AUGUSTA, Ga. (WJBF) – The Means Report is kicking off the its new year by taking a look at the State of the Medical College of Georgia with the dean of the college, Dr. David Hess. As he prepares to give his state of the college address, we discuss all things facing the school, including how they are preparing doctors to fill the shortage Georgia is facing, specifically in rural areas, and the launch of an exciting new center for immunology.

Brad Means: Dr. Hess, I know you’re so busy these days, not only getting ready for your big speech, but also just running that enterprise over there. So, thanks for taking the time out to be with us.

Dr. David Hess: My pleasure, Brad. Thanks for having me on.

Brad Means: Let me just ask you a general question to kick things off, and it’s about the pandemic. When this thing started, I didn’t think we’d still be talking about it here in early 2022, but we certainly are. How are your students and your staff holding up as this pandemic continues?

Dr. David Hess: Yeah, we didn’t think it’d be going on this long either. In fact, I thought, we delayed this talk so I could give it in person, but we’re going to have to do it virtually because of Omicron. So, you know, I guess the good news is that while we have a lot of people in the hospital, they aren’t as sick as in previous waves. It doesn’t affect the lungs as much, not as many people on ventilators. The biggest problem is so many of, in fact, the staff in my office, probably half of them are out with COVID, mostly with colds, but they can’t come to work. And that’s really been, had a huge impact in the health system and our ambulatory care clinics. You know, the people that run the clinics, the nurses, the staff, you know, people that make appointments, so many of ’em are out because of becoming positive. Even if the symptoms are mild, they can’t come to work. So, that’s been the major impact is the effect on healthcare workers and on university workers.

Brad Means: Is that, what does that look like when we go into clinics? And when we go into those places you’re talking about? Is that when we see those super long wait times, or in some cases unavailable services?

Dr. David Hess: Yeah, well, we’re trying to keep everything available, but it may be a little hard to get an appointment just ’cause there’s not many people answering the phone ’cause so many people are out, and then the clinics may take a little bit more time to get in. Now, some patients are also canceling. You know, more patients are canceling, too. So, yeah, this is just a problem all throughout, you know, wherever Omicron is, which is all throughout Georgia. So, I mean, we have the same problems that other healthcare systems in Augusta are having. But hopefully, it’ll be short-lived, and in a couple of weeks, this will die down, and we’ll get back up closer to fuller operations.

Brad Means: Boy, I sure hope so. Real quickly, what about the med students themselves? We cover on the news so much about students missing learning time and learning opportunities because they’re having to go virtual because they’re not having the traditional educational experience. Are your med students missing out on anything because of this?

Dr. David Hess: Not too much. I mean, there’s been some students turning positive, but it hasn’t had a major impact on their education like it did in previous waves, like the first wave. So, that’s good. And it hasn’t affected our research either to any great extent.

Brad Means: So, let’s talk about the state of the college, Dr. Hess, especially when it comes to the importance of distinguishing between a teaching hospital and an academic health center. MCG, of course, is the latter. What makes one better than the other?

Dr. David Hess: Well, an academic health center, which there’s probably, depending on how you count ’em, probably 120 to 150 in the country, not only teach medical students, they also teach residents. So, after you complete medical school, you have to do a residency, for example, in internal medicine or surgery. So, academic medical centers have lots of residencies, not just in the basics like internal medicine or pediatrics, but, like, they’ll have cardiology fellowships, and you know, more fellowships. And then, the other third leg is you have research, both clinical research and basic research. So, many of the discoveries made in medicine are coming from research done at academic medical centers. Most of the NIH funding in this country is given to medical schools or hospitals that are academic medical centers. And so, if you really look at the last, you know, 20 or 30 drugs that have been approved by the FDA, you know, the vast majority of those discoveries were made with NIH dollars given to medical schools or academic medical centers.

Brad Means: And so, if I’m hearing you correctly, if you can truly represent yourself as an academic health center, you can check those three boxes constantly and at a high level, it means more money, right?

Dr. David Hess: Yes, I mean, more NIH money.

Brad Means: More NIH money.

Dr. David Hess: And, yeah, I mean, it’s complicated, the funding of graduate medical education, that would be three “Brad Means Reports,” and you’d probably lose your audience ’cause it’s so arcane and Byzantine to figure it out. But hospitals that teach residents get a little bit more money from Medicare and Medicaid to enable them to absorb those costs. So, you know, for example, most academic medical centers have level one trauma centers like we have here. They may have children’s hospitals like we have here. They often have cancer centers like we have here, and they may have comprehensive stroke centers like we have here. So, those centers take a lot more ancillary personnel and cost, and so, you know, Medicare and CMS, thankfully, factors that into how they pay us. And generally, outcomes for patients are better at academic medical centers. A lot of studies show that, so –

Brad Means: Yes, it seems like you might run into a case where a patient could be in the exam room upstairs and the folks are working downstairs to cure whatever they have.

Dr. David Hess: Absolutely. That’s absolutely correct. And so, you know, a lot of the, some of the clinical trials we do here are from basic discoveries that were made, you know, across the street here on Laney Walker.

Brad Means: That’s impressive. Let me ask you this, and this is always something fun to talk about because I think that MCG does a great job of incentivizing the whole medical school experience and getting people to graduate and stay in Georgia. How are we doing on that front, serving the underserved parts of this state? I was stunned to read how many counties don’t even have doctors.

Dr. David Hess: Yeah, and, well, there’s a national physician shortage and nationally, there’s a rural physician shortage, which is quite severe. So, Georgia, you know, we rank about 40th in the country in physicians per capita, but that’s a little misleading ’cause many suburban counties of Atlanta are pretty well staffed, although even there, there’s shortages. But you know, if you look at south Georgia, you know, below I-16, just as a rough geographic boundary, many of those counties are very short on physicians, primary care physicians and specialists. And so, you know, we’re the only public medical school in Georgia. We’re a large school. We have a class this year of 260, one of the 10 largest in the country. So, we want to produce more physicians, and that’s why we shorten our curriculum to three years. So, we have this three plus curriculum, which is innovative. We’re in the second year of it. It’s possible to finish medical school in three years. Many students, the vast majority, will still spend four years here. But if you decide to do a primary care residency and stay in Georgia, you can finish in three years. And then, some students, eight this year, will get a scholarship to pay for the last two years of tuition and medical school, two of the three years.

Brad Means: Wow.

Dr. David Hess: If they commit to practicing in an underserved Georgia for two years. Now, so much of Georgia is underserved that it’s not hard to find a county that you don’t qualify for.

Brad Means: So, this is year two. So we’re a year away from getting those, I don’t want to say kids, getting those young adult medical professionals out into those communities? Are we that close to seeing it?

Dr. David Hess: Yeah, well, right, right. About a year and a half.

Brad Means: Okay.

Dr. David Hess: So, some of those students now, in January, so in the old medical school, when I went to medical school in most medical schools, the first two years out of four years of medical school are spent in the classroom. And you know, mostly, you know, you’ll see some patients, et cetera, but it’s mostly in the classroom. Now, we shorten that to 18 months. And not only do we shorten it to 18 months, but they get patient experiences in the first three to four months of medical school. So that, the three-plus curriculum, it’s already in its second year so that the ones in the second year are now starting their clerkships, so you’re right. In about 18 months, they would be starting a residency in Georgia in a primary care specialty. And I said we were able to give scholarships to eight of them thanks to Peach State Health, part of the Centene Corporation.

Brad Means: They gave you like 5 million, didn’t they?

Dr. David Hess: And the state of Georgia matched.

Brad Means: Yeah, they gave you like five –

Dr. David Hess: Pardon?

Brad Means: I think they gave you $5 million last March?

Dr. David Hess: Yeah, 5.2, and then the state matched that.

Brad Means: Wow.

Dr. David Hess: So, that’s an endowment that we’re building up for these scholarships. We’re seeking to increase that endowment so students don’t have any debt. So, you know, students, when they go to medical school, the average debt is 160,000, and they may have had undergraduate debt. By shortening the medical school one year, that saves money. And then, the students that commit to practice in underserved Georgia can have, presently, two of the three years of medical school paid for. So, that really reduces the debt because medical school tuition and, you know, is, and we’re one of the less expensive medical schools because we’re state, is still a little bit over 30,000, just tuition, so that adds up.

Brad Means: Let me ask you this real quick before we take our first break, just to rest people’s minds. They’re not getting a cliff notes doctor, then, when they cram all that medical school in such a short time.

Dr. David Hess: No, that’s a, it’s a very good, no, just the opposite. It’s even, they actually have more credit hours. You know, we actually count the credit hours. There’s more credit hours in this curriculum than there was in the old curriculum. So, they just work harder.

Brad Means: Yeah.

Dr. David Hess: They just don’t have as much time off. And it’s important for patients, as they see patients much earlier in the curriculum, and that’s critically important. Now, many students will still stay the fourth year if they want to go into, you know, orthopedics or otolaryngology, and then some students will just want to spend the fourth year. So no, this is just the opposite of cliff notes. This is like bootcamp. It’s more intense.

Brad Means: Well, and the pay off is certainly worth it, not only for the student, but for the communities that get his or her services. When we come back, we’re going to continue to talk about the state of the Medical College of Georgia with the dean of MCG, Dr. David Hess. We’ll be right back on “The Means Report.”

Part 2
Brad Means: We welcome you back to “The Means Report.” So happy that you’re here with us today, as we continue our conversation with the dean of the Medical College of Georgia, Dr. David Hess, talking about all the exciting things going on at MCG and exciting, exciting future there to be sure. Dr. Hess, you mentioned enrollment in our first segment and that right now, we’re sitting at about 260 students. Is that a good number? Do you wish it was higher, lower?

Dr. David Hess: That’s a good number of where we are now. Now, our, we want to get to 300. That’s our plan in the next, you know, four to five, six years, and that’ll be one of the, you know, probably five or six largest medical schools. We’re able to do that because, well, most of our training is in Augusta and in Athens. We also have these regional campuses, which I always call the secret sauce of MCG. And our motto is, you know, one MCG, one mission, but many campuses. So, you know, we have a regional campus in Albany. You know, talk about COVID, that’s where the first wave hit about the hardest in the country. So, we’re in Albany, the Southwest, and then we’re all in many counties and cities around there. We’re in the Northwest, Rome, and then Dalton is one of our newest areas of expansion up near the Tennessee border. And then we’re in Savannah and Brunswick. So, we’re really all over the state. Our students are in many, many counties in many areas, and that’s where they actually learn from any volunteer faculty and faculty who are actually out in the trenches. So, you get the best of both worlds. You can be here in Augusta at the academic medical center, one of really only two in Georgia. Us and Emory have really have the, fulfill the criteria for a really academic health center or medical center. And then you can be at our regional campuses and be out there with a physician one-on-one without any residents, and just you and them. So, it’s really the best of both worlds.

Brad Means: Is there a specialty? Let’s look at those 40 people sitting out there right now that could get us to that 300 enrollment mark. Is there a specialty you’d push somebody to where there’s a need these days, the future med students?

Dr. David Hess: Well, my gosh, there’s so many. I think primary care in general, which is broadly defined in Georgia here, family medicine, pediatrics, internal medicine. Psychiatry is severely short. That’s considered, OB-GYN, as you can see from the map, severely short. We have very high infant and maternal mortality here in Georgia. So, that’s really critical. And even general surgery is considered. So, everything’s short. Really, a medical student could go into almost any specialty and be desperately needed.

Brad Means: Why are those OB-GYN numbers so bad?

Dr. David Hess: Well, it’s, you know, it’s hard to have an OB-GYN practice in, you know, many counties, right? ‘Cause there’s not always the support, but Georgia has a very high maternal mortality. It’s particularly in African-Americans. And one of the things that Governor Kemp has proposed to do is increase Medicaid from six months to 12 months. So, you know, it’s access to care in a lot of these places, why our mortality is so high and we just need more, you know, we just need more OB-GYNs in the state. And then to get them in these underserved areas.

Brad Means: Well, besides the students themselves, do enrollment numbers play a big role when y’all are recruiting? When you’re trying to get teachers and researchers to come to MCG?

Dr. David Hess: I think it helps. I think it helps to be a large public medical school. I think that’s attractive to people. What is most attractive to researchers is the environment that they’re in, which includes students and also graduate students, you know. MCG and AU also has graduate students in biomedical research and other areas, so that’s another important area. These are students that get PhDs. So, that’s very important. And post-doctoral fellows, these are people after a PhD who work in a lab. So, as you know, we’ve been able to recruit some really high profile scientists just in the last few months. We’re proud to announce that we have, we’re going to have three new Georgia Research Alliance eminent scholars. These are the, you know, the best researchers in the country. Now, all these are pending board or region approval, but they they’ve all been vetted here and by the Georgia Research Alliance. So, that’s really exciting. We have some really exciting research news.

Brad Means: Well, some incredible researchers, some bright minds, the brightest coming right here to MCG, that’s exciting. What about any new programs on the horizon, new departments opening up? Any plans like that?

Dr. David Hess: Yeah, so we are proud to announce, and it’s, God, it’s almost first on the Mean show is, and, this week we’re going to announce our developing a center, a new center for immunology. And we’ve recruited two of the world leading immunologists from, that’s right, La Jolla, California.

Brad Means: Wow.

Dr. David Hess: Overlooking the Pacific Ocean are coming to Augusta, and they are Klaus Ley and Lynn Hedrick. They’re a husband and wife team. So, they also will be the first husband wife team in the Georgia Research Alliance eminent scholar list. So, there’s about 75 GRA eminent scholars in Georgia. That’s a public private partnership. Many of them are at Emory, University of Georgia, Georgia Tech, Georgia State, few other universities. And we’ll add three here. Two of them are Klaus Ley and Lynn Hedrick. And why is that important? Well, we’re through COVID. So, immunology is a fundamental mechanism and discipline to understand COVID. So, Lynn Hedrick, one of them, actually has some COVID funding to understand the immunology of COVID. So, immunology is very important for cancer, as you know, and your, some of your audience knows that many of the new cancer treatments are immunotherapeutics. What seems to happen in cancer is the immune system, instead of attacking the cancer, the white cells and these killer cells attacking and killing the cancer, for some reason, a break is put on the immune system, and now we have drugs that can, if you will, release the break. These are these immunotherapeutics. Dr. Munn here has developed an excellent immunotherapeutic, what’s called an IDO inhibitor. So, thanks to Dr. Munn and the research we had, we were attracting these people. So, Lynn Hedrick will work in the cancer center and also head the cancer immunotherapy program. And Klaus Ley will also be in the cancer center. And he more looks, he’s developing a vaccine for atherosclerosis, which is the number one killer in the world. So, we think of vaccines for COVID. We think of vaccines for smallpox. How many people thought about a vaccine for atherosclerosis?

Brad Means: Right.

Dr. David Hess: Well, that’s what he’s trying to develop. So, they’re immunologists and vascular biologists. So, they’re gonna develop this Center for Immunology and recruit 20 leading immunologists to MCG and AU over the next five years.

Brad Means: Do you think the folks at that center are going to help us be, goodness forbid, better prepared for the next pandemic?

Dr. David Hess: Yes, well, them and a lot of other work being done here, but yes, they’ll develop, they’ll help develop the therapeutics. A lot of that, you know, being ready for the next pandemic is a broader public health issue. But yeah, you know, detailing the underlying mechanisms is really important. And so, immunologists, it underlies cancer. It underlies multiple sclerosis, lupus, infections, vaccines. That’s so important, and it’s changed so much since I went to medical school. You know, it’s changing all the time. So, we will be a leading immunology center in the next few years. Augusta will be proud of the Center for Immunology that Lynn and Klaus will develop and lead.

Brad Means: No question about it. I know that aging is a big area of emphasis for MCG because of where we live and because y’all are really good at it. Have you found anything or are you working on anything to help us live longer or more comfortably?

Dr. David Hess: Well, we don’t have anything to let us live to 120 yet, but we’re, you know, we’re working on it. We want to live healthier. So, you know, Dr. Keel and Provost MacKinnon helped us launch in a cluster hire. This is a hire that’s Medical College of Georgia, the cyber center, college of science and math, many other schools here, that’s focused on inflammaging and brain aging. And in fact, Klaus Ley is in the inflammaging area, but we also hired a very prolific GRIM and a scholar in brain aging, specifically in Alzheimer’s disease. And she is Qin Wang, and she’s at UAB, University of Alabama Birmingham. And she’ll be here March, April to start an Alzheimer’s therapeutic program. So, she’s our third GRA eminent scholar. So, we’re in the midst of also looking for other recruits in the area of brain aging and inflammaging. So, inflammaging is a hot area.

Brad Means: Yeah.

Dr. David Hess: And this is as we get older, our immune system gets senescent. It doesn’t work as well. And then we get this chronic inflammation, and that’s not good. Chronic inflammation worsens aging. So, we’re trying to uncover why we get chronic inflammation and then developing drugs and therapeutics to inhibit that.

Brad Means: There is so much amazing work going on at MCG. I have about 30 seconds left for my final question. And it’s, I think the final question I asked last time is what do you, what can we expect to see in 2022 and beyond when we go downtown and we’re driving around the health sciences campus? Any new buildings or any impacts on our travel, our commute, that we should look for in the health sciences district?

Dr. David Hess: I hope we won’t be holding up your commute. You know, the fourth floor of the college of science and math building, which is already built, is going to be a research wing, but, or a research floor, but that won’t impact anybody’s driving. ’cause it’s just being built out. Most of the construction will be internally. So, I don’t think, we have some, a big research building planned, but that’s a few years off. So, I don’t think you’re going to see anything that’s going to impair your ability to drive in this area that I’m aware of.

Brad Means: Well, it’s always worth it, any sort of delays or construction, because something great always comes of it. And so many great things are going on within your existing walls. Dr. David Hess, thank you so much for all you do at the medical college, and please give our best to your team there, too.

Dr. David Hess: And thank you, Brad. We really appreciate highlighting what’s going on at MCG and AU and our health system. That’s exciting. And we want, we’re here for the community. So, it’s very important that you get this information out to the community.

Brad Means: Well, we appreciate your help in that regard. Dr. David Hess, dean of MCG.