Panel Urges UCI to Reform Medical School

A panel of outside experts on Friday recommended that UC Irvine’s scandal-scarred medical school unite its teaching and hospital campuses and persuade faculty to take administrative duties more seriously.

The panel released a report with a series of recommendations for tightening oversight, including many that the university’s College of Medicine has heard before. The panel was convened after the school was embarrassed last fall by allegations that the head of its Willed Body Program sold for personal gain some bodies donated for research, charges the now-fired director denies.

The recommendations didn’t focus specifically on the latest scandal, which has led to a series of reforms at the school. Instead they sought to explore the root causes of four recent scandals, most notably a 1995 case in which doctors in the school’s fertility clinic stole the eggs and embryos of scores of women and gave them to other patients.

“What they’re telling us is not rocket science,” said UC Irvine Chancellor Ralph J. Cicerone. “They’re saying, ‘Here are ways to improve the system.’ . . . There are things we can do, and we are doing, to strengthen our internal systems.”

The fast-growing Irvine program is unusual in that its medical center and school are in separate cities--the former in Orange and the latter in Irvine, said panel member Dr. David Korn, an executive with the Assn. of American Medical Colleges in Washington, D.C.

“It’s difficult to run a program of academics where your major campus and your major clinical teaching facility are 12 miles apart,” said Korn, a former dean of Stanford’s medical school. “It’s hard to create one culture and ethos when your mainline people are based in two separate places. That piece is more idiosyncratic to UC Irvine.”

Despite the enormous expense of uniting the two locations, Cicerone said it should be considered in the long term: “We can’t close the door on that recommendation. We have to think about it. Neither can we open that door and say we’ll drop everything else and embark on that as our central goal.”

Equally important, the panel concluded, is the challenge Irvine faces in hiring administrators and persuading faculty to focus on time-consuming and unglamorous duties of policing and paperwork rather than research.

Many of the panel’s recommendations--including proposals to beef up training and hire an assistant dean devoted to administration--echo those made late last year by medical school Dean Dr. Thomas C. Cesario. The panel also proposed including incentives for doctors to participate in the college’s internal review board and more outreach to the public.

Cesario said he welcomed the suggestions and plans to implement most of them in the coming months. A senior associate dean, to be hired soon, will be charged with evaluating administrative staffing needs. Cesario also plans to make supervision a key factor in administrator evaluations and reappointment decisions.

“I would like to think we have been taking precautions” to avoid future scandals, Cesario said. “Whether [these additional steps] would have prevented the previous incidents or not is a matter of debate. I can’t change what happened in the past, I can only change what’s in the future.”

The six panel members wrote in their six-page report that UC Irvine deserves credit for the enormous loyalty and pride of its medical school staff and for its rapid development as a well-funded research institution. However, that growth comes with a responsibility to stop merely reacting to scandals and start addressing root problems with oversight.

“The UCI College of Medicine has come a long way in a short period, and we fervently hope that your continued growth and success will not be interrupted by the types of recurrent problems that you have had to face in the past,” the report concludes.

Many of the recommendations were elementary but crucial: clearly delineate responsibilities among the dean’s office and those of department chairs; train physicians who are promoted to administration so they know their duties and are able to carry them out; ensure administrative growth keeps pace with growth in funding and research; develop a strategic plan; and set out clear standards compiled in one place.

Stephen Warren Solomon, a lawyer who represents fired Willed Body Program director Christopher Brown, said the changes are necessary.

“In terms of the Willed Body Program, I think everyone would be in favor of more supervision. They should have been doing that the whole time,” said Solomon. “I’ve said all along that my client reported everything he was doing, but it fell on deaf ears.”

So far, the Willed Body Program allegations have not resulted in criminal charges, although a probe by the Orange County district attorney’s office does continue, said Assistant Dist. Atty. Robert Molko.

Since that scandal broke in September, medical school administrators have taken several steps to reform the program. They have hired a new director--veteran funeral director Michael Godsey--and nearly doubled the pay for the position to $62,500 a year.

The school also has tightened rules about who gets to use donated cadavers and discontinued the practice of returning remains to families for a fee.

The university is still trying to identify four donated cadavers that remain from Brown’s tenure. District attorney investigators recently examined the cadavers and fingerprinted them, said Dr. Peter Lawrence, the medical school’s associate dean.

Brown is still seeking to be reinstated to his former post. His lawyer also plans to ask the university to pay for his defense in lawsuits filed against the Willed Body Program by families who question how remains were handled.