URBANA — The exam rooms are stocked with tongue depressors, the virtual reality suite is primed and "Sim Man" and his fellow mannequins have arrived.
After more than four years of planning, the new Carle Illinois College of Medicine will open Monday with its first class of 32 students.
"We even have our cadavers ready," said Dr. Judith Rowen, associate dean for academic affairs.
Classes will be headquartered at the newly renovated Everitt Lab at Wright and Green streets, home to the Department of Bioengineering and a state-of-the-art health engineering simulation lab. The college's future home base in the UI's Medical Sciences Building won't be ready until 2020, other than the newly renovated anatomy lab. For now, UI administrators are housed in the Illini Union Bookstore building.
Students begin a weeklong orientation Monday, with a welcome from Dean King Li and top administrators, tours of campus and Carle medical facilities, and a holiday barbecue with college staff and their families. Then they'll dive into their studies.
A few students started trickling into town last week, though most were expected to arrive this weekend.
"It's getting real," said Andrea Jake, director of student affairs, who was finalizing menus and other last-minute details last week. "We're finally seeing things coming together."
If starting a brand-new medical school sounds daunting, it is. There are countless details, Rowen said — from designing a curriculum from the ground up to figuring out where the cameras are placed in the observation rooms.
Jake has worked on everything from recruiting campaigns to designing the medical school patch for the students' lab coats.
"It's been exciting, at times challenging," Jake said. "You learn to expect the unexpected, and to be quick on your feet."
Carle-Illinois is the first medical school to fuse medicine with engineering from day one, in hopes of training a new kind of doctor, or "physician scientist," who can transform health care with innovative tools to make it cheaper, better and more accessible.
The toughest challenge was blending very different disciplines into one curriculum, Li said, as "typical medical doctors don't think like engineers, and typical engineers don't think like doctors."
Once they came together, they learned from each other and formed close teams to build a "first in the world" curriculum that Li believes other medical schools will copy.
"It's an incredible environment. It's like the Paris cafe at the height of the modern art movement," said Professor Martin Burke, the college's associate dean for research. "We've got a bunch of outside-the-box, fired-up, brilliant people to talk about something transformative. It is going to change the world."
'I needed to be here'
Rowen is overseeing development of the unique curriculum.
She came on board last November, from the University of Texas Medical Branch in Galveston, a pediatrician from a family of engineers whose father worked at Bell Labs.
"The norm in academia is that you take about three months to transition from one place to another. I came here, looked at it, recognized that they needed somebody right away, and only gave two-weeks notice to my former institution," Rowen said. "I knew I needed to be here."
Curriculum committees had done an enormous amount of work before she arrived, determining the courses, objectives and the team-based, problem-solving approach to teaching. But the case studies and other curriculum materials still had to be written.
Rather than offering separate courses in anatomy, pharmacology and microbiology, as with traditional medical schools, the curriculum is packaged in 13 units with a particular theme, such as the cardiovascular system or respiratory system. Teams of eight students will learn through specific patient case studies, "so within a case, the student will explore all of those topics," Rowen said.
For the cardiovascular unit, which starts in August, their first case study will be a patient who comes in with chest pain.
"So when you think about chest pain, you have to understand the anatomy of the chest. What's in the chest? How does pain travel? How does pain happen? What makes you sense pain?" Rowen said.
"And then we'll start thinking, 'Maybe he's having a heart attack. What are the questions I have to ask a patient? How quickly do I do testing and give him medicine if I really think he's having a heart attack?'"
The 'four Cs' of the curriculum
Each course will have three directors — a practicing physician, basic scientist and engineer — with components from each discipline.
During the first week of the cardiovascular unit, an engineering professor who works with cardiologists will talk about the electrocardiogram, or EKG, a simple test that measures heart function. Most medical students learn how to read data from an EKG, Rowen said, "but our students are going to learn how the machine works, how to set it up, and interpret that piece of paper that comes out of the machine."
Students will also begin seeing patients their first year, rather than waiting until later in their training. They will be paired with a Carle physician and go to that office at least twice a month to see real patients, "to put what they're learning in the classroom in real context," Rowen said.
For the cardiovascular unit, for example, they will go to a cardiac rehab center and interview a patient who has had a heart attack to explore what impact that's had on their life.
There's also an ethics and humanities thread in every course — in the kidney unit, for example, students will discuss the ethics of prioritizing patients for transplants.
Students will start off this month with a "foundational elements" unit, which Rowen calls a "jump start to medicine." It includes a week of orientation and several weeks of core concepts they need to know in biochemistry, microbiology, genetics and the like.
The unit will include the humanistic aspect of medicine, Li said, emphasizing the "four Cs" infused throughout the curriculum: competence, compassion, curiosity and creativity.
They'll study population health, to understand that patients are part of families and larger groups, factors that can affect their health.
They'll learn how to study data affecting certain populations, much like the Flint, Mich., pediatrician who first noticed that a rise in the lead levels of her patients coincided with a change in the water source for the community, Rowen said.
Students will also start a yearlong clinical integration course, where they'll work with the patient portrayers to learn how to take a medical history, talk to patients and find out their concerns.
Introducing Sim Man, the mannequin
Much of their training will take place in the new Jump Simulation Center, in the basement of Everitt Lab, patterned after a similar center at the UI Chicago's regional medical school in Peoria. It's part of the College of Engineering but its primary task is to help train medical students, Rowen said.
The simulation lab includes an ICU suite with two hospital beds, an operating room and four clinical skills rooms that look just like a doctor's exam room. All are designed to give medical students realistic interactions with "standardized patients" — people hired to portray patients with certain conditions — or mannequins programmed to respond just like real humans.
Instructors can put Sim Man, a high-fidelity mannequin, into one of the ICU beds and direct his responses from the control room next door, where technician Bob Hasty watches through one-way glass or on a bank of monitors.
Sim Man can moan, sweat, cry or have seizures as students examine him and monitor vital signs. Special syringes allow students to "inject" him with medications, and he'll respond physiologically — an increased heart rate after an injection of epinephrine, for example.
Likewise, "Sim Baby," which will be used in a simulated delivery room, turns blue if it doesn't get enough oxygen.
The college also has "task trainers," essentially mannequin body parts designed to teach specific skills — an arm used for taking blood pressure, for example.
The trainers are hooked up to computers so they can be programmed with different heart, lung and abdominal sounds or other features.
"You can do it over and over again until you get it right, which you can't do with a real patient," Rowen said.
The 'latest and greatest'
All of the rooms are equipped with microphones and cameras, so student-patient interactions can be recorded for review later in the four debriefing rooms, where faculty members can assess their communication skills or ask, "What were you thinking here?" Rowen said.
The centerpiece of the simulation center is the virtual reality suite. Students can use one of four headsets to explore three-dimensional models of the brain, heart or other body systems. A large wall monitor displays what students are seeing so faculty members can track what they're doing.
One VR simulation being developed for the neuroscience unit shows the cranial nerves from the brain that control various body systems. Their architecture and function are "very 3-D, so looking at it in a picture in a book is just not the same as exploring it," Rowen said. "You don't understand how things relate."
Project manager Jim Pait, who set up a simulation center for the Weill Cornell Medical Center in Qatar before being hired by Illinois, said the lab has the "latest and greatest" VR tech.
"The students are super excited about this, especially the ones who use VR at home for gaming," he said.
The beauty is that it gives students the chance to practice a procedure over and over before trying it on a cadaver, where "you can't hit reset," Pait said.
'If you can dream it, make it'
Throughout their training, students will also be learning how to design or improve their own medical tools, said Dr. John Vozenilek, co-director of the JUMP Simulation Center at Everitt and director of the one in Peoria.
During their first year, they can take an elective offered by Vozenilek where they can work on simulation projects and invent new ones.
They might help design synthetic skins that are more lifelike for practicing stitches, find a better way to listen to a heartbeat, or design imaging techniques that don't require a patient to lie still for a half-hour, he said.
The simulation spaces make it easier to innovate, Vozenilek said.
"You can control the circumstances entirely, because it's a simulation, and you can take your time" because you're not tying up a real ICU or emergency room, he said.
The medical school will also leverage the College of Engineering's experience with design projects where students have built prototypes in as little as six weeks.
Each medical student will receive an oversized coin, engraved with "If you dream it, make it," that they can cash in at the Medical Maker Lab, a network of labs across campus with 3-D printers and on-demand fabrication to turn ideas into reality.
"Those devices that they make as they discover medicine might actually have value in the open market," Vozenilek said. "That's very beneficial for the state of Illinois, as we strongly desire to combat that brain drain of people leaving.
"What if we start building businesses around medical education technologies?
"This is amazing, what's happening here," he said.
Students will be introduced to the simulation lab on Thursday, with mannequins in the operating room, Rowen supervising blood pressure checks and a VR demonstration by neuroscience Professor Roberto Galvez.
They will also be touring Carle that day and spending some time in their learning teams, talking about the importance of collaboration — a key component of their training — as opposed to competition, Jake said.
They'll end the week with a "white coat ceremony," where they will take the Hippocratic oath and get their official lab coats, given when students start clinical training.
Here, it's right away.
The first class, which received full four-year scholarships, is stellar, Li said, a mix of students from Illinois and other states, many with engineering degrees. A third of the class come from disadvantaged backgrounds and a significant number are underrepresented minorities, much higher than the national average, he said.
"We are attracting really the kind of student who is going to make a huge difference in the world," he said.