring acts: the power of touch, an integral part of its osteopathic medical heritage. Warm pretzels on a cold winter's day. Pumpkin carving contests. A sign-in board to say we're glad you're here. Blood drives, donation drives, charity walks, volunteerism. Smiles on the mall. Thank you for jobs well done. PCOM people are very special. Thank you for being who you are, and for asking me to join you.
For me, the most eloquent description of the soul of Philadelphia College of Osteopathic Medicine was spoken at an on-campus service, held in memoriam for Behrang Emami, a beloved student killed in a car accident days before. A friend of his family remarked that Behrang's passing had been so devastating that his parents had been unable to sleep without tranquilizers. Except on the day of his funeral. For on that day, the presence of so many caring students and other members of the PCOM community had brought sustenance. And because all this comes so naturally to PCOM, the long time members of its community are less likely to see as in any way unusual its spectacular loving spirit. How filled with awe is this place and we did not know it.
It is fitting that this inaugural should take place on Founders' Day, acknowledging the seeds of this great institution planted 103 years ago. The inaugural program summarizes a venerable history commenced by Oscar John Snyder and Mason W. Pressly, two students at the Minneapolis based Northern Institute of Osteopathy who chose Philadelphia as the future home of an osteopathic medical college. Snyder and Pressly started in two rooms in the Stephen Girard Building on South 12th Street, simultaneously accepting students and patients, and thereby establishing PCOM's rich clinical underpinnings. In 1900, one of PCOM's two graduates was a woman, foreshadowing the equal representation of women and men in today's PCOM classes. The College now counts over 7700 individuals among its graduates, women and men who have gone on to brighten the health prospects of untold numbers of patients. As in any long history, the College has had its difficult times, particularly the late 1980's contraction of its clinical faculty and the sale of its hospital some years later. Yet, under the leadership of Chairman Lotman and Vice Chancellor Finkelstein, the PCOM community marshaled its strength, rebuilt its campus, expanded its academic offerings, and went on to fulfill, at the highest level of excellence, this mission: "to provide programs of study to educate skilled professionals in health and science fields and competent and caring osteopathic physicians. The programs of study are built on the foundations of primary care and an orientation to the needs of the community and are guided by osteopathic tradition, concept, and practice. The College is committed to the advancement of knowledge and encouragement of intellectual growth through research and leadership, and to the advancement of the community through health promotion, education, and service."
During the last year, the PCOM community has come together to create the strategic plan for its future. Our community has articulated the following goals:
1)Enhance PCOM's image, marketing and recruitment
2)Enhance academic quality, faculty development, and scholarly activity
3)Expand the depth of clinical and basic science faculty
4)Create multiple new revenue streams
5)Change the organizational structure to maximize effectiveness
6)Expand facilities and enhance infrastructure
7)Enhance student services, and
8)Increase community service and outreach.
Strategies have been defined to achieve each of the goals, and, where needed, dollars, personnel, technology, and space are being assigned to assure their implementation. PCOM now has the foundation of a process to catalyze continuous planning and improvement, and there is no limit to what we can achieve for ourselves and for those we serve.
It is, therefore, fitting today that I share with you some of my visions for new undertakings in fulfillment of our teaching, research, and service missions:
1) PCOM will make a transition to competency-based outcome assessment and insure that every graduate possesses 100% of the competencies necessary for career success.
The last three decades have witnessed an increasing public mistrust of higher education fueled in part by failure of the university community to articulate the learning outcomes of all its graduates. For institutions that offer graduate education in health science professions, the public is asking: How do we know that graduates will be practitioners who will treat us competently, compassionately, and without error?
Happily, PCOM already has advanced outcomes-assessment paradigms in each of its academic programs, paradigms praised by external groups. But we can and will do more. My vision is a PCOM clinical assessment lab that is greatly expanded, and closely tied to each component of PCOM's clinically oriented curricular components. At the beginning of each curricular module, students will come to the clinical assessment lab for formative evaluation, receiving feedback on the clinical and interpersonal competencies that they already possess, and having delineated those competencies that will need to be acquired in the course of the instructional sequence. Following appropriate instruction, students will return to the assessment lab for summative evaluation. Only when all of the competencies stipulated by faculty are mastered will students be certified in that module. As a result, PCOM graduates will not be individuals whose test scores have fallen within the top standard deviations on normative assessment measures. They will be graduates who can do everything that faculty have defined as prerequisite to their success as practitioners.
2) PCOM will access cognitive science as it pursues curricular change.
Assessment alone will not insure total competency acquisition. PCOM already has vibrant, rigorous curricula, delivered by outstanding faculty. And those curricula are dynamic, continuously changing in response to an enhanced knowledge base and student feedback. Now cognitive science must also contribute to curriculum revision.
Health care delivery curricula are now often rooted in problem-based case presentations. But research by Papa, Aldrich, and Schumacher (1999)2 has shown that the diagnostic abilities brought to solve particular cases do not generalize to other cases. The good news is that those specific cases which are presented to students tend to be remembered and used. Hence, cognitive science dictates that clinical curriculum be comprised of a carefully selected set of problem-based cases, chosen by faculty to give our students all of the prerequisite knowledge and competence they require in their respective health professions. At each stage of their education, students can be asked to outline concept trees which contain disease states, etiology, presenting symptoms, alternate disease states with comparable symptoms, and treatment modalities. The key to this teaching is the encouragement of higher order thinking skills, so that competence is measured by the students' ability to make appropriate cross-connections between all components of the concept tree. (West, Pomeroy, Park, Gerstenberger, and Sandoval, 2000)3 Using cognitive science, PCOM will seize vast new opportunities for curricular enhancement and student achievement.
3) In a manner respectful of its founding heritage, PCOM will expand the breadth of its academic offerings, on campus, and at remote sites.
The interdisciplinary nature of PCOM's faculty affords significant opportunities to respond to evolving academic needs related to its core disciplines. Rooted in its department of psychology, PCOM has introduced a few months ago a new Master´s Degree program in Organizational Development and Leadership. Physician assistant and basic sciences faculties are defining a new Master´s degree program rooted in forensic studies. Members of our osteopathic medical faculty are designing two new programs. One focuses on neuromusculoskeletal science, and the other a continuing medical education program requested by physicians to learn about, and ultimately gain certification in, holistic medicine. Osteopathic diagnosis and treatment is a major component of this new endeavor.
Some of PCOM's existing academic programs take place off-campus. On-line and video-conferencing support already link students in Harrisburg and East Stroudsburg with those in Philadelphia, and students at off-campus rotations with on-campus instructional support. New PCOM offerings are anticipated in the Southern United States, Europe, and the Pacific Rim. It is my vision that PCOM take its place among our Nation's finest comprehensive health care universities.
4) PCOM will continue to build strategic partnerships with sister institutions to combine programmatic strengths.
The College is fortunate to already offer a joint D.O./M.B.A. track in concert with St. Joseph's University. The University of the Sciences in Philadelphia is our partner in a D.O./Ph.D. program in health policy, and in a linkage between its undergraduate and PCOM's graduate program in Physician Assistant Studies. Under an agreement signed last year with Penn State's Abington campus, gifted psychology students recommended by faculty can commence enrollment in PCOM's Master's degree program in Clinical Health Psychology at the conclusion of their junior year, and receive their baccalaureate degree upon successful completion of their first year's work in the Master's program. And, PCOM and Peirce College are engaging in discussions on several projects of mutual interest.
These strategic partnerships with sister institutions broaden opportunities for students while avoiding redundant investments for educational delivery. I am delighted that PCOM is embarking on new partnership with Pennsylvania's sister osteopathic medical college, the Lake Erie College of Osteopathic Medicine. Through this partnership, the two institutions will endeavor to develop common on-line modules for some key clinical rotations, and areas of common importance. We ultimately envision the strongest partnership ever forged between two independent osteopathic medical institutions.
In his Book of Facts published in 1979, Isaac Asimov suggested that everything then known would be only three percent of the knowledge base of 20294. If we extrapolate that prediction to today's time, 97% of everything known in the year 2052 will have been discovered between now and then. With knowledge exploding, no single academic institution can lay claim to expertise. Partnerships and alliances with other universities will become a PCOM norm.
5) Research: PCOM will greatly expand its contribution to the fund of knowledge, augmenting both its basic science and clinical research efforts.
PCOM has a proud history of research, and some of its current explorations, including the possibility of infectious underpinnings to diseases like Alzheimer's, could have profound implications. PCOM hopes to establish a Center of Excellence for Research on Diseases of the Aging, and might partner with such entities as the FRIDA foundation in the Center's establishment. Concurrently, PCOM will expand its own interdisciplinary research efforts. During the past weeks, for example, protocols have been established to explore the impact of psychotherapeutic and osteopathic manipulative medical interventions on individuals suffering from inflammatory bowel disease. PCOM's exploration of manipulative intervention on headache sufferers should also come to fruition shortly. And PCOM has received approval for a pilot study on the impact of osteopathic manipulative medical intervention on recovery rates and length of stay for acute heart attack patients.
A major step forward to osteopathic clinical research was taken in the establishment of a National Center for Osteopathic Research at the University of North Texas Health Sciences Center College of Osteopathic Medicine. Once appropriate protocols are established, PCOM researchers will link with the Center to add to the growing body of empirical validation for osteopathic manipulative interventions.
6) Service: PCOM will be a staunch advocate for national and local policies assuring wellness for all people.
A few months ago, I attended the poster sessions of medical students from Commonwealth Universities who had participated in the Bridging the Gaps program. These students were reporting on their experiences as they fanned out into underserved Pennsylvania communities to offer assistance. The stories they tell require that one sit up and take notice. I am still particularly struck by the narrative of a PCOM student who had endeavored to teach dental hygiene to seven- and eight-year old children who had never owned a toothbrush.
PCOM cannot stand outside the policy debates about initiatives to provide access to quality health care. December 27th's Wall Street Journal indicates that 39 million Americans, 18.1 million of whom work full time, currently carry no health insurance.5 We must work through appropriate advocacy channels on the State and National levels to assure some form of universal coverage.
PCOM's health care centers, located in underserved areas of our City and State, have witnessed first hand the impact of this access crisis. Our centers will never turn away a patient because of inability to pay, but the number of uninsured has skyrocketed in recent years. In order to respond to the needs of our patients, ever mindful of our educational mission, new treatment models will have to be developed. These models, reflecting nation wide practices, will need to focus on efficiency and effectiveness, and in so doing will embrace allied health practitioners to carry part of the delivery burden. I am delighted that psychological services are now being introduced into our centers, and look forward to the near term presence of physician assistants and physician assistant students to add to our response capability.
Concurrent with access blockades, the impact of physician practices has been eroded through a plethora of new regulations that have multiplied physician paperwork demands, and in Philadelphia through a tort system allowing jury awards which have spiraled malpractice costs. Through our advocacy organizations, we must work diligently for tort reform. Otherwise, we can expect to hear more about hospitals and physicians experiencing increased liability costs which this year (according to the Delaware Valley Healthcare Council) leapt from 23 to over 160 percent. Between 1997 and 2000, Southeastern Pennsylvania has witnessed a 20 percent reduction in the number of orthopedic surgeons, and a 15 percent reduction in the number of obstetrician/gynecologists. This outflow of needed physicians must be stopped, and now.
7) And lastly, PCOM will greatly broaden its community service through systematized relationships with vital community groups.
In mid-September, Governor Schweiker invited the Presidents of Philadelphia area colleges to a special meeting at which he shared his plans for the reform of the Philadelphia Public Schools. No matter what the perception of the school management schema, the facts underlying his press for school reform are an indictment: 57% of Philadelphia's school children fail standardized proficiency assessments in reading and math; 80% score less than proficient. "Only 13% of 11th graders are able to read local newspapers with 75% comprehension.6" Our society is only fifteen years away from a time when there will be three members of the workforce for every individual in retirement. When the social security system was founded, there were 16 workers and a much shorter life expectancy. If every one of those three workers is not highly educated and well compensated, the next generation of Americans will be the first in our history to face economic prospects much worse than their parents. And Philadelphia cannot be left without the highly educated individuals who must compete globally for economic growth and prosperity.
Individually, PCOM students and faculty have devoted much time and effort in the public schools. But now that a standard core curriculum is envisioned, the potential of the university community to make a difference is greater than ever. PCOM can offer psychological services, science curriculum and health care support along with contributions from its sister Philadelphia Universities. We can make a difference, and in the process develop bonds that will make students think about PCOM when they think about graduate education in the health sciences. Concurrently, PCOM will expand its faculty and student diversity agendas, so that our community has greater representation from all our Nation´s communities. And I hope that PCOM will reinstitute its osteopathic medical requirement for community service, because such service is one of two variables which predict medical students leaving school with the same deep sense of compassion with which they come. (Coulehan and Williams, 2001)7.
With the strong foundation forged by our history, and an unlimited future fueled by our energy and resolve, this institution will make an ever greater difference in the lives of those it touches. May we continue to experience great joy as we do our work, and may we gather on many Founders´ Days to reflect upon the outcomes of our efforts, and collectively exclaim: "How filled with awe is this place."
1. Gates of Prayer. The New Union Prayerbook. Weekdays, sabbaths, and festivals; services and prayers for synagogue and home. New York: Central Conference of American Rabbis; 1975: 373.
2. Papa FJ, Aldrich D, Schumacker RE. The effects of immediate online feedback upon diagnostic performance. Academic Medicine. 1999 October;74(10 Suppl):S16-8.
3.West DC, Pomeroy JR, Park JK, Gerstenberger EA, Sandoval J. Critical thinking in graduate medical education: A role for concept mapping assessment? JAMA. 2000 September 6; 6284(9):1105-10.
4.Asimov I. Isaac Asimov's book of facts. New York: Grosset and Dunlap, 1979.
5.The 39 million who musn't get sick. Wall Street Journal. 2001 December 27: A1
6.Schweiker, M. A proposal to transform the Philadelphia School District into a high-performance system of schools for the 21st Century. Presented to: Mayor John Street; October 31, 2001; Philadelphia, PA.
7. Coulehan J, Williams PC. Vanquishing virtue: the impact of medical education. Academic Medicine. 76(6):598-605, 2001.