UNLV Builds

By Paul Harasim

When you read the TSK Architects’ design brief for the five-story, 135,000 square foot building that will be the first permanent building for the Kirk Kerkorian School of Medicine at UNLV – construction on the facility slated for completion by summer 2022 – you can’t help but zero in on this paragraph:

The anchor for student instruction, community partnerships and for the building itself is the super-floor on Level 1 of the building. Nestled six feet into the earth, the super-floor houses the training functions of the building, including standardized patient rooms, a simulation suite, virtual anatomy classrooms, and a pro-section (cadaver) lab, as well as the offices for administrative and technical staff who run the simulation center. It is unique in medical education to have a facility that places all of these program elements on a single floor in close proximity to one another. Having this proximity will allow the school and their community partners opportunities to run a wide variety of simulation scenarios, workshops and events to train students, maintain certifications of licensed professionals and explore medical care in new and exciting ways.

So the Kerkorian School of Medicine, in temporary facilities on UNLV’s Shadow Lane campus since the medical school opened as the UNLV School of Medicine in 2017, won’t be following the leader in medical school design. It is a leader.

Kirk Kerkorian, for whom the school was named in April, was himself a leader. A gaming pioneer known as the father of the megaresort on The Strip, Kerkorian died in 2015 at age 98. He was the founder of MGM Resorts International and considered one of the central figures in making Las Vegas a premier global tourist destination. Since his death, hundreds of millions of dollars have been given away around the world, anonymously, by his estate, according to an announcement by his confidants. They also say that it is only because the medical school is in a city he loved, will the school, the recipient of millions of dollars of his philanthropy, be the one and only place that carries his name.

With an eye for design that kept patrons of his resorts coming back for more, Kerkorian, no doubt, would have appreciated the educational wizardry designed into the new medical education building that will bear his name. Flexibility will be a key feature of the structure. While the school’s class size is now 60, the building is designed to appropriately handle a class of 120.

Fifteen typical patient rooms will be on the super-floor, allowing mock examinations to be run using trained patient actors. Each room is equipped with microphones and cameras to monitor the interaction between students and actors. Debriefings and evaluations of students will be carried out in adjacent conference rooms that are shared with the simulation suite, where students can practice procedures on mannequins that breathe, cry, sweat, and respond to medications.

Divided by three operable partitions, which can allow the simulation rooms to function separately, the simulation rooms – which will also be connected to a control room by both cameras and microphones so the staff can run a variety of scenarios and later provide feedback – can also open up and operate as a multi-bed suite. A simulated operating room, with appropriate surgical equipment, will also be ready for use. Virtual anatomy classrooms will be filled with specialized tables allowing students to virtually explore cellular structure, as well as anatomy and physiology. The prosection lab, with space for eight cadavers that offer students a tactile anatomical experience, will complement the virtual anatomy program.

Yes, Kerkorian, who so appreciated great design, couldn’t help but appreciate the design being built into the Kirk Kerkorian School of Medicine at UNLV, where gardens, welcoming visitors on Level 2, also set off a walking trail offering students a way to work off stress.

To help complete the school’s sophisticated design, Mike Purtill, a TSK architect, says his Las Vegas firm enlisted Los Angeles-based CO Architects, a specialty group that designs medical schools and hospitals throughout the United States. Purtill points out that administrators at medical schools today, including those at the Kerkorian School of Medicine, are demanding buildings and layouts to facilitate multidisciplinary instruction of small groups. New medical education buildings at two Texas medical schools, the University of Texas at Austin Dell Medical School and the Texas Tech University-El Paso School of Medicine, both reflect the same educational philosophy as the Kerkorian school. Large lecture halls, where students diligently take notes to supplement loads of book learning, are no longer the gold standard.

“I went to medical school in a more traditional era, where the first two years were delivered mostly by lecture,” says Neil Haycocks, MD, the vice dean for academic affairs and education at the Kerkorian School of Medicine. “This was probably nice for the institution, as it needed only two lecture halls most of the time...Things have obviously changed a great deal in the last two decades, with a much greater emphasis on active learning, small group learning, and hands-on practice prior to the starting of the clinical clerkships.”

Barbara Atkinson, MD, the planning and founding dean of the medical school and the only woman to head three medical schools in the U.S., played a large role in the design of the building. She notes that the design of the super-floor space also encourages human interaction through circulation patterns and proximity of spaces. Both, she says, enhance the informal collegiality that produces a more efficient learning environment, free of the formality that has been found to stifle learning give and take.

The school’s current dean, Marc Kahn, MD, adds that the many opportunities for simulated learning within the new building are also a safer way to learn than students watching a professor and then practicing on a live patient. Dr. Kahn made sure that in his new office, on the medical school’s fifth floor where administration offices will be found, he has sightlines allowing him to see students walking by so he’ll be able to easily and informally greet them and talk about their educational experience.

Talk about a school designed with attention to detail.

Though the Nevada legislature greenlighted a new medical school for UNLV in 2014 and welcomed its first class of 60 students in 2017, it took six years before construction on a new building began. Three attempts to begin construction on a permanent campus for the medical school, developed by UNLV administrators and the Nevada System of Higher Education (NSHE), fell apart amid tensions between the UNLV donors and NSHE. It wasn’t until late 2020 that construction finally began on the new building that’s quickly shooting up in the Las Vegas Medical District near downtown.

What finally made the project a go, according to Maureen Schafer, Dr. Atkinson’s former chief of staff at the medical school, was advice last year from Robert Lang, PhD. Lang, who died in June, had held the Lincy Endowed Chair in Urban Affairs at UNLV and served as executive director of both the public policy think tank, The Lincy Institute, and Brookings Mountain West, a partnership between UNLV and the Brookings Institution, a Washington, D.C.-based research organization.

According to Schafer, Lang suggested to donors that the creation of a nonprofit development corporation could get the stalled project off the dime. It did. Through the formation of a development limited liability corporation called the Nevada Health and Bioscience Corp. (NHBC), donors to the school, largely the Engelstad Foundation and Kerkorian’s charitable Lincy Foundation, along with unnamed philanthropists, committed to more than $150 million to build the medical school. With Schafer installed by donors as NHBC CEO, the funding arrangement by the development corporation – it will manage how its philanthropic dollars are spent – was approved by NSHE. Under the plan, NSHE leases the building for $1 a year until 2030, when the deed to the property will revert to UNLV and the Nevada Board of Regents.

Eight years ago, it was Lang who pushed for a study that ultimately showed a new medical school would bring about $1.2 billion a year into the economy after 15 years of startup. That study, projecting that the creation of the school would spawn new biotech companies in Southern Nevada, convinced Nevada legislators the building of a medical school made financial sense.

“Dr. Lang was a true visionary,” Schafer says.

Kris Engelstad McGarry, a trustee of the Engelstad Foundation, told the Nevada Independent that the development corporation idea shared by Lang – a mode of operation frequently used by nonprofits in other states – allowed donors to escape the existing institutional apparatus which, in her view, had strangled previous attempts by philanthropists to build a medical school. Too often, she said, they were only told “no” or only heard reasons why their ideas couldn’t work.

The state-of-the-art allopathic, MD granting medical school that Engelstad McGarry has long envisioned as a beacon for improved healthcare in Southern Nevada will welcome visitors on the second floor. There, a multi-story community space will act as an informal gathering place, as well as a space for public lectures, TED talks, and school and community events. While this forum space originates on Level 2, which will house a tribute to Kerkorian and a donor recognition wall, it will connect to Level 3 through stepped seating. Level 2 also has a cafe and small study rooms for groups of eight students.

Common to both levels 3 and 4 will be a learning resource center operated by UNLV Libraries, emphasizing the latest in digital media. Both levels will also house small group study rooms and flexible classrooms, with operable partitions that open to each other should larger groups need accommodation. The small group study rooms will have screen-sharing hardware and visual displays allowing students to work collaboratively on problem-based learning exercises. The student lounge and a fitness center will be on level 4.

The new building will also be environmentally sound. Registered through the Green Building Certification Institute, its plumbing fixture water use will be reduced by 32 percent and water-efficient landscaping allows for a 56 percent reduction when compared to baseline building requirements. Energy use will reflect a 27 percent reduction in energy use over the baseline.

It was nearly 60 years ago when James Bilbray, then a Nevada System of Higher Education (NSHE) regent, argued before state legislators that the greater population in the Las Vegas metro area, then around 92,000 (compared to Reno’s 71,000), made it the logical site for the state’s first medical school.

To this day, the 81-year-old Bilbray, a lawyer who represented Nevada’s 1st Congressional District from 1987 to 1995, finds it hard to believe legislators “couldn’t see the signs” of how Las Vegas would grow: “I actually think we had the votes to have the medical school built in Las Vegas but at the last minute the Reno option got a lift with the promise of a sizable financial gift from a foundation if the medical school was located in Northern Nevada.” While the Reno medical school did have a clinical profile in Las Vegas, he says it was so low profile that it didn’t make much of a positive difference in the delivery of healthcare to Southern Nevada, which has grown to a metropolis of 3 million, while Reno sits at 500,000.

Bilbray says he hopes the Kirk Kerkorian School of Medicine is a catalyst for improved access to healthcare, so the days of long waits for appointments are no more.

“We deserve better,” he says.

Amen.