Dean Dominick Purpura: Breaking Down Barriers at Albert Einstein
By JOAN BAUM, PH.D.

An almost life-size sculpture of Albert Einstein, with his hands folded and legs crossed, looks over Dr. Dominick P. Purpura, Dean of Albert Einstein College of Medicine of Yeshiva University (AECOM), when he is in his office. The sculpture is certainly a fitting touch.

Purpura, a celebrated, world-class neuroscientist and the longest-serving medical school dean in the country, pursues his agenda with an ethical passion and a sense of humor in the tradition of the school’s spiritual mentor. In highlighting the “small-group, student-centered problem-based learning” he has instituted at AECOM, Purpura invokes Socrates, whose dialogic method encouraged students to ask questions and think for themselves.

“The brain is a problem solver, not a sponge,” he says.

Generous in his acknowledgment of colleagues, both at the medical school and in AECOM’s affiliate hospitals, the Dean, who is also Vice President for Medical Affairs of Yeshiva University, knows exactly what he has helped change in medical education at AECOM, and why. His overall plan in curricular reform over the last few years has been the integration of what used to be the separate study of cellular biology, genetics, and pathology, for example, and the institution of interdisciplinary courses “relevant to the human condition in health and disease.”

Some years ago AECOM reorganized the “atavistic” model of medical school education based on self-contained subject matter classes, large lectures and basic science concentrated in the first two years, clinical only in the last two. Now both interdisciplinary megacourses and small, problem-solving based courses in the Education, Clinical and Research divisions define the curriculum.

And while Einstein continues to advance what it is best known for, biomedical research, a lot more attention is being paid to mentoring, career counseling, emergency medicine, ethics and preclinical clerkships. Associate Dean Dr. Deborah S. Kligler, a sociologist, notes that women now constitute 52 percent of the entering class of 180, a fact that, influenced AECOM’s greater attention to societal issues, reflected in programs such as Family Life, in which all medical students track a family for four years. There’s a “healthquake” going on out there, says the Dean, proud of his new coinage.

Seventy percent of the students in the entering class are given summer grants to work in labs, start on graduation projects in community health service and develop an early appreciation of clinical medicine.

Other success factors include faculty development, pre-clinical clerkships and program evaluations, as well as the continuing restructuring of the curriculum, which the Dean refers to with a wink as “the continuing magnificent obsession of the faculty.”

But, he does have concerns. Requiring students to look at a problem “in terms of its molecular, cellular, systemic, behavioral and epidemiological as well as socioeconomic and ethical components, in the same setting” is labor intensive. But he will not back down.

The research process, Evidence-Based Medicine, needs teachers to be academic mentors and career counselors as early as the students’ first years. This need, along with the greater work involved in the labor-intensive curriculum, has resulted in a much greater dedication of the faculty, closer cooperation among faculty in different disciplines and between AECOM and its affiliate hospitals.

Another one of Purpura’s concerns relates to these hospitals. He is tenacious in trying to break down the firewall between medical schools and their teaching hospitals, a barrier related to patient confidentiality.

Curricular reorganization at AECOM has meant that residents, who perform 60 percent of medical school teaching, and who are already working at a high patient volume, are now doing more teaching and at an earlier point in the medical school curriculum.

Einstein, it should be noted, also enrolls approximately 10 to 12 percent of its students in its MD/Ph.D. program, the second oldest in the nation. While Primary Medicine, Pediatrics, Internal Medicine and Ob/Gyn still attract 41 percent of those students declaring specialties, an increasing number of Einstein graduates select to specialize in neurobiology and psychiatry.

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