Oceania University of Medicine is the world’s first and only online medical school. While they’ve been around since 2002, they still haven’t gained much recognition or respect. But why? Is there something inherently wrong with online education or does it have more to do with “us vs them”?
The World Goes Online
20 years ago, when the internet was dominated by the likes of Yahoo and AOL, doing anything online other than email was pretty taboo. Amazon and Google were only a few years old. YouTube and Facebook hadn’t even been conceived yet. And no one wanted to admit that they actually met someone on Match.com. I was “coming of age” right around this time. When I was young, the internet was still dial-up and cost $4.95 a month. But even then, online education wasn’t new. It was just entering adolescence itself.
Education Goes the Distance
Distance education was born well before the internet. In fact, a precursor to the internet was actually developed by the University of Illinois to allow students access to course materials and recorded lectures.
The history of distance education goes back even further. The University of Wisconsin–Madison started sending lectures on phonograph records to students across the country in 1906. By 1925, both Penn State and the University of Iowa were broadcasting lectures on the radio. As soon as televisions were commonplace, credit could be earned via broadcasts from the University of Houston.
But surely medicine could never be taught this way, right? Actually, in 1965 the University of Wisconsin started implementing telephone correspondence for their medical students across the state. Michigan State University started harnessing the internet to instruct first-year medical students over 10 years ago. The faculty of Michigan’s MD and DO programs created online resources such as audio and video lectures, online homework, virtual labs, and more. The school envisions a model where all basic science courses are available online with the exception of gross anatomy labs.
And then there’s Yale. The Yale School of Medicine has operated a Physician Associate program since the early 1970s. In 2015, they announced a new division of their renowned program that would offer the first 3 semesters, also known also the “didactic year”, entirely online. The last 3 semesters, the “clinical year”, would be completed at teaching hospitals and local clinics as per usual. Students would spend several weeks on campus for immersive hands-on training. The inaugural class began in January of 2018. It would be the first time in the schools’ 300 year existence that a student could obtain a Yale degree without being on campus. Some of the first students to enroll included a PharmD and a medic of 20 years.
Online by Choice
Ok, so online or distance learning isn’t new and it’s gaining momentum. But would you have guessed that traditional medical students spend just as much time learning online as those in newer, more novel programs?
A 2018 survey by the Association of American Medical Colleges (AAMC) revealed that nearly 25% of second-year medical students “almost never” attended class during their first two years of medical school. Really? What were they doing? According to an article in STAT based on the previous year’s survey, these students “follow along with the class remotely, watching sped-up recordings of their professors at home, in their pajamas. Others rarely tune in.”
Lawrence Wang, who at the time was a third-year M.D.-Ph.D. student at the University of California, San Diego was quoted as saying, “There were times that I didn’t go to a single class, and then I’d get to the actual exam and it would be my first time seeing the professor. Especially, when Step was coming up, I pretty much completely focused on studying outside materials.”
The 2018 AAMC survey reported a few other interesting stats. For example, 66% of the surveyed medical students reported using online videos, such as YouTube, either daily or weekly. 79% reported regularly using other online sources such as Wikipedia. Yeah, it’s true. Check it out.
Online by Chance
And then there’s Harvard. Like other schools, medical or not, Harvard is scrambling to respond to the fall out of COVID-19. Rather than postpone classes for incoming first-year medical students, all classes will be moving online.
The Deans of Harvard’s Medical School don’t seem too concerned, however. In an email breaking the news, they said, “We are confident that we can uphold the excellence that is the signature of a Harvard education. We are also committed to assisting our teaching faculty in designing online courses that meet these high standards and in supporting technologies that bolster our teaching and learning initiatives.”
Online Medical School: The Future?
So, when is medical school officially going to go online? PA schools are doing it. NP schools are doing it. Medical students are already doing it. It turns out, there is a medical school allowing students to complete their didactic training online.
Oceania University of Medicine (OUM) was founded in 2002 by a private group in cooperation with the Samoan government. The program was developed in response to “Samoa’s remote location and shortage of physicians.” Over half of OUMs students are nurses, nurse practitioners, or physician assistants.
The world’s first online medical school will take you “4-and-a-half to 5 years” to complete and includes real-time virtual classroom sessions via Zoom. If you choose a part-time schedule, you’re projected to finish in about 6 years.
During the online “preclinical” phase, OUM’s online medical students are required to choose a physician mentor in their community. These mentors offer real-world experience and assess the students’ developing clinical skills. Physician mentors receive a “modest honorarium”.
The clinical phase of the program is similar to any other medical school and consists of hospital-based clinical rotations. Students at Oceania’s online medical school must spend at least one 4-week rotation on the island of Samoa.
OUMs catalogue states that most core rotations, as well as many electives, are available at the Tupua Tamasese Meaole Hospital in Apia, Samoa. The school has formal relationships with teaching hospitals in Chicago, Illinois and McAllen, Texas. OUM students have also trained in Australia, New Zealand, India, and Europe.
What does it cost to attend medical school online at Oceania University of Medicine? Just over $165,000. No financial aid is available meaning students rely exclusively on private loans or OUMs payment plan that spreads the cost of each year over 12 months.
No MCAT is required for admission but applicants from the US must have completed a full year of chemistry and completed a Bachelor’s degree with a GPA of 3 or better.
Students from Online Medical School vs The Match
A medical school degree, be it from an online program or not, isn’t worth much unless you can “match” to a residency, complete your training, and actually end up working as a physician. “The Match” refers to the process of matching medical school seniors with residency programs based on ranked lists provided by each. It’s at once a brilliant and ridiculous system deciding the fate of almost 45,000 soon-to-be doctors each year.
The Match, sponsored by the non-profit National Residency Matching Program (NRMP), claims to be “100% objective, 100% accurate, and 100% committed to a fair and transparent process.”
Except it works something like this:
Yeah, I definitely want to do that… But in all seriousness, it’s the only way to go.
Unfortunately, the other major flaw (besides a machine deciding your future) is that there simply aren’t enough residency positions to go around. Overall around 15% of medical school grads don’t match; no match means no job. The math is even worse for IMGs (international medical graduates) such as those graduating from Oceania University of Medicine.
Just over 5,000 American students studying at international medical schools registered for the most recent 2020 Match. Only 61% matched with a post-graduate training program. That means that around 2,000 are essentially out of luck. There are a few options for students who don’t match but remember that those 2,000 American IMGs are joined by another 5,000 American MD and DO grads as well as foreign-born IMGs. Those are some tough odds. I can’t imagine it’s any easier if you went to an online medical school…
What Say You, OUM?
How well do OUM students perform in the Match? Well, that’s a tough question. It would actually be easier to answer how many students have actually graduated from OUM–the answer? 66. Yes, 6-6. Since 2002. Yikes.
OUM has 150 students currently enrolled. Let’s assume that they’ve had half that on a yearly basis over the last 18 years since their inception.
75 students a year x 18 years = 1350 total students
1350 students / 66 graduates = 5% graduation rate
Those aren’t great odds.
License to Heal
After completing a residency, physicians must obtain licensure from the US state where they wish to practice. It’s a real possibility that even after having passed the USMLE licensing exams and completed a residency, you still wouldn’t be able to actually find employment as a OUM grad.
Oceania’s website states that they have graduates practicing in Arizona, DC, Florida, Illinois, Maryland, and Virginia. That’s not a huge list and I have to assume that not all of their 66 grads actually made it through the Match and into the workforce.
I really believe that online medical school will one day go mainstream. Some storied pillar of education like Harvard or Yale will just decide to go for it and they’ll be hailed as pioneers. It just won’t be Oceania University of Medicine.
The Future of the Physician
Physician training in the United States is far from perfect. It’s redundant, time-consuming, and relies on the Federal government to get trainees over the goal line via residency training. An online medical school doesn’t really change any of that–it would just make it harder for everyone to complete the process by overcrowding the match. The government has proven incapable of solving the residency problem and special interest groups like the AMA aren’t helping.
Medical school graduates aren’t capable of practicing without residency training, either. They spend half of their medical school experience reviewing basic sciences and taking time off for holidays and interviewing. Self-proclaimed Associate Physicians are trying to change that but ultimately they’re just folks that couldn’t pass their boards–not the kind of doctor most want to see.
There has got to be a better way to train doctors! There is! the equation goes something like this: Take a well-trained PA (proven over 50 years to provide care on par with residency-trained physicians), add 1-2 years of additional clinical education and what do you have? A clinically-trained Doctor of Medical Science.