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Pharmacy Schools In Tennessee

AT the turn of the 20th century, there were seven historically Black medical schools. Today, there are three: Howard University School of Medicine in Washington, D.C., Meharry Medical College in Nashville, and Morehouse School of Medicine in Atlanta. Together with the Charles R. Drew University of Medicine (which is a joint program with the University of California at Los Angeles School of Medicine), Black medical programs today reportedly account for more than half of all Black medical graduates. But the contribution is even greater than that. These schools also conduct critical research--including, in at least one case, genetic studies--in a relentless search for solutions to Black health problems that ultimately help everyone regardless of race. The schools also are getting right down to basics, providing important clinical care, and community-based health education, all of which is fine-tuned to the dynamics of the communities they serve. "Culturally competent care" is how some refer to it. The need for such service continues to be acute. Many believe Black America is on the critical list when it comes to health care needs. "We are seeing a distressing widening of the gap between minority and non-minority populations," observes Dr. James R. Gavin III, president, Morehouse School of Medicine. Blacks still are disproportionately represented among victims of asthma, diabetes, cardiovascular disease, glaucoma, prostate cancer, infant mortality and HIV/ AIDS. "Life expectancy is considerably less than that of the majority population," notes Dr. Floyd J. Malveaux, dean of the Howard University College of Medicine.

Serving the needs of a population at risk--including providing community education on healthy behavior--is what the historically Black institutions were designed to do. "We have to decide that health is an imperative for our community," insists Dr. John Maupin Jr., president of Meharry. "We want to be as healthy as everybody else. That has to be our long-term mission and vision." These schools are moving forward to meet future challenges, attracting faculty and researchers who can tailor studies to address critical needs, forming partnerships with other institutions to leverage resources, and, of course, attracting students who are committed to serving the underserved. Recruitment is an ongoing concern. "We have to do a much better job of educating counselors in high schools to let young people know of the tremendous opportunities available to them," notes Dr. Charles Sanders, dean of the Howard University College of Dentistry. There is the opportunity and the challenge for an emerging group of medical professionals to carry on in the tradition of the Black medical schools, serving the underserved, and encouraging the kind of healthy behavior that can save lives. "We have to decide that health is an imperative for our community," insists Dr. Maupin. "That has to be our long-term mission and vision."

OLDEST BLACK MEDICAL SCHOOL ESTABLISHED AT HOWARD IN 1868

THE oldest of the nation's historically Black medical schools, Howard's medical program was founded in 1868. As part of the Howard University campus in Washington, the Howard University Health Sciences Center includes the College of Medicine, the College of Dentistry, the College of Pharmacy, Nursing and Allied Health Sciences, the Louis Stokes Health Sciences Library, as well as the Howard University Hospital and Student Health Center.

Howard medical students work with community organizations and schools to educate adults about all aspects of health care. "When we talk about training individuals, we train people not just to care for individuals, but also to care for community-based problems," insists Dr. Floyd J. Malveaux, dean of the Howard College of Medicine, which admits 125 students each year.

Howard currently is on the cutting edge of research, where partnerships with other institutions can be crucial in leveraging resources. Howard's National Human Genome Center conducts research into causes of a number of Black health problems. A team of 21 researchers makes up the genetic epidemiology unit working on, among other things, sequencing DNA to identify genes that might protect against disease and to help families identify tendencies for diseases. Earlier this year, Howard announced a move that could strengthen that effort: the formation of a partnership with Chicago-based First Genetic Trust to develop the first DNA databank of African-Americans, which will enroll some 25,000 Blacks over the next five years. The hope is that the "Genetic Research in the African Diaspora, Biobank," or GRAD, will provide important clues about the higher incidence of certain diseases among Blacks.

Since it was formed in 1881, the Howard College of Dentistry--among the fifth oldest dental schools in the country--has successfully drawn underrepresented and disadvantaged students to the dental profession in an attempt to improve access to oral health care, and make the Black community a significant part of the dental education and training of this emerging group of practitioners.

The need for "culturally sensitive practitioners" is critical to providing good oral care in the Black community, according to College of Dentistry Dean Dr. Charles Sanders. "There has to be a certain level of trust between the patient and the practitioner," he says. "The consequence is better care."

When it comes to oral hygiene, problems are not limited to a patient's mouth. "One of the things we have found is that you can't have good medical health without good dental health," Dr. Sanders observes. "Patients may have difficulty controlling their diabetes if their periodontal health is not in good shape."

The College of Dentistry is concerned about looking into oral health disparities in the Black community, but also into ways of controlling the spread of the kind of harmful bacteria that cause gum disease, and lead to even worse problems. Students go out into the community to help in the ongoing educational outreach process in keeping with the school's continuing effort to train "compassionate, culturally sensitive practitioners," Dr. Sanders notes.

MEHARRY WAS ESTABLISHED IN 1876 TO CARE FOR FREED SLAVES

FOUNDED in 1876 when freed slaves in Nashville were threatened by an outbreak of smallpox and pneumonia, Meharry Medical College began as the Medical Department of Central Tennessee College to educate freed slaves as health care professionals.

"That means that we were created for a public health reason," notes Dr. John Maupin Jr., president of Meharry, which admits 80 medical and 50 dental students each year. "We were created to ensure that there were people of color who were health care providers. It means that we were to be a leader in trying to ensure good health within our community. That mission remains the same."

It is a mission that has included providing care for the local community and training to health professionals to provide service to underserved communities as Black physicians, dentists and biomedical scientists. Since 1994, Meharry has operated Nashville General Hospital at Meharry, the city's public hospital, not only handling the health care needs of many local residents, but also serving as a teaching hospital for Meharry's own students, as well as students from Vanderbilt University, Tennessee State University and Fisk University.

Meharry attracts a mix of students--79 percent of the 837 total enrollment is Black, 9 percent White--that is highly committed to improving access to good health care in underserved areas. "To get there," Dr. Maupin notes, "we have to eliminate disparities."

To succeed, Dr. Maupin believes, it will become increasingly necessary for the school to form partnerships with other institutions, attracting millions of dollars in additional research money. In 1999, he led the formation of the Meharry-Vanderbilt Alliance, facilitating collaboration between the two schools in biomedical education, research and patient care. As Dr. Maupin sees it, such partnerships provide a way to "leverage a research-intensive institution's capacities to build our capacities in the areas" that might otherwise not be served. One example, he points out, is the use of resources provided by Vanderbilt's nationally recognized cancer center to focus on problems specific to African-Americans.

"We are a small school and we need to leverage our distinctiveness with people who have greater resources and who may give us a leg up on advancing our program," he says. "That is our philosophy: strategic partnerships to leverage our capacities and develop our distinctiveness."

MOREHOUSE STRESSES PRIMARY CARE FOR THE UNDERSERVED

IT was one of the few major medical school start-ups in the latter half of the 20th century. And, since inception in 1975 under the direction of Dr. Louis H. Sullivan and other Morehouse College alumni, Morehouse School of Medicine (which is no longer connected to Morehouse College) has focused on a commitment to primary care--the diminishing area of general practice, where disparities in service continue to plague the Black community.

"It is important for us to make sure that people who come here understand that as part of our mission," notes Dr. James R. Gavin III, president of Morehouse School of Medicine, who is proud of the school's performance in that regard. An impressive 77 percent of Morehouse graduates this year elected careers in primary care--that first point of contact between physician and patient, which is so critical in detecting, treating and curing many problems that have devastated the Black community.

Students of Morehouse School of Medicine--which has an enrollment that is 81 percent Black, 7 percent White, and 12 percent Asian, Indian and Pakistani--are imbued in a culture of service to the community in a number of areas, including the school's award-winning programs in community and preventive medicine, as well the clinical research programs. And students get actively involved in providing service and education to the local community. The principal teaching hospital for Morehouse is Grady Hospital, which serves a large percentage of the urban minority population in the metropolitan Atlanta area.

The strength of the program also comes from the historic ability of the school to attract national figures in the health field, like Dr. David Satcher, former U.S. Surgeon General, who is director of the National Center for Primary Care at Morehouse School of Medicine.

"So, our students see the needs close up, they are engaged with the people on a firsthand basis and they see the appropriate kinds of role models, who are engaging people who are affected by these kinds of problems," Dr. Gavin notes.

It is a thematic mix of study--stressing an understanding of socio-economic dynamics in providing medical service--that Dr. Gavin believes will help Morehouse medical graduates work toward reducing disparities in health care service.

"At this medical school, this is such an important priority for us. We consider it as something that we attack with outrageous ambition. We are determined to make a change and to make a difference."

DREW HAS A JOINT PROGRAM WITH UCLA

IT rose like a phoenix in the aftermath of the 1965 Watts rebellion. Among the problem areas identified during that period was a lack of access to medical care in the Black community. This led to the establishment of the Charles R. Drew Post-Graduate Medical Program in 1966, the Martin Luther King, Jr. General Hospital in 1972 and finally the Drew University of Medicine and Science, a joint program with the University of California at Los Angeles School of Medicine, in 1977.

The school enjoys a unique relationship with UCLA, where Drew students spend their first two years enrolled in basic sciences. The next two years at Drew are clinical, including service at what has become the King-Drew Medical Center, a Los Angeles County facility.

"They take care of a diverse patient population that is highly underserved, but also most appreciative of the care that they receive," notes Dr. Charles Francis, president of Drew University of Medicine. "I think that part of what students learn is that it's actually more fulfilling for many of us to care for patients who really need our services."

In addition to the fulfillment, service is a requirement for the school that has a 59 percent Black, 5 percent White and 23 percent Hispanic enrollment. In fact, in addition to meeting the UCLA requirements for admission to the medical program, one of the prerequisites for the 24 students admitted to Drew each year is demonstrated experience in community service, particularly in underserved areas.

"So we get a very high-quality student," he says, "who is committed to our mission."

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