A Historical Overview
by T. Stuart Walker
The Indiana State Legislature established the Statewide System for Medical Education in 1971 in an effort to reverse two trends; 1) record numbers of graduates of the School of Medicine were leaving the state to practice medicine elsewhere, and 2) progressively fewer of the graduates were entering primary care residencies.
To help stem this tide, the Legislature established community-based Centers for Medical Education in Evansville, Ft. Wayne, Gary, Lafayette, MUNCIE, South Bend, and Terre Haute. This marked the official birth of the Muncie Center for Medical Education (MCME), but it was not the start of medical education in Muncie.
In 1968, the School of Medicine had begun a pilot program to teach basic medical sciences to medical students on the campuses of Notre Dame and Purdue Universities. By 1970, the program expanded to include the placing of four IU School of Medicine students at Ball State University (BSU).
With the action of the legislature, the number of students being sent to Muncie expanded to 10, and Dr. Charles Boyer was appointed Director of the MCME. By 1974, the first-year class was increased to its present size of 16 students.
From 1970 thru 1974, the MCME was housed on the BSU campus, sharing the Cooper Science Building with the Departments of Biology, Chemistry, Physics, Physiology and Health Science, and Nursing. Dr. Boyer served as Director of the Center until 1974, and faculty for the various disciplines were borrowed from the basic science departments housed in the science complex.
Among the early instructors were Pang Fai Ma and Eugene Wagner (Biochemistry), Duane Eddy, Ray Henzlik and Thomas Lesh (Physiology), Mohindar Jarial, Lee Engstrom, Charles Boyer and Gordon Rosene (Anatomy and Histology), and Don Hendrickson, Peter Nash and George Welker (Microbiology and Immunology). Dr. Engstrom joined the staff in 1973 when Dr. Rosene died unexpectedly early in the school year.
Dr. Boyer retired in 1974, and was replaced by a local physician, Dr. Anthony Dowell, who served as Director from 1974 thru mid-1977. If Dr. Boyer's key achievement was establishing the Center, Dr. Dowell's was moving the Center from temporary quarters on the BSU campus to a permanent home adjacent to Ball Memorial Hospital (BMH). This was important, because it gave the Center its own permanent identity, and because it moved the medical students from an undergraduate campus to a site where they could become part of the medical community.
It had been hoped that the Centers would attract young men and women to stay in the communities where the Centers were located, by making them part of the local medical community as early as possible during their educations. This had been difficult in Muncie as long as the MCME was located across campus from the hospital.
In 1975, at a cost of $500,000, the second floor of the Maria Bingham Hall was converted from a residence hall for nursing students to become the permanent home of the MCME. This location was particularly beneficial for the program because it placed the Center one floor above the BMH Family Practice Center, and across a parking lot from BMH. This made it possible for the first-year medical students to interact regularly with physicians, and to see primary care medicine being practiced. In 1975, Duane Eddy became the first Assistant Director - a post he held until 1980.
In 1977, Dr. Dowell left the Center to practice internal medicine full-time, and was replaced as Director by Dr. Douglas Triplett, an internationally-prominent hematopathologist. Under Dr. Triplett's leadership, the second year of the medical school was added in 1980, and four second year students were assigned to the MCME. Dr. Vic Jolgren was added to teach Pathology. Dr. Dan Brown taught Pharmacology, and a group of physicians at BMH under the direction of Dr. John Cullison taught Introduction to Medicine.
The second year class grew to 10 in 1981, and to its present size of 16 in 1984. This expansion of the MCME program into the second year and the addition of new faculty required that there be additional facilities to house them, so in 1982 the third floor of Maria Bingham Hall was retrofitted for medical education at a cost of $725,000.
Under Dr. Triplett's leadership, the Center began to change in other ways. In 1980, Dr. Eddy left the program to assume an administrative position at BSU, and Dr. Duncan Kennedy became the Center's new Assistant Director. Dr. Kennedy served in that capacity until his retirement in 1991, when he was replaced by Dr. Eugene Wagner. There were also faculty changes as the Center began to recruit its own faculty rather than requesting that existing BSU faculty be assigned to the Center.
This became possible in 1982 when, after years of negotiations, the Center became a freestanding academic unit within BSU - analogous in hierarchy to a college. From the Center's inception, faculty at the Center had been faculty from various BSU science departments. That meant that hiring, salary and tenure decisions now could be made within the Center, without having to depend upon the goodwill of the BSU basic science departments. This change allowed the Center, for the first time, to pursue its own course and select its own faculty.
As the faculty changed, a new emphasis on research was introduced, and faculty were hired that the Center believed would be good teachers and would establish credible independent research programs. Among the newer faculty were Drs. Stuart Walker, M. Rita Young, Roger Noble, Cynthia Schmidt (Microbiology and Immunology); Burton Webb (Physiology and Immunology); Robert Taylor, Richard Milton and Scott Herness (Physiology); Mike Lannoo (Anatomy); Brett Zimmerman (Pharmacology); and Mike Witte (Molecular Biology) - as well as a host of part-time faculty. In 1989, Dr. Triplett replaced Dr. Cullison as Director of Medical Education at BMH.
The students who were part of that first class in 1970-71 would scarcely recognize the Center today. There are now 32 first- and second-year medical students being educated both on the two floors of Maria Bingham Hall and within the Medical Education Department at BMH.
There is a new interest in inductive learning, so classes are incorporating problem solving sessions, students learn at the side of physicians in the hospital clinics and at patient bedsides, and an extensive computer laboratory has been established in the MCME, allowing the students to use computers and CD-Rom-based systems to learn and review materials from their classes. Some of the first year disciplines have incorporated computer-based exercises into their laboratory work.
Those early students would find the current faculty quite different from some thatthey had during the early years when the faculty, although excellent teachers, had little time available for research, with full-time assignments and heavy class loads within their respective home departments at BSU. Today, the faculty (including some who have continued from those early years) have made the Center a place where high quality research is done, and where students can observe and participate in federally-funded research projects.
During one recent year, the 11 full-time faculty published 17 papers in national and international refereed journals. These faculty held more than a million dollars in federal research funds (direct costs only), with projects in such varied areas as nerve function and muscle fiber development, mapping of brain development, molecular pathogenesis of intracellular infectious diseases, and transduction of taste.
During the spring of 2000, the MCME moved into the newly-constructed Edmund F. Ball Medical Education Building. This research and teaching facility houses both the MCME and the Ball Memorial Hospital Family Practice residency program. The new facility is designed to maximize the use of computertechnology and advanced presentation equipment in instruction. Additionally, faculty members have access to state of the art research facilities. With the Family Practice Clinic on the first floor and the MCME on the second floor of the building, the close physical relationship between the Center and the primary care residency program will be maintained as it was when both programs were in Maria Bingham Hall.
The MCME has radically changed physician retention patterns in east central Indiana, and has undergirded the development of residency programs at BMH. About 35% of the physicians in the Muncie area received at least part of their education here. BMH is the only Hoosier hospital outside Indianapolis with more than two residency programs: each year about 1/3 of the approximately 50 residents in the four residency programs at BMH began their medical education at the MCME.
Thus the MCME has developed, as was originally hoped, into a program that would infuse physicians into east central Indiana, and it has surpassed the expectations of the early leaders in becoming a research center and a site of innovative medical education.