Episode 53: Dr. Thomas Boyle D.O. Dean of the Chicago College of Osteopathic Medicine

An emergency medicine physician by training, Dr. Thomas Boyle, DO, FACOEP, FACEP, currently serves as the dean of the Chicago College of Osteopathic Medicine (CCOM) at Midwestern University. As a clinical assistant professor of emergency medicine, Dr. Boyle began his career at Midwestern University in 1992. From 2001 to 2008, he served as its Student Education coordinator and chair of Emergency Medicine. Following these positions, Dr. Boyle had the opportunity to serve as the associate dean of Clinical Services for CCOM, the dean of Postdoctoral Education, and even as the interim dean for one year while the current dean, Karen J. Nichols, DO, MA, MACOI, CS, took a leave of absence from the position to serve as the president of the American Osteopathic Association.

Prior to his roles in academic medicine and medical education, Dr. Boyle earned his Doctor of Osteopathic Medicine degree from the Philadelphia College of Medicine. Following graduation, he completed his intern year and went on to serve as a general medical officer in the United States Air Force before returning to complete a residency in emergency medicine at CCOM. In addition to his medical degree, Dr. Boyle also completed a Master’s in Business Administration at Saint Joseph's University Erivan K. Haub School of Business in 2019. In fact, it is Dr. Boyle’s interest in teaching that lead him to pursue a career in academic medicine.

Tune in to hear about Dr. Boyle’s pathway to becoming dean of CCOM and learn more about the osteopathic medicine program at CCOM, including what makes a good applicant for the program, elaboration on the program’s strengths, and plans to improve the curriculum for future classes of osteopathic graduates. 

Transcript

My name is Dr. Ian Storch.

I'm a board certified gastroenterologist and osteopathic physician, and you are listening

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We hope you enjoy this episode.

Hi, my name is Madly.

I'm a third year medical student and you are listening to DO or DO NOT.

On today's episode, I will be interviewing Dr. Thomas Boyle, the Dean of the Chicago

College of Osteopathic Medicine.

Dr. Boyle graduated from the Philadelphia College of Medicine.

He completed his intern year and then went on to serve as a general medical officer in

the United States Air Force before returning to complete a residency in emergency medicine

at CCOM.

His interest in teaching is what steered him towards a career in academic medicine.

Today he will talk a little bit about the osteopathic medical program at CCOM and about

his pathway to becoming the Dean there.

We hope you enjoy this episode.

All right, thank you so much for joining me today, Dr. Boyle.

We're going to start out this interview today by talking a little bit about Chicago College

of Osteopathic Medicine because you are the Dean there.

My first question is, what do you think makes this osteopathic medical school different

than allopathic school?

The difference from a curriculum perspective is obviously in osteopathic principles and

manipulative medicine, probably 15 to 18% of the curriculum in many DO schools is weighted

towards OPP and OMM.

Part of the reason why there's a difference actually in the boards between COMLEX and

USMLE.

I think that's the primary difference.

I think in the past, when I was applying, I was always told that the DO schools were

looking for a different kind of student, a student that had perhaps more multiple interests

in their background, maybe less straight-A type student.

I'm not really sure that was the case.

They are looking for students that are similar in their ability.

But I think for somebody that's identified as a good communicator and someone who listens

and has good prerequisite scores, they're considered a good candidate.

When I was applying, I worked a number of different jobs at the time.

I actually did through medical school as well.

And I think to some extent, perhaps there was a little more focus on that with the osteopathic

schools.

But besides that, unless there was a student who had a substantial research interest, which

more often would have gone towards an LCME accredited school, the major difference is

OPP and OMM.

And then what are some things that draw students to attend CCOM in particular?

So I think reasons why students want to come to Chicago is partially because it is Chicago.

It's a diverse area.

It's an area where there are a ton of activities, cultural, sports, educational.

So it is a good area for education, and it's a medical hotspot in the United States with

all the medical schools within the state and especially within the city.

I think CCOM in particular, they're looking at it's the fourth oldest school in Illinois.

It is well established.

It has a very good reputation amongst the osteopathic schools.

I think people come here because our clinical network, I think, is exceptional.

With our clinical partners, we have a very diverse group of clinical partners, including

some that have hospitals located in highly diverse and highly populated areas of the

city.

We have several that are in academic health centers as well.

And I think people recognize that the clinical training they receive is very, very good amongst

the DO schools.

We have faculty here, and this is what I tell applicants that are considering coming to

CCOM.

Our faculty here are recruited in large part because of their desire to teach, and that

would include our basic science faculty.

And that is something that is a priority in the recruitment process.

Faculty are aware that when they decide that they want to apply here, and faculty, because

of their interest in teaching, actually makes our job in the dean's office much easier.

I think among those two things, the fact that generally students perform very well on complex

when they're going through the boards, and very well in the match and placement in the

match.

So I think those combinations of areas where we tend to be successful drives the admission

process here.

And then what is the mission statement of the school, and of course you don't have to

memorize it word for word, but kind of just the general idea.

So it's actually a brief mission statement as most mission statements are.

Statements were expanded by CCOM a few years ago, so they'll occupy a page rather than

a few lines.

But I think what you would expect for an osteopathic school, educating osteopathic physicians,

provide compassionate, quality care, promoting the practice of osteopathic medicine, lifelong

learning, research, and service.

And I think for any medical school, even the non-ostopathic schools, most of the goals

within the mission statement are items that I think all schools share.

And you had mentioned earlier that CCOM is known for its reputation.

Students tend to do very well on boards and things like that.

But can you talk a little bit more about the demographics of the program?

For example, class size, where do students come from, GPA and MCAT scores for people

who are accepted into the program, things like that.

Sure.

So we are approved for 206 students for entering class size.

We usually set a target of about 202 students.

Usually the admission credentials, GPA, usually overall GPA mean of 365, overall MCAT mean

would be 507, and generally science GPA 3.5 to 3.6.

And what are some strengths and weaknesses of CCOM?

And if you do point out weaknesses, what are some things that can be done to improve our

school?

So I think our strengths, again, are really the clinical network that we have, the fact

that we have faculty that are very approachable.

The open door policy is taken very seriously here from the president's office, through

the dean's office, through the chairs, through the course directors.

We try to make ourselves available to as much as we possibly can if students have a need

or have something that they want to talk about.

The areas that I think we excel, I think our basic science instruction is exceptional.

Again, I think clinical experience here is very, very good.

And moving into the third and fourth years, I match our clinical partner sites to any

of the osteopathic schools.

I think the areas we need to show improvement are we really want to get an ultrasound curriculum

started here, and that's something I've talked with the president about.

Right now in the midst of the pandemic, making any major curricular changes is a bit of a

challenge.

We are working mostly to try to keep things moving forward with all the obstacles and

the challenges that have been imposed by the pandemic.

One of my personal interests in curriculum is in business and medicine, completed in

MBA with a health care emphasis in 2019.

My reason actually for doing that, because I was not surprisingly one of the older students

in the class, was to try to bring a business curriculum into the medical school.

The pandemic sort of shortchanged that at this point, but it is something we've already

started making some plans for how we may be able to introduce that.

I do some work with ACGME in reference to some of their competency-based education programs,

and CCOM is actually one of the hubs.

I'm the hub leader for their competency-based education program.

I think there's 15 hubs now internationally, two osteopathic hubs.

We've talked about competencies in medical education multiple times, and one of the competencies

that's actually unlisted is in business knowledge, in the business aspects of health care.

It is a massive part of what we do, and it is something that schools and GME programs

have really struggled to try to figure out where can they fit that into the curriculum,

because in my opinion, it's 40 to 50% of what you do once you start in practice.

I think in general, medicine can do a better job for those who are in medical education

for how to introduce that aspect of what we do in medical practice into our curriculum.

We are working to try to figure out where to do that, because there are some schools

that have initiated this.

Yeah, I think both the ultrasound and the kind of integrating business in the medical

school would be super helpful.

How do CCOM students do in the match?

I know that DO schools traditionally tend to do very well in primary care specialties,

but can you talk a little bit more about any other specialties that students like to apply

to?

You are correct.

The primary care is the greatest emphasis, I think, for the osteopathic schools in general.

We have a large number of applicants moving into family medicine, internal medicine, into

what my specialty was, which is emergency medicine, some going into surgery, some going

into anesthesia, a reasonable number going into PMNR and into pediatrics as well.

Overall, in the match, 2020 was the first year that there was no osteopathic match.

So it was either into the ophthalmology match, San Francisco match, military match, or into

the NRMP as the main match.

Not only did we do well, but actually the profession as a whole did very well, placement

rates of 99%.

We tend to match to the mean of what the LCME schools have done.

And then when you go through the SOAP week, we place over 99%.

Out of the last seven years, I think we've had five years where we had 100% match rate

and two years where we were over 99%, including the placement through SOAP.

And students often ask about the ability as a DO to get into competitive specialties and

any biases associated with DOs.

What are your thoughts?

So I think the cutting specialties, we still have a little ways to go.

I think it's getting better.

Personally, I saw the ACGME unification into the single-GME system as a huge opportunity

for us.

I think it will eventually start to open the door more to those areas.

We do have students that are able to match into those specialties.

We are still working through AACOM and through AOA nationally to get the word out regarding

our boards.

The vast majority of programs still do accept COMLEX, even for the traditionally MD-type

programs that would look at an MD first.

Things went so well with the ACGME, not merger, but unification with AOA into the single-GME

system that I think it surprised everyone, both us and with some of our LCME colleagues

as well.

I anticipate that things, some of what people have seen as barriers in the past with some

of the hypercompetitive specialties, dermatology, urology, neurosurgery, orthopedic surgery,

I think over time, those will end up falling by the wayside.

I think some of the things we learned during the five-year transition process with ACGME

is that in many instances, we both had, both professions had some misunderstanding about

the other.

I think it has brought the two professions much closer together than would have been

the case had it not happened.

So I tend to be pretty optimistic about this.

I don't think the kind of barriers that existed in the past will be here five to 10 years

from now.

Yeah, and that's excellent news.

What are your thoughts on the USMLE and COMLEX going pass-fail?

How can students from CCOM stand out now that this is happening?

So this is a question we get all the time from applicants.

And I think there's a couple things that need to be addressed to answer this.

So I was in favor of USMLE going pass-fail.

I was in favor of COMLEX going pass-fail for level one.

I don't see it as a challenge to our school because our school was founded in 1900 and

we have an established reputation.

I think for newer schools, this might be a little bit more of a challenge for some other

graduates simply because there's not understanding of the schools to the point where program

directors may feel comfortable with this.

I spent a great deal of my career in graduate medical education.

I was not a program director, but I was a core faculty member in emergency medicine

and I was chair of the department for some time.

Program directors, assistant program directors, these are folks that are metrics-oriented.

And while the licensing exams were in no way ever meant to be a cut score for movement

into residency or even to be granted an audition rotation, which is how many programs may be

using those scores now, they lose that with the pass-fail.

What I've heard from the GME community is many of them are going to wait for step two

or for the CE in COMLEX to make a decision in some cases.

I think there's a lot of people that may not be aware of COMLEX, what its purpose is, and

obviously it is geared towards protecting society, patient safety.

COMLEX is designed to, this is their quote, identify the minimally competent physician

entering practice.

And this is the physician who's safe practice.

And it's being used as a cut score, which is, again, that was never the purpose behind

that particular exam.

So I think going to pass-fail makes sense if the purpose of an examination is to identify

a minimum level of competency in which you are therefore ready to practice.

In that situation, does it make a difference whether the score is 75, 85, 95, if the purpose

of the exam was only to identify minimal competency?

So I find pass-fail in that situation, at least in my mind, to make sense.

But it does not give the metrics that the GME folks are looking for.

Some of our concern is that there will either be another standardized exam perhaps that

is offered to replace the fact that step one and level one are now pass-fail, or there's

going to be a little more delay as they wait for performance in step two or in the CE exam.

But it's, and again, I think there are some schools that may have a little more difficulty

with this because they may, the program directors, people that are reviewing applications may

not be as comfortable with a pass-fail score as a pass from a graduate of a school that

they don't know well or don't know the reputation of the school yet because the school is at

this point too young to really have a well-established reputation.

And so it's a long answer to what is actually, I think, a pretty complicated question.

Yeah, thank you.

Yeah, our listeners definitely are interested in knowing kind of the trajectory with those

decisions.

I'm going to switch gears a little bit and kind of turn to your background and I'll start

by asking, how did you become interested in medicine and decide that you wanted to become

a doctor?

So a couple of things.

I actually started thinking about medicine when I was eight years old, mostly because

of my family physician who was an MD and was just an exceptional doc.

And I liked what he did.

I liked how, I liked his approach.

I was very comfortable around him.

So that's what sparked my interest.

My decision to move towards osteopathic medicine was sort of a happenstance because I worked

part-time when I was in college and when I was in medical school and I worked on the

security force at the Spectrum, which was at the time Philadelphia's major indoor stadium

for hockey, basketball, concerts, et cetera.

The first aid station at the Spectrum was actually run by a group of DOs because I worked

there for several years.

I spent a lot of time talking with these groups, with these docs, and it is really what sparked

my interest in osteopathic medicine.

Plus PCOM from where I graduated was about two miles north of the college where I went

to undergrad and there was already some relationship there.

So I did have some familiarity with osteopathic medicine.

And then my experience in the interview at PCOM is really what made my decision because

they spent so much time, I think, trying to determine whether they were a good fit for

me as much as trying to determine whether I was a good fit for them.

And that really impressed me.

That's not an experience I had at other schools and that's what made my decision.

And then kind of going along with that, how was your experience throughout your time at

PCOM?

Did you take part in any extracurriculars?

Any specific people that kind of propelled you towards a certain specialty or anything

like that?

Between working and commuting an hour each way, that pretty much occupied most of my

off time.

I was very impressed with the emergency medicine physicians there.

Dr. Becker, John Becker was actually one of the pioneers in emergency medicine and they

had started an emergency medicine program back when it was still a nascent specialty.

And one of my EM rotations was in their core system and was at Frankfurt Hospital in Philadelphia

and the docs there were just wonderful.

So that's really what sparked my interest in emergency medicine.

And then I had an Air Force commitment as a general medical officer for five years after

my internship and I spent three and a half years of that in the emergency department

in what was actually a pretty busy military ER.

So that's what made my decision to pursue it and I ended up completing my residency

when I finished my military.

And how was your application process to residency?

So it was different then.

It wasn't a match process for us.

It was mostly individual applications, which substantially reduced the number of places

in which you applied.

And there was a very, very active osteopathic hospital network in the early 80s.

So many of us, there were many that ended up doing their postdoctoral training in what

would have been traditional MDU type training.

For us, many of us ended up moving into osteopathic postdoctoral programs and that's what I did

both for my transitional year, which was a requirement back then.

And then when I completed the military commitment coming to Chicago, that was actually my introduction

to CCOM when I came out here in 89.

But yeah, we actually just had a write-in application and then get on the road to do

interviews.

And can you talk a little bit about your experience being a medical professional in the military?

It was really one of the better experiences I've had.

We were, there were 23 of us, including five flight surgeons.

I was a general medical officer.

We had a 23-bed hospital that had also an 8-bed ICU in South Carolina.

It was a tactical fighter wing base.

We were also assigned to mobility.

So our area of responsibility was in the Middle East, Iran, Iraq, and Libya at that time.

So we had a fair amount of mobility training to prepare for that because that was our primary

mission.

We had 250,000 retired outpatients in that particular area in South Carolina.

So it was actually a very busy place.

I actually worked more hours when I was in the military than I did when I was in residency,

but it was a great experience.

It was being a small hospital and a large volume of patients.

We really worked well together, the docs, the nurses.

It was a very tight-knit group.

It's actually something I've not seen duplicated anywhere else in my practice.

That wasn't the case in all military assignments.

Many of them were bigger medical center-type hospitals that have some of the traditional

issues that you might have in any everyday hospital.

But in this situation, it was just much different because we were small, we were really busy,

and we really worked together as a team.

So it was really one of the better experiences I've had.

And then how long did you end up practicing clinical medicine for?

About 25 years in emergency medicine.

Okay, and then can you talk a little bit about your experience transitioning away from clinical

medicine and into academia?

Did you always think that you would end up in academic medicine?

No, I wasn't sure.

I started becoming more interested in teaching about three or four years after I had graduated

from residency, and I started small.

I was doing clinical education for the fourth-year students in their core rotation in emergency

medicine, and it kind of grew from there.

I really liked what I was doing, so I had no future plans for being full-time in academics.

But basically, if I was asked to do something and I was able to rearrange my clinical schedule

to accommodate it, most of the vast majority of the time, I said yes.

So I ended up teaching in several different areas.

Around 2001, 2002, I applied for the chair position in emergency medicine and was appointed

as chair, and I was probably by that time about 25% into medical education.

2008 is actually when I left practice.

I was offered the associate dean's position in clinical education, I think in June of

that year is when I started.

That was my last night shift.

Part of what had me looking towards another option was partially the emergency medicine

lifestyle.

It's rigorous.

Nights get harder when you're in your 40s.

As you're getting into your 50s, they get a lot harder.

So yeah, some of us were looking for options, but again, I never really thought I'd be in

a position where I could go full-time into education, but that's when I made the transition.

And then what steps did you take to ultimately become a dean?

I get the sense maybe it wasn't a plan, but how did you get there?

So I've had this discussion with other deans, and I've met really two situations.

People that set out to be dean and people that ended up becoming dean that aren't quite

sure how it happened.

I get this question all the time from sometimes from other physicians, from students, from

residents, and how did it happen?

I can't say for sure.

Sometimes it's being in the right place at the right time.

I liked being in a leadership position as chief resident.

When I was in emergency medicine residency, I think when you're in a leadership position,

not only do you get the chance to lead, quote unquote, but you have input into what happens

in whatever system or process you're working in.

And it can be more difficult to get input if you're not invested in that.

And that's the part I liked.

There was an opportunity that came up for me to serve as interim dean in 2010 when Dr.

Nichols, my predecessor, was on sabbatical as president of AOA.

Things went really well that year, and I was offered the graduate medical education dean's

position.

After Dr. Nichols' return, I spent seven years full-time in GME as the dean covering

both of Midwestern's campuses in Illinois and Arizona.

And then when Dr. Nichols retired, the president contacted me and asked me to consider coming

back to the comm as dean full-time, and that's kind of how it happened.

But it really wasn't the end result of any plan.

It was saying yes to something, and it opens a door, and then suddenly other doors open

as well.

Specifically including the military experience, that has come up in several situations I've

been in where I might have been seeking a position where I ended up getting a lot of

questions about that because people seemed to notice that.

And then switching gears again, a little bit more about your personal life.

What does your spouse do, and have they always been supportive of your career as a physician?

Yes.

My wife was a nurse when we met when I was an intern.

She was obviously with me when I was in South Carolina, and then when I moved out here,

as things started to move forward with CCLM and starting to inch away from clinical practice,

spent more time really on her career.

She had left nursing, she homeschooled our kids for quite some time, and then was interested

in completing her education.

She was a diploma grad nurse, so she ended up, she's a musician, and she wanted to finish

her training.

So she ended up getting a baccalaureate degree in music, ended up going to Northwestern for

a master's degree in literature because that was her other interest, and right now she

is at Lewis University in an EDD program.

And that was really her career goal was to move ahead with an educational background.

And this is kind of a fun question, but what is your superpower, meaning can you tell us

one thing about you that has made you successful?

Yeah, it was an interesting question.

It's not easy to answer.

There's two ways I can answer that.

One is, I think I could say I have any talent, it's finding a way to get things done, which

is a large part of what we do as Dean.

But to be honest, I think some of that comes from the career choice I make.

Emergency medicine is something that requires you to think quickly, sometimes in very high

pressure situations, and to try to think clearly while you're thinking quickly as to what you

need to do.

It's not uncommon for EM physicians as they move forward in their career that they end

up in some kind of business leadership position.

So I think part of what I learned in how to think clinically within that kind of environment

transferred well over to doing what I'm doing now.

And how do you obtain a work-life balance?

What are your hobbies?

So I'm still working on that.

We are actually, we just moved because we were in the West suburbs.

And we had made the decision, we've got a lot of pets, we've got two, I've got five

dogs, four cats, or excuse me, four dogs, five cats, and they needed some space.

So we ended up moving out to a rural area, farther West and South, it's probably about

40 minutes from campus.

And there's just so much more space out there.

I spend a lot of time with the dogs and my family on weekends.

It is a very green place, not right now, it's very white right now, all the snow, but that

has helped because we are much less congested there.

And we spend a lot of time outdoors on weekends just to try to get away from things.

It's been a, even outside of clinical practice, moving, trying to keep the medical school

moving through the COVID situation for everyone, including the students, has been quite a challenge,

much, much different than how it first started.

So trying to find some downtime where you actually get the recharge your batteries.

Right now to me is as important as it was when I was in clinical practice and rotating

shifts.

Yeah, that sounds like fun.

I have a final question here for you.

What was the best piece of advice you got throughout your education that you always

think of and would pass on to other students?

So there, well, there's a couple of things.

I was not the best student when I started out in grade one and grade two, I was just

brutal.

I was at, and I had average grades, but I didn't like it.

And I figured that's, you know, that's who you are going through the first two years.

My third grade teacher kind of turned things around for me and had a talk with me that

she thought I was capable of much more than what I was showing and gave me some help.

And suddenly I went from C's to A's and I never looked back since then.

So one of the take home lessons from that is even when you think you can't, you can

do it.

When I turn my life around, it's something that I try to pass that message on to people

that are struggling.

Take a step back, regroup, because you can do this from, you know, your question about

how to move forward being Dean against a lot of it is right place, right time.

But one of the take home lessons from that for me was when somebody offers you an opportunity

to walk through a door, think twice before you say no.

And there's times you have to say no, work life balance, emergencies, a number of things

that may force you to say no or require you to say no, but think long and hard because

you never know what other doors that opportunity may open for you.

And then the piece with the advice, we always try to give the residents.

This was one I got when I was an intern and it was from somebody who was a long time mentor

for me is obviously don't let the success go to if you have success, don't let it go

to your head and maintain balance in your life as you move ahead.

The big thing with the residents is really, well, this might sound unnecessary and redundant.

It's not what you're getting into.

I had a couple of times in my last year of practice that I met with residents.

One was a second year, one was a third year in emergency medicine that they decided they

really couldn't stand what they were doing.

They didn't like working nights, they didn't like working weekends, they didn't like rotating

shifts and it was an expectation that they had never encountered because as students,

they weren't working like that on their rotation.

So they really didn't fully understand what the lifestyle was like and I think when you're

making that choice of moving into a specialty, it's important to know what you're getting

into.

If you're choosing obstetrics, emergency medicine, trauma, any kind of critical care related

specialty, you're going to be coming in a lot at off hours.

When I left medicine that Thanksgiving, when I left clinical medicine, that first Thanksgiving

after I started full time here, that was the first Thanksgiving I had had off in 20 years.

So it's that kind of life and I think I've seen a fair number of residents who moved

into that that I think really didn't understand what the life was going to be and that's anyway,

that's advice we try to give the residents in our program is to know what the lifestyle

is before you make the decision this is what you want to pursue.

Those are good words to end off on, well, thank you so much again, Dr. Boyle for joining

us today.

This has been a pleasure.

Thank you.

Natalie, thanks for the offer.

It was fun and I hope this works out okay.

This concludes our episode of Do or Do Not.

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