Leaders in Medical Education

Dr. Ronnie Martin, Dean of the Liberty University College of Osteopathic Medicine

Osmosis Team
Aug 31, 2016

Dr. Martin served his fellow citizens and country during his 23-year association with the U.S. Army, the Army Reserves and the National Guard of Oklahoma, beginning in 1968 and ending after 1992 Desert Storm campaign. During that time he served both as a NCO and an officer, as well as, a physician. After obtaining his foundational education in chemistry and biology at East Central State University in Ada, OK, Dr. Martin graduated from Southwestern Oklahoma State University College of Pharmacy in 1974 and practiced as a hospital pharmacist in Enid, OK for 2 years. A member of Rho Chi honor society and Phi Delta Chi national Pharmaceutical Fraternity, Dr. Martin received the outstanding senior award from the university on his graduation. Matriculating at Oklahoma College of Osteopathic Medicine and Surgery in 1976, he is a 1979 graduate of Oklahoma State University College of Osteopathic Medicine. He was a member of the Sigma Sigma Phi honor society, Student Senate President and National Chairman of the Council of Student Council Presidents while in school. He received the outstanding senior reward at graduation. Dr. Martin completed his postdoctoral training at a rural consortium consisting of Tulsa Regional Medical Center and Enid Regional Medical Center, also being recognized as the outstanding graduate of the program. Dr. Martin became board certified by the American Osteopathic Board of Family Physicians (AOBFP) in 1986 and was inducted as a Fellow of the College of Family Practice in 1996.  Dr Martin received recognition as a distinguished fellow in 2005.

How did you decide on a career in medicine?
As a youth, when I figured out that I was not going to run in the Olympics or play professional football or baseball, I had the strong feeling that in life I wanted to help others and made a difference in the lives of others.  I loved science and mathematics, was a good student and felt that medicine was the way I could accomplish my goals.  

What were a few key steps in your journey from an aspiring medical student to your current position as Dean of the Liberty University College of Osteopathic Medicine?
I was not accepted into medical school initially.  I was a poor kid from a small school in a small town.  I had gone to a small college to play football, and although my grades and my MCAT were top notch in in the 99th percentile, I did not have the political and professional contacts to gain admission.  I was accepted to S.W. Oklahoma State College of Pharmacy.  I graduated #1 in my class, and I began practice in a small Osteopathic Hospital.  The physicians there supported me and encouraged me to apply again, and with their support I was accepted three years later.  I managed to graduate #1 in my class again, and I learned in the process that although I was accepted into internal medicine and cardiology, I really fit better as a family medicine physician, desiring the ongoing personal, collaborative relationships with my patients.  After GME I practiced in a small town in OK for 17 years.  During that time I served as a program director, medical director and DME and trained medical students, interns and family medicine residents for 15 of those years.  After two years however I told my wife that I was going to practice for 12-15 years and go back to school to teach as I realized that a lot of dedicated and intelligent people had taught me, but that few of them

Had taught me how to me a doctor since most of them had ever practiced.  I felt that students needed to learn from someone who had been there and one that as the saying goes.

I became faculty at OSU-COM and after two years, the Chairman of Family Medicine at Des Moines University COM.  A couple of year later, I was recruited to Nova Southeastern as Chair of FM and promoted there to Associate Dean for Academic Affairs.  In 2006 I was recruited to become the founding Dean of the new Rocky Vista University College of Osteopathic Medicine in Parker, CO.  Leaving there in 2009, I was Vice Dean at Edward Via College of Osteopathic Medicine in Blacksburg, VA for four years before being recruited to become the founding Dean at Liberty University COM in 2012.  

What is the greatest difference between the clinical side of medicine and the administrative side?
The diminishing of clinical practice and the doctor-patient relationships.  The dealing with budgets, requirements, standards become more primary than patient outcomes and wellness.  It is my job in many ways to solve problems for others in administration and on faculty so they can advance the education of students and the careers of faculty and staff.  It is more about the mission and vision or the institution and the profession and not principally the outcome of the individual patient.

Can you shed light on what distinguishes an osteopathic medical school from an allopathic medical school?
Generally I would say philosophy and mission-vision.  D.O. COM are generally community based education programs.  That means they place a higher value on community based education and disciplines.  They place a higher value on early clinical education, doctor-patient relationships, communications and wellness. The emphasis is generally more on a patient centered vs. a disease oriented approach to medicine, which results in a higher emphasis on primary care, preventative and wellness.  At Liberty, the emphasis we place on the requirement to address the body, mind and spirit of the patient is front and center of our education system.

D.O. address more directly the function-structure relationships in the body, and learn about both somatic-visceral and visceral-somatic dysfunction and the application of OMM and OPP at a higher level of intensity than allopathic medicine.

There is less emphasis on research and epidemiology at most D.O. colleges than at the traditional allopathic medical school.

What does an "average" day look like for you?
I come in around 0700 and catch up on email from the previous days and night until about 0830.  Meetings with faculty, staff, student’s along with upper administration of the university occupy most of the day as we strive to meet the educational, administrative, budgetary and development requirements of the COM and support its mission and vision.  I still try to teach some each week because I love it, and maintaining relationships with community partners and institutions form hospitals to patient organizations are important to our mission and vision.

I generally wrap up the business of the day around 5 PM and then spend a couple of hours doing correspondence, meeting the documentation needs for accreditation and certification, faculty development and recruitment or the production of required budgets, reports or lectures, etc. required for that day for the next couple of hours.

I try to get to the clinic for ½ day or more weekly, but it often falls to the side of other requirements.

What was/were the most memorable experience(s) during your medical education?
All involved patient care and the excitement of being involved in the lives of the patient, making a difference.  The first baby I delivered myself was equaled by the first time I had a patient die that I was directly involved with.  The thrill of being in the middle of saving the life of the patient who walked into ED with no blood pressure, awake and a bullet hole in his chest.  I remember to this day the first time a patient prayed with me and the first time one cried tears of joy because we told them we had succeeded in treating a life threatening illness.

There is an enormous debate these days as to whether resources should be primarily allocated to fighting diseases or the distal causes of diseases. What are your thoughts on this issue of proximal causes versus distal causes?
I am a primary care physician and a believer in preventative and primary health care.  Access to a quality family physician and primary care is the key to health, wellness and economically the most effective and efficient methods of improving the lives of the most patients.  

I believe we should be dedicating ourselves to the things that make the most difference for the most patients.  The prevention and primary care of heart disease, obesity, hypertension, avoidance of smoking or a sedate life style, bad diets, substance abuse each have the potential to improve more lives that tertiary interventions.

We are the best in the world at tertiary interventions in the US because we are so poor at preventing pathology.  As a result, we have more mortality and morbidity than we should, we are economically inefficient and our population suffers.

Our highly skilled specialists concentrate for the most part on the margins of life, the first 2 years and the last two at great expense and little change in outcomes.

What do you think is the biggest challenge facing physicians today?
Maintain the doctor patient relationship and patient centered approach to health care for the benefit of the patient in a progressively standardized, decentralized, specialized, institutionalized, none personal corporatized environment.  

The challenge to maintain competency, knowledge and skill is improved by our wealth of electronic communication but our ability to maintain the relationship with our patients is weakened by our current system.

What are most the important facets of an undergraduate’s application to medical school from an admissions perspective?
In our case, demonstration of compatibility and advancement of the mission and vision of the college is most important.  We place a premium on service, ethics, professionalism, diversity and compassion.

There are standards for grades and MCAT but they count secondary and only to the extent that they demonstrate that the candidate has the ability to be successful with the curriculum.

LOR and personnel statement, personal interview are critical to success.

How do you foresee medical education changing in the next few years?
Knowledge is no longer king.  Physicians are no longer “keepers of knowledge and skill”, as we were for generations with the internet and electronic media, knowledge is cheap.  The ability to evaluate, interrupt, manipulate and utilize knowledge along with the ability to problem solve, communicate, educate and motivate patients is becoming critical.

More emphasis on how to learn, how to communicate.  More emphasis on competency and less on pure knowledge.

For 100+ years medical school has been 2 + 2 of pre-clinical and clinical education.  For 70 of those years, that was it, you were ready to enter independent practice at that stage.  Today, no one enter practice without 3+ years of GME.  I expect to see med-education change to perhaps 1 + 3 or 3 +1 or even 2 + 1 year of clinical education recognizing that students no longer enter independent practice at graduation, rather they enter supervised practice and they face 3-4 more years of education.

More emphasis on communication and education skills.  More emphasis on utilizing those skills to work within teams of health care professionals and less independently.