Photos by Jared Soares | The Roanoke Times

Construction on the school has begun off South Jefferson Street.

Even before the students begin to apply, administration members have to hammer together documents to get the school accredited.

Walls may not yet be visible, but there are plenty of signs that the foundation of the new Virginia Tech Carilion School of Medicine is being laid.

Crews started work on the foundation of the building Sept. 17, but that was hardly the first sign that the school was on its way to becoming a reality.

With a goal to begin classes in August 2010, those spearheading the effort are under a strict timeline to get more than the building ready for students.

While the physical structure is important, an intricate process of writing a curriculum, designing an admissions policy and hiring professors are among the other foundations that must be completed for the new school to be granted permission to open.

Throughout the summer, the school's first dean and her team wrote and rewrote volumes of pages that represent every aspect of the medical school.

Deadlines for garnering the needed school accreditation must be met every few months to ensure that the school opens on time. If a deadline is missed, it could delay the opening by a year or longer.

"We have to keep with a strict timeline," said Dr. Cynda Johnson, the dean of the medical school. "We also are making sure that we are interviewing all stakeholders and have large committees to bring together the teaching, research and [patient] care components."

By the end of August, a 1,200-page document detailing every aspect of the medical school was submitted to the Liaison Committee on Medical Education, the accrediting body for medical schools.

This was the first major step the school had to take toward becoming a reality.

Should the document be approved at the committee's October meeting, the next step will be a site visit. If the site visit is successful, the school should earn preliminary accreditation at the committee's February meeting.

"It's a big deal," said Dan Hunt, a member of the committee. "We work with the schools a lot to help them get ready because without this they can't move on [in the accreditation process]. ... We have to make this first bar very high."

Among the mounds of paperwork are other, smaller indications of the school gathering the components needed to open.

Johnson has been quietly hiring associate deans, professors and other staff as the school readies for its inaugural class. An advertisement to fill six faculty positions was posted in the Chronicle For Higher Education in mid-August.

In the spring, a memorandum of understanding between Virginia Tech and Carilion detailed how the partnership will work going forward, including financial and ownership considerations. The agreement includes several clauses that allow Carilion to transfer its share of the operation to Virginia Tech.

From entrepreneurial to educational

While much of the Virginia Tech-Carilion partnership is based on the future efforts of both institutions to grow educational and research efforts, the origin of the venture harks back to an earlier relationship between the two.

The Carilion Biomedical Institute initially brought researchers from Virginia Tech into the same room as Carilion officials.

Originally billed as an effort to convert biomedical research out of Tech and the University of Virginia into profitable companies headquartered in Roanoke, the initial plan has fizzled despite a $20 million investment in 2000.

On paper, the organization still exists and holds intellectual property. But in reality, the institute has no money and its director has another full-time job at Carilion.

Still, Carilion officials say without the Biomedical Institute, the medical school would not have emerged as a viable option.

Linking the former biomedical park vision to the medical school plan is the emphasis on research. All medical students will be required to conduct medical research as part of their graduation requirements.

"Our relationship grew with Virginia Tech as a result of CBI," Carilion spokesman Eric Earnhart said. "From that, conversations grew about the medical school and research institute. I would argue that the research institute is an outgrowth of what CBI did."

A small class size and a 'team approach'

The Virginia Tech Carilion school is among five schools in the country currently in the first step of applying for medical school accreditation. There are five other schools that are in later stages of earning full accreditation.

Together, the 10 new schools are part of a wave of increasing medical education options that has recently formed as many health care fields have seen shortages in physicians, Hunt said.

The Virginia Tech Carilion school is seeking to distinguish itself from the other new schools not only by incorporating the medical research component but also by its overall curriculum.

The emphasis on students conducting medical research as part of earning a medical degree is the one factor that unites the curriculum.

"We are about inquiry, research and discovery," said Johnson, the school's dean. "I cannot emphasis that enough."

To do that, Johnson and her staff have created an "integrated curriculum" that they say is unique to medical education.

"We educate in silos, but in health care we deliver care in teams," said Richard Vari, the school's associate dean for medical education.

"We're changing that so we take a team approach to educating our students. ... No other medical school is doing that from the very beginning."

Another identifying factor of the school is a relatively small class size of 42 students a year, compared to the 100-plus class sizes at many other medical schools, Vari said.

The small class size will allow the school to focus on what Vari called "hidden curriculum."

"They will have to learn things like professionalism, altruism and treating each other with respect," he said. "These are critical to the development of a student and a physician."