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Iowa regents approve University of Iowa Health Care changes

Board president challenges UIHC to reduce duration of medical education

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The Board of Regents on Thursday approved a change in leadership over its $1.9 billion University of Iowa Health Care enterprise, merging the UIHC top role with the dean of the College of Medicine.

Jean Robillard, who has served as vice president for medical affairs of UI Health Care for more than eight years, now also will oversee the Roy J. and Lucille A. Carver College of Medicine. Debra A. Schwinn, who’s served as the college’s dean since November 2012, will become associate vice president for medical affairs — a new role focused on special projects aimed at fostering “stronger alignment of the organization’s clinical and educational missions.”

Schwinn, who made an annual salary of $767,919 in the 2015 budget year, will make $642,890 in her new role, which became effective Feb. 15. Robillard’s salary, which was $842,573 in the last budget year, will not change.

During the board’s meeting Thursday, Regents President Bruce Rastetter praised the restructuring as innovative and forward thinking, and he challenged Robillard to use the new role to shorten the length of time it takes to get a medical degree, in part, in hopes of addressing student debt.

“You’ve often had discussions and thoughts around shortening the length of time of medical school from four years to three years,” Rastetter said. “It intuitively made sense to me each time you talked about that. I would just want to encourage you to continue now with your dual leadership role and ability to work on that.”

Robillard, in essence, said absolutely.

“If there is a way to look at that and try to reduce the time for graduation, either by streamlining college for those who want to go to medical school or looking at the time of medical school, I think these are things that we have to do,” Robillard said.

Right now, he said, it takes at least 14 years to complete a medical education, including the time it takes to get an undergraduate degree, go through medical school, and complete residency and fellowship programs. Medical students leave the UI with debt ranging from $160,000 to $170,000, and Robillard said decreasing the time to graduation could cut that.

“Regent Rastetter, we will take that as a mandate, and I think we will look at this and come back to you,” he said.

Last summer, Robillard challenged the College of Medicine to investigate ways to shrink the “long lead time from education to active practice” while also maintaining quality. At the time, he cited some medical schools that had succeeded in operating six- to seven-year medical programs.

“Some studies have suggested that, in fact, the average duration of medical training could be safely reduced without a negative impact on educational outcomes,” Robillard said at the time.

On Thursday, Robillard said the change in leadership at the College of Medicine and UI Health Care was not tied to performance, but rather efforts to achieve even stronger integration.

“This will allow us to have an enterprise that makes decisions probably even faster and more efficiently than we did in the past,” he said.

The change will enable management to look at the organizations’ budgets as one, Robillard said. And Schwinn, in her new role, will help develop a UI Health Care strategic plan that synchronizes the clinical and educational missions.

“It’s very important, the way we are moving on the clinical side, to make sure that we are not forgetting the education side of our enterprise and bring it to the same level and same type of progress,” Robillard said.

In reporting the UI Hospitals and Clinics financial standing Thursday, officials said operating income stands at $58 million for the budget year to date. That is 34 percent over this time last year and more than twice what they had budgeted. Meanwhile, a faculty resignation report showed the University of Iowa had 90 resignations in the 2015 budget year — 36 percent more than the previous year.

About 72 percent of the 90 UI resignations, or 65 total, occurred in the UI College of Medicine. in 2015, but UIHC officials on Thursday told the regents that level of turnover is normal for academic medical enterprises across the country.

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