If good marriages depend upon a combination of something old and something new, then the match between recently appointed Dean Gerald D. Fischbach and Columbia University’s College of Physicians and Surgeons seems promising. The medical school, the first in the United States to offer degrees to aspiring physicians, opened its doors in 1767. Dr. Fischbach, a Cornell-trained neurobiologist who most recently studied synapses at the National Institutes of Health, has been on the job for approximately six months. “And so far,” says Fischbach, “no complaints.” Only, it seems,
ambitions.”

While savoring a can of tuna fish in the hour-long interval between two meetings, the broad-featured, soft-spoken Dean outlined his vision for a dynamic, cutting-edge medical curriculum. “We need to rethink the science-based curriculum,” he explained. “Often we have students studying the exact same material from different perspectives. We have to find a way to integrate these studies so we can eliminate the redundancies.” He placed particular emphasis on rethinking the relationship between the traditional course work undertaken during the first two years of study and the clinical component of the third and fourth year curriculum. “You can study the basic biology all you want to, but you can’t fully understand heart failure until you’ve seen patients with heart failure. Our goal is to bring students back into the classroom after they’ve experienced interactions with patients.”

The new Dean also expressed an interest in expanding programs in areas once thought peripheral to a standard medical school education such as humanities in medicine and biomedical ethics. “It’s almost any emergency,” Fischbach noted.” “We’re now faced with these important questions in such areas as stem cell research, gene therapy and the end of life. We need physicians who can talk about these issues with intelligence...It’s important to know the basic sciences, the physiology and histology, but that’s not enough anymore.”

Columbia, like many of its competitors, is currently making the transition from a more traditional “knowledge acquisition” course of study to a problem-based small-group approach to the study of medicine that is designed to help students learn to think as physicians and scientists. “It’s extremely important we make the curriculum more coherent and that we make sure the faculty are thinking about problem solving,” said the dean.

Fischbach’s whole approach to the medical field is a bit unusual. In an era when many medical school deans still emphasize professionalism and the importance of acculturating students to their new career, Columbia’s new helmsman stresses the importance of freedom. “I don’t want Medical School to shut people off. Right now it’s still very much a lock-step trade school,” he said. “I’d like to get people to the point where they’re making independent choices early on as the rule rather than the exception. I don’t believe your first choice should have to be your last choice.” He beamed with pride as he reeled off the number of Columbia medical students currently enrolled in concurrent MD/Ph.D. and MD/MPH programs.

Prior to his service at Columbia and the National Institutes of Health, Fischbach was the Chairman of the Neurobiology Department at the Harvard Medical School and had headed the Department of Anatomy and Neurobiology at Washington University School of Medicine. He is a 1965 graduate of Cornell Medical School. “I had an extraordinary time at the NIH,” said Fischbach. “I’ll admit I didn’t expect to leave.” So why did he come to New York?

“What really attracted me to Columbia was the opportunity it afforded to have a major effect on the community. Now this is a job that’s much more than just research. This is a chance to reshape how biology and medicine will be taught in the next century and also how medical services are delivered to the people of northern Manhattan. To me that’s very exciting.”

With that level of enthusiasm, Dr. Fischbach may just stick around for a while.

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