Peering from her office window, there is a bustle of activity even in January. Directly outside, construction crews tear out a parking lot to make room for a new research building. Students, faculty, employees, patients, and health care providers make their way to class, meetings, and appointments. Others cross the street to grab lunch, a beer, or coffee, or make their way to their big city-style apartments with Mill Mountain and the Roanoke Star as the backdrop.
None of that existed outside Cynda Johnson’s window 10 years ago when she arrived to serve as the founding dean of the Virginia Tech Carilion School of Medicine — except for Mill Mountain and the star, of course. In fact, her office window wasn’t even there – the building, which now houses the school and partner research institute, was only a dream at that point.
Virginia Tech and Carilion Clinic had announced their plans just a year prior in January 2007 to partner and create a new medical school and research institute. The Association of American Medical Colleges (AAMC) had recently released a report calling for increased medical school enrollments through the opening of new medical schools and expansion of existing schools to meet a projected physician shortage. It was the perfect reason for the public-private partnership to form.
“At the time, just one or two new medical schools were starting to be thought about after the workforce report came out,” Johnson, a family medicine physician, said. “In the back of my mind, I thought, I'd really like to start a medical school.”
As the thought grew, Johnson heard rumblings through colleagues about the potential school in Roanoke. Months later, she visited the small city for the first time when she interviewed for the position.
She returned to Roanoke not long after for a second interview. When the hiring committee offered her the position, she found out she was the only candidate given a second interview.
“It was a real vote of confidence,” Johnson said. “It gave me extra enthusiasm to start the school.”
She would need the extra pep in her step as the to-do list was lengthy. On Johnson’s first day, she was joined by two other employees: Phyllis Irvine, her assistant, and Terri Workman, who would oversee school business and operations.
Their task: work with architect and construction crews to design and finalize a building, create a structure to appoint faculty, build a curriculum from scratch, and pass key accreditation milestones that would allow the school to become a reality and ultimately, recruit, enroll, and graduate students.
When Johnson and Workman first arrived in Roanoke, they had left their families temporarily behind at East Carolina University, where each had worked previously. Johnson said, while tough, it allowed them to focus on laying out the groundwork of what needed to be accomplished.
“We would work all day. Then we would go to our apartments, have some dinner, talk on the phone about what we’re going to do, keep working that evening until we went to bed, and get back up and do it all again the next day,” Johnson said. “For several months, that's how we made a lot of good progress and laid out each step.”
Johnson knew the next hire would need to help her tackle the biggest piece — the curriculum. Leadership from Virginia Tech and Carilion Clinic gave Johnson two directives. “I was asked to have a problem-based curriculum because leadership had gone to see it at other schools and decided that was what they wanted. And it needed to be research intensive.”
Originally, leadership planned for the school to be five years to allow a year commitment to solely research. But Johnson began to convince them it could be done in the typical four. “We would have a research-intensive education without increasing time and cost for students,” Johnson said. “Some of my primary care colleagues wondered why I would start a school that was research intensive. It’s been very important to me to teach people that research and primary care are not opposite ends of the spectrum. In fact, there is no spectrum at all. It's a way of learning and critical thinking. It's a way to work.”
Then came the problem-based learning piece. As she searched for help and expertise, one name kept coming up: Rick Vari. Vari had been involved in medical education for more than two decades at that point and had led curricular reform at the University of North Dakota School of Medicine to implement problem-based learning. He arrived in Roanoke in April 2008.
Next was the real work of building all of the pieces of the school. Funding was secured from the state for the building in May. In October, a groundbreaking was held for the building. Behind the scenes, a lot of work was underway to put together a 1,200-plus page document for the Liaison Committee on Medical Education (LCME) for accreditation.
The following June (2009), the still-small team of about a dozen people had just finished taking some group photos when there was a call from the LCME. “They quickly told me we got preliminary accreditation. I asked them if they would be willing to say it again on speaker phone. We had everyone gathered around as they told us we got accreditation,” Johnson said. “It was too cool for words. It was our first benchmark and external validation of the school.”
The milestone meant the school could begin recruiting students that would begin their studies in fall of 2010.
“I was nervous — what if no one applied? Once we saw there were going to be a good amount of people, that was a relief,” Johnson said. “Then it was, what if no one comes? When we seated a full class, I almost couldn't believe it. And they were such good students.”
The charter class arrived for their first day on Aug. 2, 2010. “From that day on for four years, we were inventing a new year of school each year,” Johnson said. “That brought us to graduation of our first class, the culmination. From my first day through that first graduation, we were continuously inventing new things or doing them for the first time.
“It was awesome to us to see how well the first class did, on their boards and a 100 percent match to residency. It gave us assurance that we had a good curriculum, but we are never going to be satisfied. We are always going to listen to the students' feedback. We are always going to continuously improve what we do.”
In total, four classes have graduated and each continued the 100 percent match to residency.
“My dream is to one day have our graduates serve as deans of our medical school,” Johnson said. “Now, I can think out that far because I've seen them succeed in residency, get to be chief resident, start to do fellowships, and start practice.”
In May, the school’s fifth class will graduate, the last while the school is an independent, private institution. In July, the school is set to become Virginia Tech’s ninth college.
After a decade of success, integration with the public university will help prompt a second phase for the school and the area where it resides. The first phase turned what was primarily a vacant lot that was prone to flooding into a bustling area now known as the Virginia Tech Carilion Health Sciences and Technology District in the Roanoke Innovation Corridor.
Johnson looks forward to seeing the growth over the next decade. “I don’t think I’ll recognize the area, both in terms of how many buildings and people are here. And the integration won't look like integration any more. This campus will be indistinguishable from Virginia Tech and Carilion, as the heightened activity will bring us together in a way that will minimize the feel of the distance between the two valleys.”
The founding dean also sees potential changes for the school, specifically, in its next 10-year chapter. “I'd like to see growth within five years. Probably never more than twice its current size to retain all of the attributes that make VTCSOM special. We just have so much to offer and we have over 4,000 applicants per year who are looking to come here. I'd like to be able to accept more, perhaps through a rural campus or branch campus.
“We will also get to fully participate in the life of a land-grant school, through initiatives like the Cooperative Extension, as well as be involved more deeply with the other colleges and programs at Virginia Tech.”
All aspirations that will transform the view, once again, outside of the dean’s office window.
View a photo gallery of some of the highlights of the past decade for the Virginia Tech Carilion School of Medicine below: