The School of Medicine was established in 1977. So, we’re reaching our 50-year anniversary in 2027. It opened after several attempts, as state universities require the approval of the state legislature and the community. Initially, there was some hesitation, as the state government and community were concerned about whether this would be a successful initiative, even though there was a substantial need for physicians in West Virginia.
The school began in trailers, which was a testament to the will and effort of the community. We started with a very small class—an embryonic beginning—but quickly began producing outstanding physicians. Within a few years, the school started expanding its class sizes and eventually reached the stage we’re at today.
Our mission has remained the same since the beginning: to train physicians who will contribute to the health care workforce of West Virginia and the surrounding states, but primarily West Virginia. The goal has been to serve this very rural state in both primary care and in specialties and subspecialties, providing a more comprehensive coverage of all health professions.
Over time, things have evolved. From trailers, we’ve moved into better facilities, and we hope that in the next three to five years, we’ll finally create what I like to call “the temple,”castle” or “palace.” That building will be a hub for medical education and community health. It will serve as the entry point for medical students, exposing them to primary clinical care while also hosting all student activities, scholarship efforts, innovation, research, service to the community and everything else that is needed to provide the optimal education for our students. That’s the vision we’re working toward.
I joined Marshall University and the School of Medicine a little over a year ago. The president of the university, Brad Smith, gave us a mandate to focus on health care initiatives and entrepreneurship in four major areas, or pillars, which we’re pursuing ambitiously.
The first is rural health care and primary care. We aim to tailor a precision medicine-oriented center of excellence that delivers outstanding care to rural and community settings, covering both primary and specialty care. This is an area in which we will be investing a lot of effort to go all the way. This is true to all the pillars or to all the centers of excellence all the way from anything that applies to translational science to implementation, from science through epidemiology, so really the whole continuum of care and innovation.
The second pillar is one that is of tremendous importance to all of us as nobody wants to age. The issues of gerontology and geriatrics are obviously of great importance to our community, as we have an aging population. What can we do to improve wellness in the community? What can we do to prevent accelerated aging, which is part and parcel of many of the chronic diseases that afflict modern society?
We see a reduction in fertility rates and the number of babies being born, and at the same time, people are living longer, but that doesn’t mean they live healthily. One of the important questions is: How do we keep an aging community well, productive and living a satisfactory life both during their work years, potentially delaying retirement, and after retirement, continuing to live without illness?
As you may know, one of the most costly elements of health care is the last year of life, which accounts for more than 20 percent of all costs throughout a lifetime. Anything we can do to reduce the burden of disease in those final years is going to be very important, both for community wellness and welfare, but also as a way to innovate and transmit those innovations to the rest of the world.
The third area of interest, one that particularly afflicts West Virginia, is obesity. We started a very ambitious set of goals to study obesity comprehensively, from genes and gene regulation to implementation science at the population level. Rural communities are especially affected by obesity, and you can see where the cross-pollination and cross-fertilization across these areas come into play. These are not isolated towers or topics; they are interconnected and relate to each other.
If you are obese, you are more likely to age faster and develop chronic diseases like cardiovascular disease, cancer, diabetes and others. This can lead to very accelerated aging and a poor quality of life as you manage and survive through these chronic conditions.
The fourth area of focus is substance use disorder or addiction sciences. Huntington, in 2017, was the subject of a Netflix documentary called Heroin(e). It’s a remarkable documentary created because Huntington, a small town of 50,000 people and home to our university, had gained the unfortunate reputation of being the overdose capital of the world. The opioid epidemic, which has affected the United States and particularly the Midwest, placed us at the epicenter.
In response, a group of physicians, health care providers, psychologists, community advocates, firefighters, police officers, the mayor and other city officials came together to launch what we now call the “City of Solutions.” Rather than succumb to pessimism, we united to combat the crisis head-on. It’s no surprise, then, that one of our key priorities is addiction sciences.
While we’ve made progress in curbing some of the problems associated with drug addiction, there’s still much work to do. We’re focused on developing systems that not only lead to better outcomes in our region but can also be replicated elsewhere to facilitate best practices. Along the way, we’ve accumulated quite a few success stories.
Parallel to these efforts, our priority remains to train medical students from West Virginia, although we’ve noticed that our geographic region acts as a magnet for students within 100 to 200 miles. These students are attracted to our medical school because it’s close to their families and offers excellent training in a solid university that focuses on the pillars I’ve mentioned.
Our medical school has grown steadily and now accepts about 90 students each year from 2,700 applicants—a very selective process. We prioritize those who align with our mission to serve the state’s health care needs. We’re accountable to the university’s Board of Governors and the state legislature, and the support we receive is tied to fulfilling our mission.
We look for students with an internal drive and a will to serve, both as health care providers and as examples to their communities during their four years of training. They need to be excellent students and outstanding individuals, with a deep understanding that medicine is a lifelong learning process. In medicine, you don’t learn everything in four years—you barely learn what to learn, what you need to know.
To prepare students for modern health care, we heavily invest in simulation-based training, bringing together multidisciplinary teams of physicians, nurses, psychologists, respiratory therapists, pharmacists and others. Medicine today is multidisciplinary and patient-centered. Decisions require input from the entire health care team, so we create opportunities for students to engage in this approach from day one.
In parallel with all this, we invest in clinical care and partner with the Marshall Health network, a large academic health center that serves as our base. This partnership is mutually beneficial: we provide health care to the community through our physicians and faculty, while the health care system offers locations and opportunities for our trainees—both medical students and those completing their specialties—to engage in a complex, hybrid health care system. This system encompasses rural, urban, semi-urban, primary, secondary, tertiary and quaternary care, enabling students and trainees to experience all facets of medicine before pursuing their professional careers.
Through this partnership, we also develop research initiatives, collaborating with the rest of the university and investing heavily in areas like basic research, genomic research and laboratory bench-based studies. These efforts extend to clinical trials, population science and other innovative projects, providing opportunities for students and trainees to engage in research and innovation. Good ideas often come from diverse directions, and fostering a sense of scholarship and academia is essential for our students’ success and for our physicians to gain recognition for their contributions to science.
To summarize, the integration of the university and its colleges plays a critical role in our operations. We are part of the Marshall Health network, and metaphorically, the School of Medicine is like a child carried by two parents: one being the Academic Health Center and the other the university. Together, they support the school, while the community and state serve as the playground for our activities. This collaboration creates a dynamic environment that ensures the successful training of individuals who will make us proud throughout their careers.
