A GREAT discussion.
http://jacksonville.com/news/health-and-fitness/2010-09-21/story/groupl-uf-odds-over-medical-school-jacksonville (http://jacksonville.com/news/health-and-fitness/2010-09-21/story/groupl-uf-odds-over-medical-school-jacksonville)
QuoteThe University of Florida’s reluctance to establish a four-year medical school on the First Coast is being questioned by a community group with a host of high-powered members.
A tentative push for a Jacksonville-based medical school is being led by a regional health council, which released a critical report last week during a meeting of the Florida Board of Governors, the leading body of the state’s 11 public universities.
The Healthcare and Bioscience Council of Northeast Florida, comprised of academics, healthcare professionals and community heavyweights, made its intentions clear from the start.
“We do not see our needs being met on a permanent basis without a major change in approach towards the Jacksonville healthcare and bioscience community by the University of Florida leadership,†the report states.
The council discussed the possibility of circumventing UF and starting a new medical school with the assistance of another institution.
Last Wednesday’s meeting was packed with academic leaders from each of the state’s major research institutions, including Florida State University and the University of Central Florida.
The first reference to Jacksonville creating its own four-year medical school was made in 2007 during the committee’s first meeting, but the proposal was modified because of UF’s involvement with Shands Jacksonville, said council chair Yank Coble. The issue was resurrected because Jacksonville is one of the few major cities in the country that has a public university but no medical school.
Members agreed in 2007 that the most cost-effective way to improve the region’s medical future was to continue investing in Shands. But UF officials said the school doesn’t want to transform the Jacksonville facility into a full-fledged medical school, leading council members to discuss other avenues.
“We find ourselves at the crossroads â€" either a new course must be charted for the future or we accept the status quo,†the report said.
Shands Jacksonville is a clinical site for third- and fourth-year medical students who are rotated in every four to eight weeks. But Shands lacks any academic offerings for less-seasoned medical students, and Coble said most upper-level students are more likely to return to Gainesville than stay in Jacksonville when their residencies end.
“It’s more efficient if students can be here for all their third or fourth years instead of being brought over in rotations,†Coble said. “And if they have to find apartments instead of living in the on-site dormitories, they would be more likely to stay around once they finish. Having an established medical school presence like that could only help the local economy.â€
The hospital has no plans to increase the number of medical students or residencies in Jacksonville, said David Guzick , president of the UF and Shands Health System.
That’s for a reason. Guzick said bringing first- and second-year students to Jacksonville when they already have the required courses in Gainesville would be an unnecessary duplication that would cost taxpayers. The same would be true of keeping medical residents in Jacksonville any longer than the customary four to eight weeks.
He said the focus should be on improving Shands now so the city could benefit later.
“If a group uses the influence of community members for philanthropy and to boost state funding, we’d be able to do more,†Guzick said. “We don’t need to be bringing the first-year med students here. We’d be a better service to the community if we invested in research and clinical offerings â€" concrete work that can benefit the local economy.â€
It’s unclear what school would take a chance on establishing a four-year medical school in Jacksonville.
University of North Florida President John Delaney said the First Coast college isn’t in the market to become a research-driven university with a top-tier medical school.
“We’re focused on growing at our own pace and being one of the best undergraduate institutions in the state,†Delaney said. “If I was given $60 million, I wouldn’t use it on a med school. I’d use it to improve our existing programs â€" every time.â€
Coble said it’s too early to say if there are any other schools that would be willing to establish a four-year site in Jacksonville. However, there is a precedent.
Mercer University in Georgia recently developed a regional medical campus in Savannah. And Coble’s alma mater, Duke University, even has a location in Singapore.
But Coble cautioned that the council’s discussion was mainly exploratory. No serious steps have been made to secure a Jacksonville-based medical school. He said the council’s report is based on the community’s input, and many residents feel Jacksonville needs a stronger base for healthcare and medical research.
The council and UF and Shands administrators plan to meet sometime in the next few weeks to discuss the report.
“We have great assets here in Jacksonville, so we need to explore every option,†Coble said. “We wouldn’t be doing our job if we didn’t at least see what we could do to improve
Sometimes you get a second chance to make a first impression. Don't screw it up this time jax....
If UF refuses to work with the community, this community group should look to partner with another school.
The State made a mistake by approving 2 new medical schools at UCF and FIU a few years ago. With the recent budget cuts to higher education in Florida, there is no way that UF, FSU, and the rest of the SUS will let there be another new med school. The only hope would be to get some type of satellite program from FSU, USF, or UCF. I know FSU tried to establish a partnership with Mayo a few years ago, but that fell through.
I give this group credit for trying, but its very unlikely to happen.
Also, the article made it sound as if FSU and UCF were at the meeting to hear information about this report. It was a Board of Governors meeting and every state school is at every BOG meeting, where all kinds of things related to education in Florida are discussed.
No odd's about it, if we have a medical school, we CAN get a VA Hospital. It's like getting two massive economic benefits from a single entity.
As is, "OFFICIALLY" and on the "QT" at our VA Clinic next to Shands I learned we have the #1 visited VA Clinic in the USA, and we are dead last in services. Even the Patient amenities suck, no PX, no Cafe, no Snack Bar, short on parking (including a garage which should be condemed). No general waiting room, no library, and magazines so old that Monday I picked up a Time Magazine and Roosevelt was on the cover....... Teddy!
OCKLAWAHA
when the FSU school was approved about 10 years ago, people said there wasn't enough room....then said the same thing about UCF and FIU
fact is, we have 6 med schools in the whole state (UF, USF, FSU, FIU, UCF, and Miami)...Philly metro area has that many alone...remember we have close to 20 million people in FL and the largest elderly contingent in the nation!
Quote from: thelakelander on September 21, 2010, 09:08:38 PM
If UF refuses to work with the community, this community group should look to partner with another school.
This is news to me, I didn't realized they were trying to get a medical school in Jax. Are they only considering public universitites? I'm curious as to why JU or even Mayo College of Medicine weren't mentioned...
Quote from: tufsu1 on September 22, 2010, 08:36:18 AM
when the FSU school was approved about 10 years ago, people said there wasn't enough room....then said the same thing about UCF and FIU
fact is, we have 6 med schools in the whole state (UF, USF, FSU, FIU, UCF, and Miami)...Philly metro area has that many alone...remember we have close to 20 million people in FL and the largest elderly contingent in the nation!
Fact is that we have added 3 of those in the past 10 years. 2 in the past couple years. Both the UCF and FIU schools were highly debated and weren't exactly sure things. There is no way the state would allow another new med school to pass through. Especially since the ball was rolling on the UCF and FIU med schools before the economy tanked. There would be an uproar in higher education in the state if another new school was proposed. Also, with the 3 new schools there will be no shortage of doctors in the state by any means.
The FIU school was approved because it is located in a metro area with significantly more voting power than Jacksonville will ever have. There was also a far greater need for a med school there. They are actually located in MUCH closer proximity to the large elderly population you speak of.
The UCF school was approved because UCF received significant donations for the program and because it is a growing university that didn't have a med school or law school. With FAMU getting a law school in Orlando, UCF had long since thrown its weight behind a new med school. It also could sell the new medical research center at Lake Nona. This is a huge medical research complex with a lot of $$$ and bigtime research going on.
The blunt reality is that Jacksonville does not have a research university. We are located within a two and half hour drive of 3 medical schools, 2 of which are new.
In theory it would be excellent if Jacksonville could get a medical school, especially downtown, but it is not going to happen.
I hope these people involved are just trying to leverage Shands or Mayo into expanding, because otherwise they are wasting their time. I can think of about 5-10 things that the city would be better served lobbying the state for.
That would be based on me following the approval of the UCF and FIU medical schools at the time and understanding the current climate of higher education in the state, as well as the severe budget shortfalls the state is dealing with now.
I'm not an expert on the subject by any means, but I know enough to know that it is a pie in the sky idea.
Quote from: CityLife on September 22, 2010, 10:04:55 AM
The FIU school was approved because it is located in a metro area with significantly more voting power than Jacksonville will ever have. There was also a far greater need for a med school there. They are actually located in MUCH closer proximity to the large elderly population you speak of.
Umm? We have no need? You seem to forget while the average person in South Florida might die of organ failure due to old age, the average Jaxson dies in boating, monster truck, stock car, deer hunting and bowling accidents.
And while geriatric medicine is well established rutilusgutteratics is a new field. OCKLAWAHA
Quote from: Ocklawaha on September 22, 2010, 10:30:25 AM
Quote from: CityLife on September 22, 2010, 10:04:55 AM
The FIU school was approved because it is located in a metro area with significantly more voting power than Jacksonville will ever have. There was also a far greater need for a med school there. They are actually located in MUCH closer proximity to the large elderly population you speak of.
Umm? We have no need? You seem to forget while the average person in South Florida might die of organ failure due to old age, the average Jaxson dies in boating, monster truck, stock car, deer hunting and bowling accidents.
And while geriatric medicine is well established rutilusgutteratics is a new field.
OCKLAWAHA
Yes there was clearly a greater need. Jacksonville's population of a little over a million is an hour and half drive from the UF med school and 2.5 to FSU's. South Florida's population of about 5.5 million was served by 1 medical school, Miami and that is a private school, though UM med does get state $$ quite a bit.
Teaching hospital, Savannah, great if your dying from some exotic tropical jungle rot, just a 2 hour ride. Stephen, I really though you'd be the first to land on the "rutilusgutteratics," comment. Oh the humanity!
OCKLAWAHA
Quote from: stephendare on September 22, 2010, 10:34:41 AM
Quote from: CityLife on September 22, 2010, 10:19:51 AM
That would be based on me following the approval of the UCF and FIU medical schools at the time and understanding the current climate of higher education in the state, as well as the severe budget shortfalls the state is dealing with now.
I'm not an expert on the subject by any means, but I know enough to know that it is a pie in the sky idea.
Well we can agree that you arent an expert at any rate. ;)
Im just ribbing you a bit, but there is a serious plan to implement a Medical School in this town, and it is being put together by serious people.
It will need a mayoral push, but the resources are there to make it happen.
I'll be interested to see what this group comes up with. Hopefully they will be able to raise a significant amount of private $$, because they are going to have a hard time getting financial support from the state.
I wouldn't jump on CityLife too much...he is correct in stating that it is a major uphill climnb...especially to get a publicly funded med school here.
UF, USF, and Miami were adamant 10+ years ago that there was no need for the FSU school...but John Thrasher, Jim King, and President Wetherell made it happen.
Then they all ganged up and derailed the FIU school for several years...and it only passed so "they" could put one at UCF too.
To bad we let that FSU medical school ride off in the sunset to Daytona Beach a couple of years ago.
Quote from: thelakelander on September 22, 2010, 12:09:00 PM
To bad we let that FSU medical school ride off in the sunset to Daytona Beach a couple of years ago.
I think that had A LOT to do with UF, from what I have been told. My mom is well-regarded in this field, which gives me the unique opportunity to speak with certain parties in the medical field. It is something I question constantly. As such, I don't get invited to dinners as much as I used to, lol.
Stephen is right. There is a focused push going on in this community to make this happen. Citylife is right that it is an
uphill climb, but nothing that is truly worthwhile is ever easy. :)
Quote from: thelakelander on September 22, 2010, 12:09:00 PM
To bad we let that FSU medical school ride off in the sunset to Daytona Beach a couple of years ago.
Wasn't that a result of Mayo turning FSU down? A strong FSU/Mayo partnership with an even stronger UF/Shands would have bred quite a bit of competition and been good for the city.
If this group really just wants UF to expand its services in Jax it will use the threat of bringing FSU med to town.
I know that a few years ago FSU med was not happy in Tallahassee and wanted a strong presence in a larger population center.
Quote03/03/2006
FSU med school not promising
by Bradley Parsons
Staff Writer
Florida State University’s medical school wants Jacksonville’s Mayo Clinic to host a local campus, but a clinic representative gives the idea a negative prognosis.
The FSU College of Medicine wants to include Jacksonville in its growing network of satellite campuses, but says it has so far received a chilly reception from the local medical community. FSU spokesperson Doug Carlson said in a briefing paper that numerous meetings with area hospitals including Mayo have failed to produce anything beyond internship opportunities.
“We have not sensed that the medical community in Jacksonville has been eager to partner with us in training our students,†said Carlson in the memo.
FSU appealed to Jacksonville’s mayor’s office to help spur talks with local hospitals. The Mayo Clinic responded by touting its own medical school.
Jacksonville’s Mayo Clinic serves as one of three national campuses for the Mayo Clinic College of Medicine. Last year, Mayo Jacksonville taught 17 of its own medical students and 20 visiting fourth-year medical students.
Mayo Jacksonville has hosted students from all of Florida’s medical schools, including FSU, said Layne Smith, director of government relations for Mayo Clinic Florida and St. Luke’s Hospital. Mayo offers in-state tuition to Florida students.
Mayo trains some fourth-year medical students from FSU. But, Smith said hosting a satellite campus would be impractical. The schools’ programs are too different, he said.
“FSU’s focus is really on family practice and on the rural, underserved folks,†said Smith. “The Mayo Clinic’s focus is primarily on the high-end stuff. For instance, we have the largest liver transplant program in the country.â€
Blending the programs could cause problems for Mayo’s accreditation, said Smith.
The slow progress in Jacksonville has sent FSU looking for alternative sites. The medical school plans to open campuses in Immokalee in southwest Florida and Daytona Beach.
FSU’s medical school has regional campuses in Pensacola, Sarasota, Orlando and Tallahassee. Students receive field experience by rotating among the satellites, which each have an annual budget of about $2 million.
Daytona and Immokalee welcomed FSU. NCH Healthcare System in Naples plans to transfer to FSU a 28,000 square-foot medical center in Immokalee. The Daytona campus has been endorsed by the Halifax Medical Center, Daytona Beach Community College and Indian River Community College.
Those expansions touched off local concerns that Jacksonville might be replaced in FSU’s plans by Daytona, but Carlson said that’s not the case. FSU still has strong interest in a Jacksonville campus, he said.
The mayor’s office wants an FSU campus in Jacksonville, said spokesperson Misty Skipper. She said FSU would continue to get City Hall help in exploring local partnerships.
http://www.jaxdailyrecord.com/showstory.php?Story_id=44660
I doubt the FSU/Mayo model would have been much different than the existing UF/Shands model...FSU students still take early classes on campus.
Yeah............excluding his stance on "Ethics" which I happen to disagree with and received no reply via his website..........I have one..........why are they not joining up with the VA for a multipurpose facility? I understand a lack of private funding, but they have not pursued Federal Funding for something oriented towards veterans? Seems to me to be a win win situation not only for the local economy, but active duty and retired?
This is an important conversation for the City of Jacksonville. Last year, posted here on Metro Jacksonville, I wrote a letter to Kelly Madden with the Chamber on the Kansas City Chamber trip (2009 trip) and discussed the importance of the healthcare industry in Jacksonville. In the letter, and since, I have said that, in the long run, the healthcare industry should not just be a targeted industry for Jacksonville, it should be a defining industry. We have an extraordinary inventory of healthcare assests. With the Mayo Clinic (only three in the country), UF Proton Beam (few in the nation), Nemours, Shands Jacksonville, great area hospitals (Baptist, Memorial, St. Vincent's), Brooks Rehabilitation Hospital, and the proximity of the largest research university in the southeast in the University of Florida, we truly have extraodinary healthcare assets. The healthcare industry is the number one employer in North Florida. And, importantly, is it high wage per capita and, unlike other sectors of this economy, will grow in the future.
One of the missing pieces, however, which I have discussed at length over the last year, is a medical school. This is important for our long term future. We are the only only metropolitan area in the State of Florida without a medical school. We are, to my knowledge, the largest metropolitan area in the nation without a medical school. There are many ways to approach this issue, including our very important relationship with the University of Florida and the great teaching hospital and UF presence at Shands. Other approaches may also be considered. Regardless, we have the potential for Jacksonville to be known statewide, regionally, and nationally for our healthcare industry. A medical school is an important part of that long term vision.
First off, thank you for joining the discussion Mr Mullaney.
Just to point out...
QuoteUF Proton Beam (few in the nation)
First Coast Oncology here in town will also soon be online with proton beam therapy as well. They are using a different type of proton machine than what Shands uses.
Anyway,
What specific ways/facilities does the city have or can be made available to entice UF or Mayo to expand their medical school facilities?
Also, what headway is being made on a VA hospital in town?
How are you looking to attract more medical research(big money) projects to Jacksonville? Are you looking to create special economic zones that would make such opportunities economically viable to relocate/establish in Jax?
What about plans for existing or new small business relating to the healthcare industry, specifically research-related types of business?
I am concerned about, just like you are Rick, about the lack of a VA Facility and a full blown school for this region. Not only is active duty and dependents care somewhat limited, but with the numbers of retired former members in this area, why has there not been a collective effort to do something? By collective, I am refering to private/federal effort to address this issue? It would seem to me with, just the shear numbers in this area, Gainsville, is a bit far to go for simple medical care and a teaching/care facility in this area should be a logical tie in between UF/Mayo and a school! I did read your letter,concerning the Kansas City visit, and see parallels between that region and ours. What effort, if any, is ongoing at this time? Jacksonville is in a unique area and situation and I would like to see how we may advance or expand this possibility!
I think the best idea for a full blown medical school in Jax may be one in which Mayo is enticed to go the whole nine yards here. They are already in Jax, do research, have a hospital, own the land, are bringing in students from Rochester, and have an instant reputation. How much more would it take for them to make a leap to a full medical school in Jax? Once established, maybe the existing state medical schools would be more willing to create additional partnerships to further enhance the possibilities.
Here is another thought: Does the U.S. Military have a captive medical school, say, focused on the injuries and medical issues associated with war? Or, do they outsource all such research? Maybe Cecil Field could be a location for such an institution. Such a school could be partnered with a substantial VA hospital in Jax.
Another option would be to attract a well known foreign medical school/research facility to build a U.S. campus in Jax. Such as the Pasteur Institute:Quote
The Pasteur Institute (French: Institut Pasteur) is a French non-profit private foundation dedicated to the study of biology, micro-organisms, diseases and vaccines. It is named after Louis Pasteur, who made some of the greatest breakthroughs in modern medicine at the time, including pasteurization and vaccines for anthrax and rabies virus. The institute was founded on June 4, 1887 and inaugurated on November 14, 1888.
For over a century, the Institut Pasteur has been at the forefront of the battle against infectious disease. This worldwide biomedical research organization based in Paris was the first to isolate HIV, the virus that causes AIDS, in 1983. Over the years, it has been responsible for breakthrough discoveries that have enabled medical science to control such virulent diseases as diphtheria, tetanus, tuberculosis, poliomyelitis, influenza, yellow fever and plague. Since 1908, eight Pasteur Institute scientists have been awarded the Nobel Prize for medicine and physiology, and the 2008 Nobel Prize in Physiology or Medicine was shared with two Pasteur scientists.
Today, the Institut Pasteur is one of the world's leading research centers; it houses 100 research units and close to 2,700 people, including 500 permanent scientists and another 600 scientists visiting from 70 countries annually. The Institut Pasteur is also a global network of 24 foreign institutes devoted to medical problems in developing countries; a graduate study center and an epidemiological screening unit.
The international network is present in the following cities and countries:
* Algiers, Algeria
* Bangui, Central African Republic
* Brussels, Belgium
* São Paulo, Brazil
* Phnom Penh, Cambodia
* Dakar, Senegal
Institut Pasteur de Lille
* Lille, France
* Pointe-Ã -Pitre, Guadeloupe
* Cayenne, French Guyana
* Ho Chi Minh City, Nha Trang and Hanoi, Vietnam
* Tehran, Iran: (Pasteur Institute of Iran)
* Abidjan, Côte d'Ivoire
* Tananarive, Madagascar
* Casablanca, Morocco
* Nouméa, New Caledonia
* St Petersburg, Russia
* Tunis, Tunisia
* Athens, Greece
* Montevideo, Uruguay
* Bucharest, Romania
* Niamey, Niger
* Yaoundé, Cameroon
* Seoul, South Korea
* IPS Shanghai, China
* Pasteur Foundation New York, USA
* Canadian Pasteur Foundation, Montreal, Canada
* Hong Kong University - Pasteur Research Centre Hong Kong, China
* Pasteur Institute of India, Coonoor, India [2]
http://en.wikipedia.org/wiki/Pasteur_Institute
By the way, any medical school plans should include ways to leverage the school into spawning locally based biomedical companies that leverage its resources and research.
Quote from: stjr on September 22, 2010, 07:06:43 PM
Here is another thought: Does the U.S. Military have a captive medical school, say, focused on the injuries and medical issues associated with war? Or, do they outsource all such research? Maybe Cecil Field could be a location for such an institution. Such a school could be partnered with a substantial VA hospital in Jax.
Yup! Walter Reed US Army Hospital and Bethesda Naval Hospital are both cutting edge research hospitals that regularly take care of our US presidents. OCKLAWAHA
Ock..........you forgot about the Senators and Rep's also!
Quote from: stjr on September 22, 2010, 07:06:43 PM
I think the best idea for a full blown medical school in Jax may be one in which Mayo is enticed to go the whole nine yards here. They are already in Jax, do research, have a hospital, own the land, are bringing in students from Rochester, and have an instant reputation. How much more would it take for them to make a leap to a full medical school in Jax? Once established, maybe the existing state medical schools would be more willing to create additional partnerships to further enhance the possibilities.
I have no idea if they would be interested but this is a great great idea. In terms of rep it would be day one in the group of seriously prestigious schools in the field and a real feather in the cap for Jax..
Quote from: Rick Mullaney on September 22, 2010, 05:11:41 PM
This is an important conversation for the City of Jacksonville. Last year, posted here on Metro Jacksonville, I wrote a letter to Kelly Madden with the Chamber on the Kansas City Chamber trip (2009 trip) and discussed the importance of the healthcare industry in Jacksonville. In the letter, and since, I have said that, in the long run, the healthcare industry should not just be a targeted industry for Jacksonville, it should be a defining industry. We have an extraordinary inventory of healthcare assests. With the Mayo Clinic (only three in the country), UF Proton Beam (few in the nation), Nemours, Shands Jacksonville, great area hospitals (Baptist, Memorial, St. Vincent's), Brooks Rehabilitation Hospital, and the proximity of the largest research university in the southeast in the University of Florida, we truly have extraodinary healthcare assets. The healthcare industry is the number one employer in North Florida. And, importantly, is it high wage per capita and, unlike other sectors of this economy, will grow in the future.
One of the missing pieces, however, which I have discussed at length over the last year, is a medical school. This is important for our long term future. We are the only only metropolitan area in the State of Florida without a medical school. We are, to my knowledge, the largest metropolitan area in the nation without a medical school. There are many ways to approach this issue, including our very important relationship with the University of Florida and the great teaching hospital and UF presence at Shands. Other approaches may also be considered. Regardless, we have the potential for Jacksonville to be known statewide, regionally, and nationally for our healthcare industry. A medical school is an important part of that long term vision.
Thanks for taking time to share your vision.
I agree that we have some excellent health care assets, however it is probably a little too late for Jacksonville to be known statewide, regionally, and nationally for our healthcare industry. Mickey Mouse already beat us to the punch there.
Orlando has a new Medical City at Lake Nona that is pretty darn impressive. At the medical city is the Sanford Burnham Medical Research Institute, UCF's new College of Medicine and College of Biomedical Science, Nemours Childrens Hospital, Orlando's New VA Medical Center. UF is also building a 115,000 square foot research center at the medical city that will focus on pharmacy and biomedical research.
With the amount of investment that the state has made in Orlando, it is unlikely that Florida will duplicate a new medical school or research complex a few hours up the road in Jacksonville. It is also likely that any new medical research institutes looking to come to the state will choose to locate to the Lake Nona complex due to the synergy there. Or in Martin/West Palm Beach Counties. The Scripps Research Institute just opened in Jupiter and Torrey Pines in Port St. Lucie, both of which opened due to large state incentives. Both of those are major national medical research institutions.
In theory, I think the idea of improving our medical community is great, but as usual Jacksonville is 5-10 years behind the state. Hopefully we can get UF/Shands or Mayo to expand their mission in Jacksonville, because the idea of a new med school seems like a long shot.
Best of luck to you Mr. Mullaney
Quote from: Ocklawaha on September 23, 2010, 12:15:33 AM
Yup! Walter Reed US Army Hospital and Bethesda Naval Hospital are both cutting edge research hospitals that regularly take care of our US presidents.
Yes, Ock, these are great hospitals. But, are they medical schools? How much research do they do or do they act as vehicles to outsource it to other institutions? Even as what they are, maybe its time they opened a "warm weather" branch here like Mayo did. ;D Just think of all the military facilities in the Southeastern U.S.
P.S. I realize the Jax NAS already has a hospital. But, we are talking here about a national facility doing research and teaching, on a whole different plane from a regular hospital.
QuoteP.S. I realize the Jax NAS already has a hospital. But, we are talking here about a national facility doing research and teaching, on a whole different plane from a regular hospital
Hospital??
NAS has a meat market on base ;)