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In Katrinas Wake Intensive Care for an Institution

August 25, 2006
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Tropical storm Allison roved and rained across southeast Texas for five days in June 2001, flooding much of Houston’s downtown, including Baylor College of Medicine and many of the other hospitals and medical schools in the city’s enormous medical complex.

    Few would have guessed that there was a silver lining of sorts behind all those drenching rain clouds. It didn’t reveal itself until Hurricane Katrina slammed New Orleans in August 2005. The ensuing floods engulfed the city, including Tulane University’s School of Medicine. And the damage was far worse than what Allison brought to Houston.

    "When it became clear that Tulane University’s medical school was going to be affected, we knew exactly what the situation was like," says Claire Bassett, a spokeswoman for Baylor. "We had had the experience of knowing what water devastation is like and what it’s like to lose space and equipment."

    A few days after Katrina’s devastation, Tulane’s medical school administration realized it couldn’t hold classes for at least the fall of 2005. So when Baylor administrators met with the leadership of Tulane and its medical school on September 7 last year, it took no time for an extraordinary agreement to emerge. Baylor offered to host all 600 of Tulane’s medical students.

    The 300 first- and second-year pre-clinical medical students would take required courses at Baylor, using the same classrooms as Baylor’s own 343 pre-clinical students. Tulane’s other 300 medical students, in their third and fourth clinical years, when they start learning to care for patients, would be hosted by Baylor and three other Houston-area medical schools: University of Texas Health Sciences Center at Houston, University of Texas Medical Branch at Galveston and the Texas A&M Health Science Center College of Medicine. About 50 of Tulane’s 521 residents were accommodated at these three institutions, and 30 Tulane medical school faculty members also went to Baylor.

    Doubling the number of students in a medical school—half of whom were arriving without their academic records—required ingenuity and a return to some old-school methods of record-keeping on the part of Baylor’s registrar’s office.

    Tulane had lost its Web site and IT resources, including all essential information on the medical students.

    "Baylor set up a Web site for the Tulane students to log in and register and tell us their location and contact information," says Lisa Chebret, Baylor’s registrar.

    Chebret and her office contacted the Association of American Medical Colleges, a national organization that registers and maintains a database on all American medical college students. Fortunately, Tulane’s registrar had updated medical student information for the association just days before Katrina hit.

    "That information was what our office used to verify identification and all necessary information, such as class assignments," Chebret says.

    Once Tulane students got the word about Houston and started arriving, Chebret bought 600 manila folders to create academic records for them.

    "We probably spent about two weeks setting up a hard paper system for them," she says.

    Then Chebret and her office spent another week developing four documents for each student that covered everything from identification and verification of enrollment to evaluations of clinical students, class assignments for pre-clinical students and the status of alumni, whose records were lost along with the rest. Chebret estimates that she and her colleagues worked 16- to 20-hour days for three weeks between September 7 and October 1, the day orientation began. That excludes the week lost due to hurricane Rita, which hit Houston in late September. Tulane students lost three weeks of classes due to Katrina.

    The medical school’s faculty, meanwhile, also had to revise their academic approaches, as well as their personal lives, in order to integrate Tulane’s students into their program.

    "We changed our grading system from honors, pass and fail to just pass and fail because of the stress," says Dr. Marc Kahn, a hematologist and oncologist and the associate dean for admissions and student affairs for Tulane’s medical school. "We had to figure out a new exam schedule and how we’d teach the various concepts," he says.

    "There was probably a three-week period where the vice dean and I saw each other more than our spouses did and worked about 20 hours a day to get this done, but there was no choice," Kahn says. "The faculty who taught the different courses also had to do a fair amount of work to re-scope the classes."

    Baylor made office space available for Tulane’s 30 faculty members, who did nearly all of the teaching of the Tulane students. The students shared auditorium and classroom space on a rotating schedule. Baylor students attended auditorium classes in the morning and small group sessions in other rooms in the afternoon. The Tulane students followed a reverse schedule.

    Sharing went a little further in the anatomy lab that all first-year medical students must take. Students are required to dissect cadavers, and Baylor College arranged it so that five Baylor students and five Tulane students shared one cadaver.

    "Anatomists all do (teach) pretty much the same thing," says Cassius Bordelon, associate professor, cell biology, and an anatomy instructor at Baylor. "There was no reason to make it difficult for them. "I told the anatomists at Tulane to come in, and we’d portion out (share) the cadavers."

    As with other classes, the Baylor and Tulane students used the anatomy lab on different days.

    When Tulane’s IT services began functioning again in October, Baylor e-mailed all student information to the school in the form of spreadsheets. Information on clinical students was in constant flux because of their changing rotational schedules.

    "I’d tell Tulane what openings we had at Baylor, and Tulane would send the assignments back to me," Chebret says. "We had to keep track of that all the way through May."

    Although clinical Tulane students did start returning to New Orleans in the fall of 2005, the university’s pre-clinical students spent the entire 2005-2006 academic year in Houston. Despite Katrina, Tulane retained 98 percent of its medical students. New-student application levels rose for the 2006-2007 year.

    One medical school opening its doors to the entire student body of another had never been done before, and Tulane’s leaders could scarcely express their appreciation.

    "There are few other medical schools who could have done this," says Dr. Paul Whelton, senior vice president for health sciences and dean of the School of Medicine at Tulane. "The four institutions in Texas really stepped up to the plate, and they didn’t ask for anything in return. There is nothing I could say that would reflect our level of gratitude. Without Baylor’s unconditional assistance, I don’t know where we’d be today."

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