Supplying CT’s Health Care Workforce
The No. 1 source of physicians and dentists who practice in Connecticut is UConn Health, whose schools have been graduating physicians, dentists, biomedical researchers, and masters of public health for five decades. This month we hear from Dr. Bruce T. Liang, dean of the UConn School of Medicine (and UConn Health’s interim CEO and executive vice president for health affairs) and Dr. Steven Lepowsky, dean of the UConn School of Dental Medicine. The deans explain the role of the medical, dental, and graduate schools in preparing and producing generations of professionals to maintain Connecticut’s health care workforce.
(Dr. Bruce T. Liang, Dr. Steven Lepowsky, Carolyn Pennington, Chris DeFrancesco, April 2022)
Chris: Do you know who Connecticut’s No. 1 producer of medical and dental professionals is? Today on the Pulse, we learn more about UConn Health’s contribution to the state’s health care workforce.
This is the UConn Health Pulse, a podcast to help you get to know UConn Health and its people a little better, and hopefully leave you with some health information you’ll find useful.
With Carolyn Pennington, I’m Chris DeFrancesco. We talk a lot on this podcast about clinical and research advances.
Carolyn: But today we’re talking about the education that makes those advances possible. To do that, we welcome the deans of UConn’s medical and dental schools: Dr. Steven Lepowsky is dean of the UConn School of Dental medicine, and Dr. Bruce Liang, dean of the school of medicine, in addition to serving as UConn Health’s interim CEO and executive vice president for health affairs. Thank you both for making the time to speak with us today.
Now UConn Health has been graduating physicians and dentists for 50 years now. What does that milestone mean to you? And let’s start with Dean Lepowsky.
Dr. Lepowsky: Thank you, Carolyn. It’s an incredible milestone, and the school of dental medicine is exceptionally proud of its role in training, educating, and graduating the dental workforce for the state of Connecticut and beyond. As the only school of dental medicine in Connecticut, and the only public dental school in all of New England, we have a unique role in ensuring that we offer opportunities for those individuals who will provide the citizens of Connecticut with all of their oral health care needs.
We are different from many dental schools in a number of ways. We are one of the few dental schools where our students participate in a shared biomedical sciences curriculum with their colleagues in the school of medicine, which provides them a better foundational experience to be able to treat patients with a variety of dental needs.
We’re a small school. We’re one of the smallest in the nation, which distinguishes us in that our students know all the faculty, our faculty know all their students. We have a relatively strong ratio of students to residents — in addition to our doctor of dental medicine program, we sponsor residency programs in eight different disciplines. That provides our students with a very, very rich background in dental medicine with a strong basis in research and evidence-based decision making.
Carolyn: Dean Liang, now, what does that 50 year milestone mean to you?
Dr. Liang: It means a great deal. I’ve been here 20 years and been part of the 50-year trajectory and development. And I think the medical school and UConn Health have changed and transformed tremendously. We used to have less than 60 students, and now we are at 110 medical students per class. And that’s important because we’re the single largest source of future physicians, surgeons for the state of Connecticut. Most of our medical students come from Connecticut, so after they finished their training, they likely will stay or return to the state to serve citizens of Connecticut, because partially they like the environment, they like the state, and also partially because they want to be close to their families. As their parents age, they want to be nearby.
And I would say there are four legs to the stool. The three legs are the research, clinical care, and education; the fourth leg is actually community collaboration. It’s something we encourage our students, staff, and faculty to do outside of their work environment to get out into the community. I’m very pleased to tell you that we’re seeing a lot of community engagement and collaborative efforts throughout the state. The AHEC program, which is federal and state funded, reaches out to four corners of the state and something we are very proud of.
Chris: How has the education Dean Lepowsky, of medical, and dental students over 50 years — I’m sure it’s evolved quite a bit? And look no further than the pictures on the wall in the hallway on the way to your office, you could see the gender and racial breakdown of the classes, lots of change over five decades.
Dr. Lepowsky: Lots of change and more change to come over the next 50 years. But what hasn’t changed is our fundamental basis of a strong education in biomedical sciences, coupled with incredibly rich training in clinical sciences. Since our first class of 12 dental graduates in 1972,
Dr. Lepowsky: Twelve. Twelve in the first class. The number of individuals graduating from the school of dental medicine has grown. We now currently graduate approximately 52 new dentists each year. That class of 52 is much more diverse than it used to be. In the early years of the school, this class was predominantly male. Now we’re enrolling classes that are at least 50% female, if not more, and our classes are much more diverse in every sense of the word, close to reflecting what the population of the citizens that we serve are.
Carolyn: And hasn’t the way you teach those students really changed, like the team-based learning and just the curriculum changes over the years.? Can you talk a little bit about that Dean Lepowsky?
Dr. Lepowsky: Certainly, there have been significant changes in the way we educate students. Years ago, much of the training was the “sage on the stage,” with a faculty member talking at students. The education is much more interactive. It is based in team learning with groups of individuals learning together, so it closely emulates how people will practice, in today’s practice of dental medicine and beyond.
Dr. Liang: Ten years ago with decided that we’re going to have a new curriculum. Because the biomedical knowledge is exploding, we have to have a new way of teaching our medical students, not just the knowledge and the content base, but also how to think and how to solve and reason when confronted with a medical problem — how to find credible source of new biomedical knowledge so that can be applied to the benefit of the students. We are now six years into this brand new curriculum, called MDELTA, replacing the original legacy curriculum, so that the students are learning basic science under the umbrella of a clinically relevant, real case. So they can see the relevance of what they learn in the basic science to the clinical issues. And we’re also weaving in more clinical exposure from the get-go. We’re weaving in more exposure to the health systems; it’s not just learning the knowledge and how to diagnose and treat a particular clinical conditions. Also, some of the business aspects, some of the enterprise aspects of a health system, as well as a so-called social determinants of health — where a person’s well-being is also very much influenced by where they live, their access to nutrition, the ability to have exercise opportunities or physical environment, the kind of food they eat, and addressing the psychosocial aspect of a disease so that they can seek help and be compliant with, for example, appropriate medications as needed.
Chris: Diet and exercise and lifestyle — now you sound like a cardiologist.
Dr. Liang: Yes, I am.
Chris: I think one of the things that might not be very well known about the UConn School of Dental Medicine, Dean Lepowsky, is the overall contribution to society, in terms of access to care for people who otherwise might struggle with access to dental care, which is something that the students get involved in before they graduate.
Dr. Lepowsky: Thank you for bringing it up. We pride ourselves in being the largest provider of care to underserved populations and citizens throughout the state and throughout the region. But beyond that, more than 50% of all of the practicing dentists in Connecticut are graduates of our program. And that increases each year. We’re incredibly proud of the commitment that our alumni demonstrate to serve the needs of the state, which they do so with dedication and compassion. Our alumni have served and continue to serve in leadership roles throughout the state, including at the Connecticut State Dental Association, lead community-based organizations in addition to traditional practice settings, and we think that’s because our students are required to participate in volunteer service commitments throughout their education. And therefore our alumni continue to do that throughout their practice serving communities in need.
Chris: As far as the attrition that the health care fields are facing nationwide and in Connecticut, particularly with primary care physicians, but physicians, nurses, and dentists. How is the UConn School of Medicine helping address that? And also not just the students, but the folks who maybe have been students elsewhere, who then come here for residency and fellowship, then they come to the workforce through UConn as well. So how does that all fit into the conversation?
Dr. Liang: That’s a great question, Chris. We’re not just interested in keeping our medical students after they graduate to stay in Connecticut and serve Connecticut, but also resident physicians after their graduate medical education, so-called residency programs, for them to stay here as well. So after they graduate from medical school, they’re actually not really a doctor yet. I mean, they are a doctor with an MD degree.
Chris: They have their degree.
Dr. Liang: But they need to go through that residency training to really become able to take care of patients. So at the graduate medical education level, it is also very important, close to 70% of our medical school graduates either practice in perpetuity in Connecticut or they stay for residency. And when they are here as resident physicians, they of course learn — that’s their primary goal — but by learning, they are actually performing a service, caring for the patients. In the middle of the night, it’s the resident doctors who are right next to the patients, and they oftentimes are the ones that will save the lives of a patient who was sick enough to be in the hospital.
So we have one of the largest residency programs in the state. We sponsor 68 graduate medical education programs at any given time, with 680 resident physicians or subspecialty fellowship physicians. And these are really also a very important source for future doctors, surgeons, physicians, you name it, specialists, primary care doctors.
Chris: Dean Lepowsky, I can’t imagine it’s not something we have to acknowledge it in the field of dental medicine as well?
Dr. Lepowsky: Absolutely. Currently about 50%, a little more than 50% of all of the dentists practicing in the state of Connecticut, are our alumni. They’re individuals that graduated from our DMD program. And I mentioned, we sponsor a number of residency programs as well. So in addition to almost 1,900 alumni of the school that received their DMD program, we have approximately 1500 individuals that completed their residency training with us. Many of those residents are individuals that completed their dental training with us, and then they remain in practice in Connecticut. But many of the residents completed their dental training at other dental schools. But when they complete their residency training here with us at UConn, they tend to stay in Connecticut to practice, which further grows our influence and our stature within the dental workforce.
Beyond training our DMDs and our residents, we also partner with a number of community health centers throughout the state in support of programs that train dental hygienists and dental assistants. So we provide clinical training for those other partner institutions, with which further create the dental workforce for Connecticut.
Carolyn: And UConn Health also has a graduate school program. Can you mention, the dental students get a masters of science, of dental science also?
Dr. Lepowsky: Many of the individuals that participate in our residency programs do so in combination with a program in the graduate school, that results in their completion of their specialty training and the receipt of a master of dental science degree. That training is designed to better prepare people for careers in academia, research and beyond. In addition to the residents that receive the master of dental science program, we sponsor a combined program where selected individuals receive both the doctor of dental medicine degree, and a Ph.D. In biomedical sciences. We’re one of a small handful of schools nationally that sponsor a combined DMD-Ph.D. program, which is designed to create the next cadre of dental scientists, which would take positions within academic institutions, research institutions, and the like.
Dr. Liang: The graduate school is something that we don’t talk about enough. We have a robust graduate school here focusing on biomedical sciences and also public health. For example, we host, in the school of medicine, the master of public health, and that’s the only one for the whole UConn. And recently, in the last five years, we tripled the number of enrollees or students in the master of public health program. We used to have maybe 19 or 20 so-called MPH students per class. The last three years, we are over 60 such students per class. So we’re triple the number of MPH degree students. And they’re going to come out and serve the state because, again, majority of them come from Connecticut, and the pandemic teaches us the importance of having public health experts who can advise us. So that’s very important.
The other aspect is the biomedical science graduate school. We have over 100 PhD students at any given time, and these are future scientists. These are future researchers who will discover a new cure or new treatment or new diagnosis of medical conditions. And they’re also potentially work force for the growing biomedicine, entrepreneurial startup companies or existing biotech or pharmaceutical companies in the state of Connecticut. So it’s a very important workforce, also as a place to train future scientists.
Chris: Before we say goodbye, I want to hear from both of you, why, as Connecticut’s only public academic medical center — and the state’s only dental school in your case, Dean Lepowsky, and in your case, Dean Liang, the state’s only public medical school — why are these important state assets worthy of continued investment? Dr. Lepowsky?
Dr. Lepowsky: The school of dental medicine is a critically important asset to the state of Connecticut in that we provide care on an ongoing basis to thousands of residents in the state who otherwise would not be able to access dental care. And in doing so, we’re providing an incredibly rich educational experience for our students and our residents, all of our trainees, who then take those experiences with them through their professional careers. As I said, the majority of whom will practice in Connecticut. That creates not only the dental workforce, but it also creates some economic drivers for the state of Connecticut, as most of these individuals will own or operate dental practices, which creates jobs for many, many other individuals supporting the economic growth of the state while providing necessary oral health care.
Chris: What makes the UConn School of Medicine worthy of continued state investment, Dean Liang?
Dr. Liang: Well, as the single largest source of future doctors, physicians, and surgeons for the state, this workforce is critical as Connecticut citizens age, and the need is going to be there and ever growing. We also provide a great medical education for those students. They are extremely well-trained clinically; they can recognize and treat every clinical condition. And we train a lot of primary care doctors, internists as well as family medicine doctors and pediatricians — over 50% of our pediatricians in the state of Connecticut have some tie in some way, shape or form with the UConn School of Medicine Department of Pediatrics. And that’s done in collaboration with Connecticut Children’s.
We’re also a major biomedical research and innovation hub. We garner well over a $100 million of extramural grants every year. And this will stimulate entrepreneurship will stimulate startup companies in forming, creating jobs, and really just drive the biomedicine and the bioscience sector of the state of Connecticut. So the economic impact, as you may have heard, is $2.2 billion every year, and that’s significant. And that’s only going to grow, because as we grow, the economic impact is going to continue to be increased.
Chris: Excellent. That’s Dr. Bruce Liang, dean of the UConn School of Medicine and interim CEO and executive vice president for health affairs at UConn Health. Thank you for joining us. Thank you to Dr. Steven Lepowsky, the Dean of the UConn school of Dental Medicine.
That is our time for today for Deans Steven Lepowsky and Bruce Liang, and Carolyn Pennington, I’m Chris DeFrancesco. Thank you for listening to the UConn Health Pulse. Be sure to subscribe so you can catch us next time, and please share with a friend.