Q&A: New Dean Describes Innovative Approach of Kaiser Medical School
After his first 100 days as the new dean and CEO of the Kaiser Permanente Bernard J. Tyson School of Medicine (KPSOM), John L. Dalrymple, M.D., spoke with Healthcare Innovation about challenges facing traditional medical education and some of the innovative approaches KPSOM is taking.
Earlier this year, Dalrymple joined KPSOM from Harvard Medical School, where he served as a senior associate dean and within this past year, was still a practicing physician in Obstetrics and Gynecology at the Harvard-affiliated Beth Israel Deaconess Medical Center. Previously, he also served on the leadership team at the then newly formed University of Texas, Austin, Dell Medical School as the assistant dean for clinical integration.
Dalrymple replaced founding Dean and CEO Mark Schuster, M.D., Ph.D., who stepped down at the end of June 2024 after the school’s inaugural class graduated. Schuster remains a professor in health systems science at KPSOM.
Dalrymple, a Texan of Mexican-American descent, grew up in Corpus Christi, working in his family’s barbecue and Mexican food restaurant. “Working in that restaurant taught me a lot about work ethic and community responsibilities, and because my parents had only a high school education at the time, they enforced in me and my sisters the importance of a formal education, I think that's really where I got my deep interest in education,” he said.
Healthcare Innovation: Are there some particular challenges or pressures facing traditional medical education across the country today, and are there some ways that this opportunity to lead KPSOM allows you to help address some of those?
Dalrymple: Absolutely. You’re hitting on a really critical topic of discussion nationwide, and that is how do we best train our future physicians? There are many opportunities and some challenges with our medical education in the country. What Kaiser is doing is certainly innovative and on the forefront of addressing some of those challenges.
One in particular that really caught my eye is the focus on health system science and how we think about integrating training the next generation of physicians beyond the traditional approach, which includes biomedical science and clinical science, which many medical schools have. KPSOM is unique in this, and a big draw for me was their integration of health systems science education alongside biomedical and clinical sciences. And it's integrated from day one all the way through. It allows our students a chance to learn about how healthcare delivery is provided in the complex health system and in society in which medicine is practiced. By having those skills alongside the traditional skills, I think our students are better equipped to meet some of the challenges.
HCI: Do many new physicians get kind of a shock when they see how things actually work in terms of having to deal with the finances or the relationships between different types of organizations? Can they have a steep learning curve once they’ve begun to practice?
Dalrymple: Yes, absolutely. That is certainly the traditional approach that many of us went through in medical training. The focus has always primarily been on the biomedical basic sciences and the clinical sciences, and certainly as M.D.’s move into residency and further graduate medical education, they are forced to integrate and apply what they've learned in medical school into a health system. So just by by trial and error, I think, physicians learn about the incorporation of healthcare practices in their training. We’re forced to learn how to practice in a very complex system, and certainly in a way that we might not have been formally trained, whether it be the financing or the complexities of working in a healthcare organization, not only in the hospitals but in the outpatient centers.
On top of that is meeting patients and communities where they are, and thinking about the social determinants of health and the different communities that our patients come from. We want to ensure that we're providing the right care to those communities, and that means ensuring that we have a curriculum that allows our students to be ready to meet the needs of a diverse community, no matter where they're going to practice.
HCI: The implementation of artificial intelligence in healthcare is changing so fast. How can you incorporate that into the medical school curriculum?
Dalyrmple: That’s a really exciting area. I just came back from the Association of American Medical Colleges national meeting, and artificial intelligence was front and center. We have to think beyond the use of artificial intelligence in the delivery of patient care, but also how we can use it in actual education, the efficiencies of education and the assessment and evaluation of our students, and, of course, in the administrative work that's involved in medicine and education. So we're certainly at the forefront, and like many other schools, we’re moving into that space quite rapidly, and want to be thoughtful and responsible as we think about. AI.
HCI: How big is the emphasis on health equity at KPSOM and are there a few examples of how that impacts students’ experience?
Dalrymple: I would say health equity is at the center of everything we do. It is foundational. It is our North Star, and it's ultimately what we hope and anticipate that our students are going to go on to focus on.
That includes making sure that we have a diverse faculty, staff and student body. We also integrate the principles of health equity into the curriculum so that the students understand the communities that they're serving. We actually have a community learning service component to the curriculum, so all of our students engage in a community service center where they actually rotate and spend time at a Federally Qualified Health Center and learn about community engagement, community partnerships, and really understand what the needs are of communities.
I think it's one of the most critical parts of the medical school, and one of the reasons the school was founded. Also, one of the reasons we focus on wellness and resiliency for our students is to ensure that whoever we bring into the school is going to be able to serve the needs of their patients and communities wherever they go.
HCI: Does being part of Kaiser Permanente offer particular advantages to this medical school in terms of training opportunities or partnerships for the students or for who's available to be faculty?
Dalrymple: Absolutely yes to all of that. One of the big draws for me was familiarity and awareness of the impact of the Kaiser Permanente healthcare system — the fact that it's an integrated healthcare delivery system focused on value-based care and health equity It provides a great model for how our students can learn about an optimal healthcare delivery system. The fact that all of our students in their required clerkships rotate through Kaiser Permanente hospitals with Permanente physicians allows them to see upfront and experience the delivery system that it is. And as such, we've leveraged that relationship and all of our preceptors in the required clerkships are actually Permanente medical physicians, and that includes at all the specialties that are typical in medical schools.
HCI: You have been in your new role there about 100 days. What have you learned from meeting with faculty, staff and students?
Dalrymple: It's been an amazing 100 days going on this listening tour, engaging with the faculty, the staff, the students, the preceptors. I've managed to visit the majority of all the clinical sites that our students rotate through, and certainly sat in on classrooms, talking to the staff and the departments. What I've learned is how aligned and centered everyone is on the mission of the school. Everyone interacts with deep respect, integrity and deep devotion to the mission. It's what drew everyone and drew me to the school, and it's what's keeping us there. There's also a deep passion to improve and to make things better, and I think that's the focus on healthcare innovation. We want to make sure that we innovate and we bring the best approaches to medical education and help ensure that our graduates will be change-makers as well.
This may seem naive and very sort of pie-in-the-sky, but we're at this transition point between traditional medicine and traditional medical education, and realizing that we have a great opportunity to make a difference and impact medical education with the goal of impacting the delivery of healthcare, and that that has come through loud and clear In those 100 days that I've been here.
HCI: I understand the school has had several key milestones this year, including graduating its inaugural class of students, announcing full accreditation, matching 100% of the graduating students to residency placements, and announcing a one-year extension to the tuition waiver policy. Those all seem like pretty big things.
Dalrymple: You definitely hit the highlights. I mean, for a school to get from startup phase to matriculating and graduating its first class is an enormous milestone. Coupled with full accreditation by LCME, I think that is one of the biggest milestones that any school can achieve. The 100% matches is really a huge milestone. Our students matched some outstanding programs’ residencies across the country.
I think with that now in our rear-view mirror, we can look ahead to what comes next. That includes a comprehensive curriculum a review that we're going to be doing this coming week, where we're going to critically look at the four-year curriculum and determine how it’s going. What are the areas to continually improve? What do we need to add in or take away? And it's a chance for us to really be thoughtful as we approach this next phase of the medical school.
HCI: How many students are in each class?
Dalrymple: We do have one of the smaller schools in the country. We have 50 student a year.
HCI: Do you think that could change?
Dalrymple: That is a question on the table. It is certainly one of the key questions that we're going to be grappling with in our strategic plan: how do we take the best of the program, the best of the school and curriculum, and refine it and potentially grow it? And what does that actually look like? Certainly, there is a projected physician shortage in the United States, especially in the primary care field, and I think as a school, we're looking at what we might be able to do to help address that.
