Strong one-health foundation at Midwestern

University well-versed at establishing professional health care programs
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The cool repose of the empty, unlit surgical suite belies the desert heat outside beating on the tinted windows at Midwestern University College of Veterinary Medicine. This training area will start getting more use this year as members of the inaugural third-year class return to Glendale, Arizona, to begin classes Aug. 29 and delve more deeply into their clinical education.

Midwestern may be new to veterinary medicine, but it has educated health care professionals for more than 100 years. With more than a dozen programs of study and about 6,400 students at its two campuses—the other located in Downers Grove, Illinois—the university focuses on one health and quality clinical education as well as community service.

Kathleen H. Goeppinger, PhD, president and CEO of Midwestern University, said, “Our mission is providing health care professionals at the master’s and doctoral level who meet the needs of society.

“Veterinary medicine, in my mind, was one of the professions that fits with our mission of health care. We have a chance to integrate our programs ... that will make us unique and successful.”

Tradition of excellence

Midwestern traces its history to the Chicago College of Osteopathic Medicine, founded in 1900. But its current iteration didn’t take form until Dr. Goeppinger came along.

She joined the university’s board of trustees in 1985, and a year later, the college moved from Hyde Park in Chicago to a newly purchased campus in the western suburbs. Following the relocation, the board voted to begin the development of new academic programs within the health sciences. This led to adding pharmacy and health science colleges by 1992 and a renaming to Midwestern in 1993.

Dr. Goeppinger became CEO in 1995, after a five-year stint as chairperson of Midwestern’s board of trustees, and led the university’s expansion into Arizona the following year. She came to Midwestern from Loyola University Chicago, where she received a doctorate in international policy and was a professor of industrial relations.

Commuting between Arizona and Illinois each week, she brings a business sense honed during a 19-year career at the department store chain Carson Pirie Scott (now Carson’s), where she rose through the ranks to become a vice president in charge of human resources, leaving in 1985.

Dr. Goeppinger is intimately involved in all levels of decision-making at the university. In fact, she and her late German Shorthaired Pointer, Rudy, assisted in deciding the layout and materials for the Companion Animal Clinic.

The 14 examination rooms can accommodate six people because Dr. Goeppinger disliked the tiny rooms at her veterinarian’s office, especially with Rudy weighing 100 pounds. In addition, she and Rudy walked on all the flooring on campus until they found two surfaces that Rudy never slipped on, even when the floor was wet. These flooring materials are now installed at the CAC.

There are no plans for a veterinary college at the Illinois location, Dr. Goeppinger said. On the other hand, the university is looking into a combined-degree program for veterinary students with other colleges. However, that likely won’t happen until the DVM-degree program receives full accreditation.

One health in action

Joint efforts among the veterinary program and other health profession programs at Midwestern have already begun on various levels. For instance, every first-year student on campus takes the interprofessional health care class. This teaches them the importance of working as a team with their colleagues in other professions, Dr. Goeppinger said. That kind of collaboration continues later on with community service efforts.

Madison Skelton performs surgery on a dog
Madison Skelton, a third-year student at Midwestern, performs surgery on a dog from a shelter during her second year. (Courtesy of Madison Skelton)

MWU’s Health Outreach through Medicine & Education Project has delivered medical care and preventive medicine education weekly at local homeless shelters since 1999. The program plans to expand that outreach by bringing in veterinary students to perform physical examinations on homeless people’s pets. In addition, the university annually participates in international mission trips through DOCARE International, a medical outreach organization. This year, Dr. Thomas K. Graves, dean of the veterinary college, and 89 others in the veterinary, optometry, dental, podiatry, osteopathic medicine, and pharmacy colleges traveled to Guatemala to provide health care to underserved populations.

As the veterinary college gets its research endeavors off the ground, one health will be a major focal point. A team of veterinarians, dentists, and pharmacists already is working on obtaining two one-health grants. Other interdisciplinary research has started as part of Midwestern’s Institute for Healthcare Innovation, which oversees clinical trials, translational research, and technology development related to human and veterinary drugs, biologics, devices, nutritional products, and diagnostics.

“Research needs to be an important part of the program. Like the clinics, it takes time to build,” said Dr. Brian Sidaway, associate dean for clinic operations. Veterinary faculty members are currently doing research on the human-animal bond and infectious diseases.

Hands-on learning

The curriculum, too, is a work in progress but is being guided by results from the North American Veterinary Medical Educational Consortium.

Kathleen H. Goeppinger, PhD
Kathleen H. Goeppinger, PhD, president and CEO of Midwestern University, says while the veterinary college tuition may be higher than at state universities, it is priced close to that of similar private universities and "provides a great product so students are investing in their own futures." (Courtesy of MWU CVM)

Spearheaded by the Association of American Veterinary Medical Colleges in 2010, NAVMEC looked at how to create next-generation veterinarians who can meet society’s changing needs. One of its goals is to “Graduate career-ready veterinarians who are proficient and have the confidence to use an agreed-upon set of core competencies.”

“That’s been our primary focus and vision: What skills are perceived as lacking and not developed by veterinary graduates, and how can we help to make those better?” Dr. Sidaway said. “The primary focus of the veterinary college is to attempt to produce grads who are highly employable, who have good day-one skills, so they are not only competent to perform medicine and surgery and communicate but also to be confident in those skills.”

The simulation laboratory in the Companion Animal Clinic has students interact with standardized clients every quarter. They will do this 27 times in their first three years, so by the time students go into clinical rotations, “they’ve got a wealth of knowledge behind them already and can communicate their findings to an owner, talk to them about the financial aspect of treatment, and in a difficult situation, they will know how to discuss euthanasia,” Dr. Sidaway said.

As far as clinical skills, first-year students’ first week involves a CPR laboratory, and within the first month, they are performing physical examinations on live animals. Further, they participate in case discussions to model the way clinicians work through a case to arrive at a diagnosis.

The Companion Animal Clinic
The Companion Animal Clinic became a 24-hour facility earlier this year. The American Animal Hospital Association–accredited clinic has a large primary care component but also offers specialty services, including dentistry. In fact, general practice and surgery are conducted in the same area of the hospital. (Photos by Malinda Larkin)
The Equine and Bovine Center
The Equine and Bovine Center’s indoor stalls, to be used when the temperatures rise in the summer, were recently finished. Veterinary students have a number of laboratories during which they palpate, for example, haptic models and live cows.

 

Second-year students have a principles of surgery class with a laboratory component before performing recovery surgeries in the second quarter of the year. Working in groups of three, each student will be involved with 24 spays and neuters on shelter animals, each performing the procedure eight times while faculty members monitor and provide immediate feedback.

The students are responsible for everything from the physical examination to postoperative care and discharge.

“Students get training that not many other places do not only as far as scope and number of surgeries and how early in program but also with community service. This is at no cost to shelters, and they’re sent out for adoptions,” Dr. Sidaway said.

Third-year students start clinical rotations in March. In their fourth year, students spend eight months in core rotations on campus in either the small or large animal track. Six of those months are dedicated to primary care, the other two months to pathology and emergency medicine.

The CAC, which sees around 600 patients a month, includes specialty services of emergency and critical care, internal medicine, surgery (orthopedic and soft tissue), and anesthesia—with the hope to add more as other faculty come on board. The pharmacy suite opened in July; oncology and rehabilitation services staff just began seeing patients this summer.

The Equine and Bovine Center, the other part of Midwestern’s Animal Health Institute, has an ambulatory service that is now operational but is still building its caseload, which consists of about 100 animals, mostly small ruminants and horses. In addition, the Diagnostic Pathology Center recently opened and has a growing caseload of necropsies to perform and surgical biopsies to examine.

A mobile unit for shelter medicine work has been in place for about a year and will be an integral part of the college’s shelter medicine rotation. For now, students can go with the faculty during weekends and breaks to assist with clinics held on local Native American reservations and in underserved urban areas.

Making their own way

Madison Skelton, a third-year veterinary student at Midwestern, has participated in some of the mobile clinic’s community service events. She traveled to the Chemehuevi Indian Reservation in Lake Havasu, California, where the team performed nearly 30 spay-neuter surgeries and vaccinated more than 50 dogs and cats.

“It was a very interesting experience, very high pressure. You’re in a small cabin of a trailer with nine other colleagues, two doctors, and one technician. It can get very claustrophobic, but I probably learned the most,” Skelton said.

She has enjoyed the hands-on experience in classroom and clinic, too. On their days off, first- and second-year students can shadow doctors at the CAC in primary care, internal medicine, oncology, and ophthalmology. Skelton also worked at the Equine and Bovine Center this summer.

She’s one of 24 in her class from Arizona. Her desire to stay in-state helped sway her to choose Midwestern even before she heard back from the other three veterinary colleges she applied to.

Students received financial counseling from the university even before stepping on campus and afterward. Plus, topics such as personal finance and debt management and practice and personal business issues are addressed in the curriculum. That helps, as Midwestern’s veterinary tuition and fees—at $57,085 for this academic year—are the highest among U.S. veterinary colleges except for Colorado State University’s out-of-state tuition. That’s not to mention, Midwestern’s tuition increases annually between 4 and 7 percent, but Skelton said the university was upfront about the costs from the beginning.

The 24-year-old wants to enlist in the Army Veterinary Corps after graduation. And within five years out of school, she’d like to buy a mixed animal practice while continuing to work with local Native Americans and their animals. Ideally, she’d relocate to her hometown of Queen Creek, where she says there is one veterinarian who responds to farm calls within 100 miles of the area.

Skelton says she checks the market for veterinary practices in the state to see what clinics are for sale, what they are grossing annually, what they’re selling for on the market, and the percentage of market share. Of the veterinary situation in Arizona, she says the cities are mostly taken care of, but the rural areas are seeing more and more doctors retire.

Students such as Skelton—and Midwestern—are ready to help guide the future of the profession.

Related JAVMA content:

Midwestern closer to accreditation (July 1, 2013)

Midwestern appoints Sidaway as first dean (March 1, 2013)

3 universities interested in veterinary programs (July 1, 2011)