Between 15 and 20 students each year have been admitted to the Brown Medical School through the Brown-Dartmouth College program since 1981, but the partnership is now being phased out of existence. The program, which allows students to spend their first two years of medical school at Dartmouth and their last two years at Brown, will be ending once the program's current students have graduated.
The 2006-2007 academic year saw the last first-year class of 15 students enter the program, said Philip Gruppuso, associate dean of medicine for medical education.
The program, which is billed as an opportunity to experience both rural and urban medicine, began over 20 years ago because of mismatched resources - Dartmouth had fewer clinical facilities but more basic sciences facilities than Brown. "We could accommodate more pre-clinical students than they could," said Joseph O'Donnell, senior advising dean at Dartmouth Medical School. Students graduated from the program with an M.D. degree from Brown.
The Brown-Dartmouth program made sense in the traditional medical school approach where the four-year experience was divided between basic sciences and clinical work. Students completed basic medical science coursework in their two "pre-clinical" years and spent the last two "clinical" years in hospital clerkships. But recently, medical education has become more of a "four-year package," O'Donnell said, pointing to Brown's development of its new "MD 2000" curriculum. "It became illogical to do in two different places," he said.
"It just made more sense to be in one place for four years," O'Donnell said of ending the program. Dartmouth has also integrated the basic science and clinical years. "We've put much more clinical material in the first year ... and much more basic sciences in the fourth year than ever before," O'Donnell said.
"Both schools thought (ending the program was) the best thing to do," O'Donnell said, though "it's with some degree of sadness we feel up here about the end of the relationship."
"On balance, I'd say the program ending is a bad thing," Gruppuso said, adding that Dartmouth provided an "excellent pre-clinical training program and their students did well in clerkships." Plus, he said, the program's students "lent some experiential difference," to Brown's clinical program.
"It was good while it lasted," Gruppuso said.
"The program really worked," O'Donnell said, explaining that on every measure - including grades on clerkships, residency acceptances and medical licensing exam scores - the graduates from the joint program mirrored those who spent four years at either Brown or Dartmouth. "I have very warm feelings about it," O'Donnell said.
The program was highly competitive and consistently received far more applicants than there were available spots, Gruppuso said.
The program fostered great relationships and friendships between Brown and Dartmouth faculty but not as many joint research programs as had been envisioned at its inception. "The distance between Hanover and Providence proved to be hard" to manage, O'Donnell said.
"Students who went (to Brown) had an excellent experience," said O'Donnell, who also described ways Dartmouth is trying to fill the void for students looking for an urban medical education experience. One way is with its new Urban Scholars program, supported in part by the Harvard Pilgrim Health Care Foundation, which gives students urban medical experiences in Manchester, N.H., and Boston.
Nathaniel Link MD'08, who spent his first two years of medical school at Dartmouth, said he enjoyed the "good urban-rural mix" the Brown-Dartmouth program provided. When he applied, he "thought it would be nice to have a change of location part-way through medical school. ... I wanted to have both those cultural experiences."
"I am really happy in the program and sad it is ending," Link said.
