Springboard - Tufts First MBS Class

By Jacqueline Mitchell

Since she was three years old, Alexis Leonard has loved to dance. The daughter of a physician and pediatric physical therapist, Leonard also knew she might want to be a doctor some day, so she completed her pre-med requirements as an undergraduate at Northwestern University. But as graduation approached, she put off applying to medical school to pursue her passion for dance. Leonard worked as a manager for one dance company and performed with another. But when a fellow dancer hurt his ankle, it was Leonard who took him to the hospital.

Sitting amid the hospital's hustle and bustle at age 22, she thought, "This is where I belong." It had been three years since she'd taken her last science course, but Leonard applied to medical school "not knowing much about the process." Exceeding her own expectations, she got wait-listed. That's when a Boston-based relative mentioned Tufts' M.S. in Biomedical Sciences Program (MBS). "I knew I had to do it," she says. "I had to find out if I was any good at this stuff, because my focus had been different at college. And I had to find out if I enjoyed it."

So in August 2007, Leonard was among the 53 members of Tufts' first MBS class. The one year degree program, with Alvar W. Gustafson as faculty director and Vivian Stephens-Hicks as course director, is one way Tufts intends to address the impending physician shortage, projected to hit around 2016 as babyboomer physicians retire just as that generation--still 79 million strong--enter their 70s.

Estimates vary, but the American Medical Association expects a shortage of at least 35,000 primary- care physicians by 2025, and the Association of American Medical Colleges has called for a 30 percent increase in medical school enrollment to meet the health-care demands of an aging, wealthy nation.

Increasing the number of medical students will require action on a few different fronts - from accrediting more medical schools to reducing student debt - but will also depend on having a large enough pool of qualified applicants. That's where the MBS program comes in. "Tufts has had a long legacy of leadership in medical education and curriculum innovation," says Gustafson. "We've built our program around this great tradition."

While Tufts' MBS program is certainly not the only post-baccalaureate premedical program, its size and intimacy make it unique. With 78 students in the 2008-09 class, the MBS program is less than half the size of the first-year medical school class, which averages around 170 students each year. That means more individual attention from professors in the classroom.

Beyond the classroom, each MBS student is assigned to a faculty advisor who serves as an "academic partner," says Stephens-Hicks. And MBS students have yet another resource in the faculty members who serve as thesis advisors. "The faculty really care," Leonard confirms. "They want you to excel. They want you to be exceptional first-year med students."

The MBS coursework mirrors the first year of medical school. If the first-years have human physiology in the morning, the MBS students have it in the afternoon, covering the same material and taught by the same professors. Occasionally, MBS students watch first-years' lectures from a neighboring classroom via video feed.

In addition to the seven first-year medical courses, including anatomy, pathology and clinical medicine, MBS students take two electives from Tufts' programs in biomedical sciences or public health. Tutoring and MCAT test preparation are available, though not required, and all students complete a thesis, based either on work done in the lab or at the library. MBS students also have the option to complete a second year of the program to obtain a master's in public health, either in epidemiology and biostatistics or health services management and policy.

So far, Leonard is fulfilling her own high hopes. After one year in the MBS program, she took the plunge and applied to medical school again. Now a first-year student at Tufts Medical School, Leonard says the MBS program far exceeded her expectations. "I thought MBS was intense, but nothing compares to the first year of med school. But I feel like I can handle it. I would be in a very different place without MBS."

In fact, Leonard continues to work with her MBS professor, Gerald J. Kochevar, a lecturer in pathology. She spends time in his lab every week doing cancer research. "It's been a nice bridge from the MBS program, and I certainly would not have had this experience incorporated into my medical education if it hadn't been for MBS," she says. Kochevar has influenced her in other, more informal ways, too; he got her involved in the Tufts President's Marathon Challenge. She plans to run the Boston Marathon, her first, this spring.

It was the promise of just this kind of faculty involvement that led Richard Koff to enroll in Tufts' MBS program. Koff, a biochemistry major, felt a little lost among UC-San Diego's 20,000 undergraduates. That's one reason he graduated still needing one course to apply to medical school. At Tufts, "the people I met during the admissions process were by far the most helpful and encouraging," he says.

Growing up with a mom with an autoimmune disorder, Koff had "been around doctors a lot," and in high school, he began to think about pursuing a career in science. In college, Koff did research in the psychology department. After graduating and working for a pharmaceutical company conducting enzyme assays on the blood of Alzheimer's patients, Koff realized he missed interacting with patients. "I began to think clinical medicine might be more my cup of tea," he says.

When he didn't get into medical school on his first try, Koff was accepted to post-baccalaureate programs at Boston University and Georgetown as well as Tufts' MBS program. He says he has thrived at Tufts, in part because of its "family feel" and because of the supportive faculty. Koff cites John Castellot, professor of anatomy, as a faculty member he really got to know, and Kochevar, who was Koff's academic advisor.

"He was open to meeting anyone at any time," says Koff. "Compared to my undergraduate experience, that's a huge difference." Now a firstyear medical student at Tufts thinking about going into internal medicine, Koff hesitates to call the first year of medical school easy, but he notes that "there's a lot less worry."

Administered by just four people-- Gustafson, Stephens-Hicks, program coordinator John Blust and administrative assistant Carol Avitable--the year-old MBS program has already recruited 16 of its alumni to tutor its current crop of would-be doctors. "We are blessed that our students come back for that direct, peer-to-peer mentoring," says Stevens- Hicks. "I am really delighted to offer more and more services to the students."

One innovation Stephens-Hicks is particularly proud of is the Tufts Community Assistance and Responsibility Experiences for Service (CARES) initiative. MBS students are strongly encouraged, but not required, to spend some time volunteering at local hospitals, health centers and shelters. The CARES program has made inroads with 15 sites in Boston, such as the Dana-Farber Cancer Institute and Rosie's Place, a shelter for homeless women.

"Being able to make a connection with the community and give back, medical schools look for that," says Stephens-Hicks. How do students fit volunteer work into their alreadypacked schedules? That's part of the lesson, too, says Stephens-Hicks, and one Koff took to heart. "Time management is the biggest key to excelling in some pretty difficult coursework," he says.

While the MBS program is still in the fledgling stage - and Gustafson and Stephens-Hicks and their colleagues continue to envision ways of adding more and better experiences for students' it has already proven a success by almost any measure. For one thing, the applicant pool has been larger than expected. The first year, MBS administrators were hoping for at least 30 students; they enrolled 53. Last year, they aimed for 75 and admitted 78. They received hundreds of applications each year, according to Stephens-Hicks, and will cap the class at 100 students.

Stephens-Hicks is "elated" to be associated with a program that gives people the chance to improve themselves and loves hearing about former students' accomplishments, including the 15 students who made it to medical school after just one year of MBS. In addition to the eight students now at Tufts University School of Medicine, MBS alumni are enrolled at Tulane University's School of Medicine, University of South Florida's College of Medicine, Creighton University's School of Medicine, the University of Arkansas College of Medicine and SUNY Downstate College of Medicine.

Now, as a first-year medical student at Tufts, the former dancer Leonard "thank[s] God every day" that she went through the program. If anything, the mood for her is lighter the second time around. "It's funny to be in lectures again - the professors tell all the same jokes," she reports. "But you can never hear the material too many times." TM