Medical Education in Post-Katrina New Orleans

Abstract

THE MOST COSTLY NATIONAL DISASTER IN US HISTORY occurred on August 29, 2005, when Hurricane Katrina ravaged the Mississippi and Louisiana Gulf coasts, and the ensuing breaches in the New Orleans levee system resulted in flooding of approximately 80% of the city. The survival of Tulane University School of Medicine and Louisiana State University School of Medicine at New Orleans (LSU), both located in downtown New Orleans, was severely jeopardized as every major educational and teaching facility flooded following the storm, closing both undergraduate and graduate medical training programs. However, both schools quickly moved their educational programs to new locations and reestablished training for students and residents 1 month later. Tulane and LSU have now returned their educational programs to New Orleans despite faculty losses, closure of some traditional training hospitals, and a diminished population of greater New Orleans. The ability of both schools to survive and thrive has significant long-term implications for the delivery of health care in the region and the ability to train future physicians for the state of Louisiana. Tulane and LSU are situated almost adjacent to each other in downtown New Orleans, but because of the differences in the private and public nature of the 2 schools, the impact of Katrina and the solutions to recovery differed. The effects of Katrina on the educational programs of both schools are summarized in the TABLE. Immediately following Katrina, Tulane moved its medical student programs to Houston, Texas, using facilities at Baylor College of Medicine while LSU moved its preclinical classes to LSU’s Pennington Biomedical Research Center near the main campus in Baton Rouge, Louisiana. Both schools resumed classes within 4 weeks. Communication was one of the earliest challenges. For 6 weeks, Tulane’s electronic communications were unavailable, so students telephoned school administrators and provided notification of a student-created listserv. Baylor College of Medicine subsequently provided a Web site for Tulane to use to disseminate information. LSU installed a new data center with preexisting backup tapes. Housing was another immediate concern. Tulane used an online housing registration system created by Baylor College of Medicine, primarily with housing donated from the Houston community. In Baton Rouge, many LSU students were able to make living arrangements, but others had no access to affordable housing. With support from the Federal Emergency Management Agency, a Baltic ferry at the Port of Baton Rouge served as home to hundreds of LSU students, residents, staff, and faculty. The emotional and financial toll had a significant effect on all students, but none experienced significant physical harm. Tulane students received mental health support from Baylor College of Medicine mental health personnel, while LSU provided counseling to its students and residents, prioritizing those who remained in hospitals during the evacuation. The DeBakey Foundation, private donors, and students from other medical schools provided more than $200 000 to Tulane students for property losses. Even so, financial losses were a factor in the transfer of 7 students. Similarly, the LSU Alumni Association established an emergency fund to help students and residents with major financial losses. Despite these issues, retention of students was excellent at both schools (Table). Maintaining the admissions process was also challenging. For the first academic year following Katrina, Tulane had no change in applicant numbers and continued its medical school application process by interviewing applicants in Houston. The class of 2010 represented 32 states; however, Louisiana matriculants increased from 28% to 36%. At LSU, application records were lost in New Orleans and the process had to be restarted with an extended deadline; however, the size of the applicant pool, all of whom were Louisiana residents, did not change. There was no change in the quality of incoming matriculants at either school based on mean scores of Medical College Admission Tests and grade point averages (Table). Both schools quickly resumed medical student education without compromising quality. Student performance,