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Starting from scratch

Yale Medicine Magazine, 2017 - Spring


Long before “patient-centered care” was common parlance in the medical profession, Bonita Stanton, M.D. ’76, was practicing it in the slums of Dhaka, Bangladesh. A staff scientist and director of the urban volunteer program at the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) in the 1980s, Stanton organized poor, mostly illiterate village women as research assistants in a case-control study that led to significant reductions in diarrhea among village children.

“It didn’t take much to realize that I couldn’t design the study,” said Stanton. “The women had to help me because I didn’t know anything about their culture and their circumstances.” So Stanton put them on her team.

Throughout her career, Stanton has relied on teamwork to face challenges outside her comfort zone. When she returned from Bangladesh in the late 1980s at the height of the rise of the HIV epidemic, she harnessed the expertise of inner-city Baltimore youth and recreation center directors to devise a program for preventing risky sexual behaviors. She brings that collaborative spirit to her latest endeavor as founding dean of Seton Hall University-Hackensack Meridian School of Medicine, the first private medical school in New Jersey, which is set to open in the summer of 2018.

“It really matters to be able to collect the right people in your cabinet,” Stanton said of starting a medical school from scratch. The pediatrician and infectious disease specialist has hired most of her cabinet, and department chairs have also been appointed. Leadership of the fledgling medical school is now hiring faculty members to add to the many who will come from within Seton Hall University and Hackensack Meridian Health, an integrated health care system in New Jersey.

The 55 students of the new school’s inaugural class will study in the research facility that once housed Swiss pharmaceutical company Hoffmann-La Roche. The six-story building that straddles the New Jersey town of Nutley and the city of Clifton is already steeped in medical history—Valium and interferon were discovered there.

The curriculum, which will prepare future doctors to pursue any medical specialty, is currently a work in progress. Stanton’s cabinet and about 150 Seton Hall faculty members, including basic scientists, physician and non-physician health care professionals, lawyers, social workers, and communications experts, are developing a course of study that reflects the school’s vision: “Each person in New Jersey, and in the U.S., regardless of race or socioeconomic status, will enjoy the highest levels of wellness in an economically and behaviorally sustainable fashion.”

The vision embodies the values of Stanton’s career, which she has spent combating health disparities and caring for the disenfranchised. Stanton has taken adaptations of the HIV prevention program she created in Baltimore to China, Namibia, and Vietnam, among other countries in Africa and Asia. Concurrent with her position at icddr,b, she was a maternal and child health specialist at the World Bank.

“It’s all about servant leadership: serving people and working together to find the best way to serve,” she said. “That belief is at Seton Hall University’s core, and it really aligns with how I see medicine as well.”

To realize the school’s vision of equal access to care for all at a reasonable cost, Stanton again points to the importance of teams. The new medical school’s curriculum will emphasize collaborative learning and collaborative care—the College of Nursing and School of Health and Medical Sciences at Seton Hall will move there from their current location in South Orange. “Part of the reason for the high cost of care is that we have not been skilled in working as a team with our professional counterparts across disciplines,” said Stanton, referring to nursing, occupational and physical therapy, and related fields. “We must learn very early on to deliver care in a team, and the best way to do that is to be trained that way.”

The curriculum will also stress appropriate use of care settings, from doctors’ offices to hospitals—another means of making care more efficient and affordable.

Establishing the mission and vision for the school, said Stanton, is a critical challenge in starting a medical school. “The mission and vision define the entire fabric and constitution of the school. But this critical challenge is also what makes the opportunity to start a school so wonderful: You start with a blank slate.”

Stanton relishes the opportunity to start from scratch, she said, because it gives her the opportunity to make her own mistakes rather than be restricted by the past mistakes of others. She gives the School of Medicine much of the credit for her comfort with uncharted territory.

“Yale Med’s educational format made it so much more likely that its graduates could step into a situation (such as starting a new medical school) with few guide rails or established paths and design the best routes for our purposes,” Stanton said. “At Yale we weren’t studying for grades because there were no grades. We were studying to learn.”

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