Columbia
University College of Physicians and Surgeons: Dean Gerald Fischbach
By
Jacob M. Appel
If
good marriages depend upon a combination of something old and
something new, then the match between recently appointed Dean
Gerald D. Fischbach and Columbia University’s College of Physicians
and Surgeons seems promising. The medical school, the first in
the United States to offer degrees to aspiring physicians, opened
its doors in 1767. Dr. Fischbach, a Cornell-trained neurobiologist
who most recently studied synapses at the National Institutes
of Health, has been on the job for approximately six months. “And
so far,” says Fischbach, “no complaints.” Only, it seems,
ambitions.”
While savoring a can of tuna fish in the hour-long interval between
two meetings, the broad-featured, soft-spoken Dean outlined his
vision for a dynamic, cutting-edge medical curriculum. “We need
to rethink the science-based curriculum,” he explained. “Often
we have students studying the exact same material from different
perspectives. We have to find a way to integrate these studies
so we can eliminate the redundancies.” He placed particular emphasis
on rethinking the relationship between the traditional course
work undertaken during the first two years of study and the clinical
component of the third and fourth year curriculum. “You can study
the basic biology all you want to, but you can’t fully understand
heart failure until you’ve seen patients with heart failure. Our
goal is to bring students back into the classroom after they’ve
experienced interactions with patients.”
The new Dean also expressed an interest in expanding programs
in areas once thought peripheral to a standard medical school
education such as humanities in medicine and biomedical ethics.
“It’s almost any emergency,” Fischbach noted.” “We’re now faced
with these important questions in such areas as stem cell research,
gene therapy and the end of life. We need physicians who can talk
about these issues with intelligence...It’s important to know
the basic sciences, the physiology and histology, but that’s not
enough anymore.”
Columbia, like many of its competitors, is currently making the
transition from a more traditional “knowledge acquisition” course
of study to a problem-based small-group approach to the study
of medicine that is designed to help students learn to think as
physicians and scientists. “It’s extremely important we make the
curriculum more coherent and that we make sure the faculty are
thinking about problem solving,” said the dean.
Fischbach’s whole approach to the medical field is a bit unusual.
In an era when many medical school deans still emphasize professionalism
and the importance of acculturating students to their new career,
Columbia’s new helmsman stresses the importance of freedom. “I
don’t want Medical School to shut people off. Right now it’s still
very much a lock-step trade school,” he said. “I’d like to get
people to the point where they’re making independent choices early
on as the rule rather than the exception. I don’t believe your
first choice should have to be your last choice.” He beamed with
pride as he reeled off the number of Columbia medical students
currently enrolled in concurrent MD/Ph.D. and MD/MPH programs.
Prior to his service at Columbia and the National Institutes of
Health, Fischbach was the Chairman of the Neurobiology Department
at the Harvard Medical School and had headed the Department of
Anatomy and Neurobiology at Washington University School of Medicine.
He is a 1965 graduate of Cornell Medical School. “I had an extraordinary
time at the NIH,” said Fischbach. “I’ll admit I didn’t expect
to leave.” So why did he come to New York?
“What
really attracted me to Columbia was the opportunity it afforded
to have a major effect on the community. Now this is a job that’s
much more than just research. This is a chance to reshape how
biology and medicine will be taught in the next century and also
how medical services are delivered to the people of northern Manhattan.
To me that’s very exciting.”
With that level of enthusiasm, Dr. Fischbach may just stick around
for a while.
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