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Making Rank

Aug. 24, 2006

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U.S. Army advertising has moved away from its longtime motto, "Be All That You Can Be" in favor of "An Army of One." But the retro slogan still works for the Army/Baylor graduate program in health care administration at Fort Sam Houston in San Antonio. The grueling regimen squeezes maximum value out of every student, every faculty member and pretty much every waking moment.

How else could decades of students have navigated a one-year push through 60 hours of classes followed by a yearlong, six-hour credit residency in pursuit of a master's degree in health administration?

Even more challenging is the program's newest academic track -- a joint master's degree in business and health administration approved by the Baylor Board of Regents last October -- which requires an additional 87 hours.

"This first year has been my greatest academic challenge," says Air Force Major Kate McShane, a nurse from Erie, Pa. "I am sure that is related to the accelerated pace. But, at the same time, you get the feeling that if you can handle this pace, if you can stay organized and focused, you can accomplish anything that you set your mind to."

The relentless pressure, however, hasn't lessened the popularity of the program, created in 1951 when the Army expanded its certificate hospital administration training program into a full-blown master's program by linking with Baylor. It was the 11th graduate healthcare administration program in the country, the first in Texas and remains the only such military program, according to civilian professor David Mangelsdorff, a Fulbright scholar who is the enthusiastic "historian" of the program.

"The students refer to it as 'taking a long drink from a fire hose,'" says Lt. Col Nick Coppola, the program's director. "Typically, the first year they spend about 40 hours in class and another 50 hours studying each week in addition to maintaining all the other military standards required of them. So that's a pretty appropriate metaphor."

He should know, since he took that drink himself almost a decade ago. Then, Coppola's idea of a break was retreating to a room his study group rented at the San Antonio medical center "that would at least get us off the post," he says. "We'd order pizza, but we kept right on studying."

The program boasts a 96 percent graduation rate and was ranked 20th nationally in 2003 by U.S.News and World Report. Several factors keep the numbers up, faculty members say: one, students are drawn from a highly qualified pool; two, going to school is their full-time job; three, poor results in the classroom are reflected in the permanent job performance files of both students and faculty; and, four, the average student age is 34 with six years of professional experience compared to graduate students nationwide whose average age is 24 to 26 with very limited job experience.

"Before the admissions committee even sees the applicants, they already have been severely screened by their respective military branch or government agency," says Army Major Marsha Patrick, an assistant professor with the program.

Entering classes range from 40 to 50 students. Typically, 10 to 15 will be Navy, four to six will be Air Force, two will be Coast Guard, one will be a civilian employee from the Public Health Service or the Department of Defense, and the remainder Army.

"If you graduate from college with a 2.0 GPA you can still apply to Harvard Business School's MBA program," Coppola says. "You won't get accepted, but you can apply. Here at Baylor, you have to be a top-level performer just to be allowed to apply -- and then there is more culling on this end." (Patrick and Coppola, for example, competed as students against nearly two dozen other soldiers for two of the Army slots).

Those who make the final cut "receive the equivalent to a $250,000 scholarship," Coppola says. "They remain on full salary, get housing and medical benefits and have all their textbooks and even a laptop computer provided -- and we remind them of that."

In return, the students "remind us sometimes that they earn every cent of that scholarship because we work them so hard," says Kenn Finstuen, a member of the civilian faculty for two decades, who adds that, "if they skip class they are AWOL."

Just as the student's progress is part of his or her personnel file, the faculty also is held to high standards. "If there is a problem, our superiors want to know what we are doing to help the students succeed," says assistant professor Chris Garcia, a Navy commander. "The government is investing a lot of money and the different branches are sending some of their best and brightest here. Everyone is fully invested in turning out the best trained graduates possible."

Both students and faculty comment frequently on the mentoring relationships that develop from the almost-constant interaction. There also is a lot of empathy from the teachers -- the overwhelming majority of the military faculty are themselves products of the program; of the 24 directors to head up the program, 18 have been alumni, including Coppola.

Military life reality puts faculty and students into contact much more frequently than traditional graduate programs. The two groups often do their mandatory physical training together, bonding during 5 a.m. runs. Additionally, faculty members do all the lecturing, perform administrative duties of the graduate program (admissions, registrar and marketing) and personally supervise all the theses/research projects.

"The faculty has always been a real strength," Coppola says. "The program is able to draw on the permanent civilian faculty for stability and maturity while the transient military faculty arrives with new PhDs and the latest information and thinking in the field."

The return of former students to the faculty builds on earlier relationships to enhance mutual respect among professors. "Four or five of my former students have been program directors, which means they became my bosses," Finstuen says.

The link between students in the program and Baylor University is a lot deeper than merely the name of the school on their diplomas.

Coppola jokingly refers to the classrooms and offices at Fort Sam Houston as "the real Baylor campus" and the one in Waco as "our north campus." He sits on the University's graduate council and another faculty member is on the curriculum committee.

"Last year's class, on their own, organized a day when they all came to class wearing their Baylor shirts," Coppola says. "I thought it was a great idea, so this academic year I made it official -- every Tuesday the officially mandated 'uniform of the day' is a green Baylor shirt and khaki pants."

Of course, much of the fraternal pride is generated by being part of an acclaimed professional academic program. An "unusually high" percentage of Army/Baylor graduates go on to complete PhDs, says Mangelsdorff. Other data he's collected substantiates that Baylor grads earn promotions at a quicker rate (and reach higher levels) -- and the hospitals with Baylor-trained administrators score higher on scientific surveys of patient satisfaction -- than those headed by non-Baylor graduates.

Mangelsdorff has also documented more than 20 Baylor graduates who have been program directors (often founding directors) of health administration programs at universities across the United States.

"It's hard to go to any professional meeting anywhere without running into Baylor alumni," says retired Army Lt. Col. Jody Rogers, who is a graduate, a former program director and now president of the program's Executive Advisory Board that was formed in March. "I still get a bit intimidated when I realize I'm standing before a class of Baylor students because the students are so sharp and I know they have such great futures ahead of them."

An informal network -- built around 2,500 alumni and including current and former faculty and the "preceptors," those who oversee the residencies at their hospitals -- provides long-range benefits.

"Our students don't just pursue a master's degree -- they are grafted into the Baylor family," Coppola says. "We belong to a unique group of healthcare leaders" who share a sense of pride by challenging and conquering "one of the military's toughest and most elite graduate programs.

"Baylor is a brand name in the Department of Defense Health Affairs field because Baylor grads make a measurable difference in health care and have a well-earned reputation for being very knowledgeable," Coppola adds. "But I don't think people [outside the field] realize the impact Baylor has on military preparedness/readiness. Our grads are more able to handle missions coming toward them because of what they learn here."

The curriculum takes into account the special flavor of federal health care, as well as integrating current events into courses.

"More than 60 percent of the present student body has already served in Iraq and we even had one faculty member who taught here between assignments in Iraq," Coppola says. "We've expanded the courses to include administration of field hospitals and all the special problems that presents. One student I'm supervising right now is writing his graduate thesis on the interoperability of deployed medical assets in Iraq while he's on combat duty."

Army Major Eric J. Newland, a Nebraska native, says he applied to the Baylor program precisely because of his combat experiences as a medical service corps officer.

"I have been involved in the provision of health care from the bush in Africa to the deserts of Iraq," Newland says. "I understand how to design an evacuation plan that takes a wounded soldier at the forward line of troops to one of our modern medical centers in Europe or the United States.áThe tools that I did not possess were those required to lead and manage care in our modern health care centers and facilities. This was an opportunity to study, synthesize and incorporate innovative management, financial, statistical, legal and organizational theory and demonstrated best practices into my set of tools."

Newland says the program has benefited him on multiple levels. "Professionally, it has equipped me to solve complex leadership and managerial challenges in all fixed facility and austere health care delivery environments. Personally, the professors have challenged, encouraged, mentored and collaborated with me to stretch and reach beyond what I thought I could accomplish. Spiritually, I have been encouraged with a very positive environment in which to operate and learn," he says.

With an eye toward future events, Coppola preaches the value of the Army/Baylor program.

"The medical care portion of the Department of Defense budget is getting bigger every year," says Coppola, who explains that the budget doubled between 2001 and 2006, from $19 billion to $38 billion, and is currently 8 percent of the total. By 2015, the estimate is that medical care will account for 12 percent -- or $64 billion. "We all better hope we have the very best hospital administrators possible to handle the taxpayer's money wisely."


Webextra

To find out more about the Baylor-Army masters in hospital administration, visit www.baylor.edu/graduate/mha

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