Dr. Akram Boutros, CEO of MetroHealth in Cleveland, was speaking to a group of 11th graders on a hospital field trip several years ago when one student asked how he got his job. He asked them to guess.
“Luck?” one student ventured.
“The concept of a career was foreign to them,” he recalled in a recent interview in his office. In most Cleveland counties, the employment rate is higher than the national average. “They’re not exposed to many opportunities and don’t know how to get to opportunities.”
That exchange inspired him to propose locating a public high school on MetroHealth’s campus, so students could interact with hospital professionals of all types and do internships in whatever areas interested them. He knew of no other hospitals in the country that had done this.
The project was part of his public safety-net hospital's broader commitment to improving the community’s health by addressing social factors including education and employment opportunities.
After he proposed it, "every objection you can think of, we heard,” Boutros said with a wry smile, recalling warnings about siphoning money away from healthcare and the risks of teenagers interacting with adults and sick people.
Boutros pushed ahead anyway. In partnership with MetroHealth, the Cleveland public school system opened the Lincoln-West School of Science and Health in 2015, less than a mile from the hospital in a heavily minority, lower-income neighborhood on the west side of Cleveland. In 2016, the hospital converted a corridor of nursing education rooms into seven classrooms for Lincoln-West students.
Now, 105 juniors and seniors, nearly half of whom are English-language learners, take all their classes at the in-hospital campus, just off the hospital’s main lobby. They shadow and are mentored by physicians, nurses, therapists, IT specialists, attorneys, fundraisers, supply chain leaders, electricians and other hospital staff. During their senior year, they do an internship in a hospital department, concluding with a “senior capstone” project presentation.
Freshman and sophomores study at the high school's other campus, visiting the hospital for monthly career talks with hospital professionals.
Teachers create projects centered around healthcare issues, such as Native American healthcare access and how much it costs to go to the doctor. There's a "white coat" ceremony when students begin mentorships. The school and hospital currently are fundraising for a $250,000 student chemistry lab at the MetroHealth campus.
This past June, 95% of the school’s first class of 20 graduated, with all of them going on to colleges and universities and many preparing for healthcare careers.
“I didn’t know anyone working in healthcare,” said Zachariya Abdullah, a skinny 16-year-old junior who came to the U.S. from Iraq. He was beaming because he had received his U.S. citizenship hours before being interviewed for this article. “I wanted to become a nurse and being here at this school gives me lots of opportunities and experience to join the medical field.”
Michelle Hughes, Lincoln-West’s principal, said her students benefit greatly from the regular contact with MetroHealth professionals. “In traditional high schools, you can tell students that they can be this or that, but it doesn’t feel real to them,” she said. “Having conversations with professionals makes it real and attainable.”
MetroHealth staff, she added, are enthusiastic about working with the students, and the school often gets more volunteers than it needs. “The employees see themselves in the students,” she said.
When classes end for the day, the students are quiet and orderly in the hallway, unlike in typical high schools. "It's like night and day between here and the other campus," Hughes said. "It's about business. Working with professionals sets high expectations."
Eric Gordon, the Cleveland schools superintendent, said Lincoln-West’s in-hospital campus is part of his system’s broader effort to partner with business, research and healthcare organization to provide students with a career orientation.
Another public high school, the Cleveland School of Science and Medicine, has students doing internships with physicians and scientists at Cleveland Clinic and Case Western Reserve University. Unlike Lincoln-West, that school has a select admission policy.
Gordon said he greatly enjoyed watching Lincoln-West students go through the same training MetroHealth medical professionals receive in examining a mechanical patient, observing how they responded when the “patient” moaned.
“Not only has Dr. Boutros championed this great opportunity, but all the people who work with him see these kids as their kids and are making sure they succeed,” Gordon said.
In the longer term, the on-campus school could directly benefit MetroHealth by attracting healthcare professionals. “It’s part of our workforce development strategy,” said Tiffany Short, the system’s director of culture and organizational effectiveness. “Those students hopefully will come work for us.”
Boutros hopes the Lincoln-West experience will inspire similar partnerships between schools, health systems and other organizations across the country. “I urge every anchor institution to do this,” he said. “The payback is massive. The staff loves it, you are collectively improving lives, and you are creating lifelong customers.”