Chang Chelsea, Cobos Everardo, Sander Michael D, Tapia Beatriz, Hocker Michael
Internal Medicine, University of Texas Rio Grande Valley School of Medicine, Edinburg, USA.
Orthopedic Surgery, University of Texas Rio Grande Valley School of Medicine, Edinburg, USA.
Cureus. 2025 Jun 9;17(6):e85631. doi: 10.7759/cureus.85631. eCollection 2025 Jun.
Medical schools must evolve with the changing healthcare landscape and financial pressures. Academic Health Centers have responded to these changes with a novel organizational model known as an integrated service line. Traditional medical school departments often create silos, lack of alignment, and financial burdens. To our knowledge, we were the first medical school to implement an integrated structure combining the tripartite missions of academics, research, and clinical services. The University of Texas Rio Grande Valley School of Medicine accepted its charter class of 55 medical students in 2016 with a traditional medical school department model. By 2023, it had 154 full-time faculty, 14 departments, a growing clinical practice with 25 ambulatory sites, and no university teaching hospital. Facing changes in the local healthcare landscape, medical school leadership implemented a restructuring of the medical school and its outpatient health system into Integrated Service Units (ISUs) in 2023. This study aims to (1) describe the institutional steps taken to implement an ISU model across academic, research, and clinical domains of a medical school; and (2) evaluate initial outcome observations in the first one-year post-implementation. Over six months in 2023, the institution successfully implemented its vision of reorganizing the medical school across the academic, research, and clinical care areas. The new structure had seven ISUs: Primary and Community Care, Medicine and Oncology, Surgery Specialty and Musculoskeletal, Neuro and Behavioral Health, Surgery, Medical Education, and Clinical Support Services. This paper delves into the challenges, opportunities, and key lessons learned. Embarking on the ISU transformation led us out of our comfort zones and beyond conventional paradigms. Preliminary findings across academics, research, and clinical services are presented and support that within the first year, the ISU model has accelerated the ability to accomplish our vision of transforming the health of the Rio Grande Valley. Next steps involve examining the long-term impact of the ISUs on the medical school, residencies, patients, and the health system. Areas of focus include financial success, faculty recruitment and retention, and research impact.
医学院必须随着不断变化的医疗格局和财政压力而发展。学术健康中心通过一种名为综合服务线的新型组织模式来应对这些变化。传统的医学院系往往会造成各自为政、缺乏协调以及财政负担。据我们所知，我们是第一所实施将学术、研究和临床服务这三方使命相结合的综合结构的医学院。德克萨斯大学格兰德河谷分校医学院在2016年以传统医学院系模式接收了其首届55名医学生。到2023年，它拥有154名全职教员、14个系、一个不断发展的临床业务部门，有25个门诊地点，且没有大学教学医院。面对当地医疗格局的变化，医学院领导层在2023年对医学院及其门诊医疗系统进行了重组，组建了综合服务单元（ISU）。本研究旨在：（1）描述在医学院的学术、研究和临床领域实施ISU模式所采取的机构性举措；（2）评估实施后的第一年的初步成果观察情况。在2023年的六个多月时间里，该机构成功实现了其在学术、研究和临床护理领域重组医学院的愿景。新结构有七个ISU：初级和社区护理、内科与肿瘤学、外科专科与肌肉骨骼、神经与行为健康、外科、医学教育以及临床支持服务。本文深入探讨了挑战、机遇以及汲取的关键经验教训。开展ISU转型使我们走出了舒适区，超越了传统范式。本文呈现了学术、研究和临床服务方面的初步发现，并支持以下观点：在第一年，ISU模式加快了实现我们改变格兰德河谷地区健康状况这一愿景的能力。后续步骤包括研究ISU对医学院、住院医师培训、患者和医疗系统的长期影响。重点关注领域包括财政成功、教员招聘与留用以及研究影响。
