As one recent admit to the Yale Physician Associate program scrolled through his Facebook newsfeed on March 10, he was surprised to see headlines stating that Yale’s program would likely be made available online. Since the announcement, this student has chosen not to enroll at Yale.
The day after the Wall Street Journal reported that Yale had approved a proposal to offer an online Master of Medical Sciences program — the University’s first full-time online degree program — an email was sent to all current PA students and select alumni confirming the news. Spearheaded by PA Program Director James Van Rhee and Deputy Dean for Education at the Yale School of Medicine Richard Belitsky, the proposed online degree will allow PA students to view lectures and attend discussion sections from the comfort of their hometowns. Yale’s PA community has objected to the proposal, and hearing the news from the press before their own professors is only one of their many complaints.
Although the online program will be a joint venture with 2U, a well-established education technology company, PA students and alumni are concerned that the development of the degree did not take into account the views of the students themselves.
“We feel as though our input is not valued or welcomed, and that we have been excluded from the planning process despite demonstrating interest and being stakeholders in the outcome,” reads a collective statement from the PA classes of 2016, 2015, 2014 and 2013.
Van Rhee explained that he thought incoming PA students had been included on the email announcement sent to current students — they had not — hypothesizing that perhaps their Yale emails had not yet been activated. In addition to apologizing to students, he held small, online town hall meetings with the incoming class to address their concerns and answer their questions. But Van Rhee said he does not share their concerns about the online program.
In fact, he thinks the online expansion will only enhance on-campus students’ experience.
Described as an expansion in class size, the new online PA program will run alongside the current on-campus program, enabling students who do not live in New Haven to have access to Yale’s academic resources. Currently, roughly 36 students are admitted to Yale’s PA program on a rolling basis each year. According to Chandra Goff MED ’14, an alumna in the PA program, the University intends to grow that number nearly tenfold to 350 students, answering calls from the medical community to increase the number of primary care clinicians.
A SURPRISING ANNOUNCEMENT
Rumors of the online expansion of the PA degree had begun circulating among current students and alumni as far back as spring 2014, said Goff. But it was only in March of this year that the PA community received confirmation of the program, which includes online coursework, clinical rotations in their hometown and roughly two weeks spent on Yale’s campus.
A March 10 email sent from the medical school dean’s office to students and alumni informed recipients that, after “six months of thorough study,” the school had approved a new pathway for earning the PA degree and was awaiting approval from the Accreditation Review Commission on Education for the Physician Assistant, the national PA degree accrediting agency.
But students such as the anonymous student who decided not to attend Yale were disappointed that they were not informed that the launch would be happening so soon.
During his interview for the program in October 2014, no one mentioned to the student or other interviewees about the possibility of the online degree, the student said. Goff explained that students who were helping run the interviews for the incoming class of 2017 were specifically told not to reveal the plans to establish an online degree.
According to incoming PA student Lauren Prince MED ’17, had she known that her degree would likely be made available online, she would have chosen to matriculate at a different university. Like many other incoming students, she said she had no knowledge that plans were underway to make her degree available online. But Van Rhee said the University had to be discreet about the potential launch partly to guard against illegal financial behavior.
“When you’re a publicly traded company, you have to worry about insider trading,” Van Rhee said. “When people are in a position to know information that others wouldn’t, it isn’t fair to the shareholders.”
According to Bloomberg, 2U’s share prices increased by more than 20 percent in the week after their partnership with Yale was announced.
In addition, the contract was not finalized until shortly before the announcement, Van Rhee said, and it would have been inappropriate to release uncertain information. Still, he said that though he did not tell students which company Yale was planning to work with, many were aware that Yale was in negotiations with a company to offer an online degree.
“If we could’ve announced it earlier, I would’ve been glad to,” he said. “I know people see this perception as trying to hide things, but we have not shied away from talking to anybody. I have been as transparent as I can be.”
STUDENT INPUT DURING COURSE DEVELOPMENT
Last April, the Yale Committee on Online Education released a nearly 30-page document titled “Online Education — Pathways for Yale.” Citing examples of successful online degree programs, including those offered at Stanford, University of North Carolina’s business school and Duke’s environment school, the document advised the University to invest in programs that would “[extend] the school’s impact around the globe by increasing the number of those benefiting from its educational programs.”
According to Van Rhee, the proposed online PA degree will do just that.
While the committee was crafting its recommendations, the University vetted several companies that could provide the technological framework for expanded online educational offerings. Companies began to reach out to Van Rhee earlier that year — even before the committee’s document was released — but discussions did not become serious until later, in the spring of 2014, he said.
Van Rhee said he began to consult with current PA students on the proposed expansion in the late spring or early summer. He met with the first-year students as a group, though he said that at that point, much of the plan had yet to be fleshed out. Later that week, he met with a smaller group of representatives from the second-year students, per their request. Afterwards, he brought student concerns to a task force that had been created by Dean of the School of Medicine Robert Alpern.
After those first two meetings, Van Rhee said, student input on the program was much more informal. Still, students often initiated small group meetings with him to discuss the proposal’s progress, and he received many emails detailing student concerns and suggestions.
“Did we do something formal all along? No, we didn’t, but we did communicate,” he said.
Throughout, Van Rhee said, he brought student concerns to the task force that was working on finalizing the plans. The task force, whose membership was determined by Alpern, included one PA faculty member and no students. Though Goff emphasized that Belitsky is normally supportive of PA students, she said she was disappointed that students were not included in the task force, nor told when it was formed.
But Alpern said he was not aware that students wanted to participate in the group.
Van Rhee said that when he brought student concerns to the task force’s attention, those concerns were often issues its members had already been considering.
“We’ve taken [all student complaints] to heart, and they’re all serious concerns,” he said. “But all of their concerns were things I had talked to students about before […] that I was concerned about, the task force was concerned about, the medical school was even concerned about. And these are all issues we think we’ve addressed.”
He acknowledged that at the town hall held after the announcement, many students were adamantly opposed to the proposal. Going forward, Van Rhee said it will be important to communicate to students how the online program will work, and how it will maintain Yale’s high educational standards.
He emphasized that no efforts were made to exclude students from decisions or keep the news hidden. And yet, PA students and alumni maintain that their exclusion was intentional.
CLOSED OFF TO COMPLAINTS
Students interviewed said they are concerned that the rigor and reputation of the online degree will not match those of the regular degree. Administrators did not share these concerns.
“I’m afraid that an online version only compromises the quality of the PA education and ultimately puts patients and America’s health care at risk,” Meredith Keppel MED ’14, an alumna of the PA program, said in an email. “An online version of the program would increase the quantity of PAs, but at what price?”
According to Van Rhee, Yale’s current PA program has already been allowing some students to complete their clinical rotations at pre-approved off-site locations that are monitored by the University for some time. Students, however, are concerned that Yale’s high standards for these locations may be compromised as the number of proposed locations expands exponentially.
But Van Rhee said he is confident that the University will make sure to only approve sites that are up to par.
Goff also expressed concern that students enrolled in the online program may not receive high-quality practical training. Though the online course of study requires students to be on campus for two weeks to learn practical skills, Goff said she does not think this will be enough.
Other students were also concerned that having an online program would dilute the prestige of the program as a whole.
Because many patients already do not understand what PAs do, Goff said, it may be harder for PAs who studied traditionally to have their expertise recognized if patients are made aware of the online program’s existence.
Kelsey O’Dell MED ’14, an alumna of the PA program, added that PAs are also misunderstood by medical practitioners themselves.
“We have still had the unfortunate experience of having a professor walk into our classroom to teach, and ask us if we had completed undergraduate degrees,” O’Dell said. “In fact, many of us also have completed additional master’s degrees.”
But Van Rhee said students who complete the program through distance coursework will be just as prepared as their on-campus counterparts. They will meet the same admissions requirements, take the same exams, work clinical rotations at Yale-approved sites, pass the same graduation requirements and ultimately take the same accrediting exam.
“They’re all going to meet the same requirements and do the same thing,” Van Rhee said. “So I think they deserve the same degree.”