Bringing the Seminary to the Hospital: Q&A with Charles Milliken

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Starting in the fall of 2018, students in Perkins School of Theology’s Houston-Galveston (H-G) Extension Program began reporting to Houston Methodist Hospital to attend many of their in-person classes. (Due to the pandemic, H-G classes shifted temporarily to fully online in 2020, and this year the program is meeting at another location.) The partnership between Perkins and Houston Methodist was shepherded by Dr. Charles R. Millikan, an ordained United Methodist clergyman and the hospital’s vice president for Spiritual Care and Values Integration. Millikan shared his perspective on how the two institutions work together to help students prepare for holistic ministry.

Q: How did Perkins H-G classes come to be located in a hospital?

A: A few years ago, Dean Craig Hill and I talked about re-invigorating the H-G program. At the time, the program was hosted at St. Luke’s United Methodist Church, which was under construction and could no longer provide space for classes. So we got creative and put together a consortium of places in Houston where we could hold classes: St. Paul’s United Methodist in Houston, Moody Memorial Methodist in Galveston, St. John’s United Methodist in downtown Houston, and the hospital. So we have four sites, with Houston Methodist at the center. In non-pandemic times, most 
in-person classes are taught at the hospital, with some offered at the other three locations. H-G students spend 40% of the class time face-to-face and 60% online. Usually, the students attend the in-person classes in the evenings for one week at the beginning and end of the semester.

Houston Methodist became a center because it has phenomenal resources, including IT and food service. The hospital hosted the classes at no charge and provided meals to the students for free. The hospital also has tremendous conference space that can house as many students as need be, as few as 10 or as many as 50 students. We’re also located in the center of the Houston Museum District, which might lend itself in the future to interesting venues for courses, such as the Museum of Fine Arts or the Holocaust Museum.

The move to Houston Methodist took place in 2018, the same year that H-G launched its program in the hybrid format, combining in-person and online coursework. Full-time students may earn the Master of Divinity (M.Div.) in three years, or Master of Arts in Ministry (M.A.M.) degree in two years, without having to take courses at the Dallas campus. Houston-Galveston students take courses with many of the same professors as those students based at the Dallas campus, so this is a very appealing option to students who work in full-time ministry or in secular jobs.

Q: You also played a key role in the inception of the H-G program in 1994.

A: Yes. At the time, I was senior pastor at Moody Memorial Methodist, and there was no ATS-accredited seminary in the Houston area. I discussed the possibility of an extension campus with Dr. Robin Lovin, then dean at Perkins.  We held an Inside Perkins event in Houston at St. Luke’s United Methodist Church to gauge interest, expecting a dozen or so potential students. More than 150 attended and 64 enrolled! Moody donated $400,000 to help launch the program and St. Luke’s provided office space. United Methodist Bishop Cynthia Fierro Harvey and BJ Hightower (now a senior chaplain in the Houston Methodist system) were among the students in the first classes in the program.

Q:  What are the advantages of situating theology classes in a major medical center?

A: Perkins shares a similar culture and sense of mission as Houston Methodist, which is a faith-based hospital system. As a Methodist institution, the hospital treats patients holistically, where spiritual care is seamlessly integrated into the physical care. The partnership provides a great training ground for anyone who aspires to go into ministry, and especially for those with an interest in the chaplaincy.

Another advantage: at the hospital, you’re around other people, not just theological students. We’re in the center of a very large Methodist institution. Students are studying in a place where birth, death and healing are taking place round the clock.

The partnership has sparked some unique collaborative courses, including an elective course called Health Care Holy Care, usually offered during the January term. Taking advantage of the hospital setting, students “shadow” chaplains at Houston Methodist and attend lectures on pastoral listening skills, bereavement, spiritual care, confidentiality, compassion fatigue and topics such as suffering and God’s will, or how to deal with patients who pray for miracles, or those whose religious beliefs may lead to harm. This course is open to all Perkins students regardless of their campus location but tends to attract students who have a particular interest in chaplaincy.

The H-G Extension Program also occasionally offers an elective in Bioethics, team-taught by Dr. Dallas Gingles, site director of the Houston-Galveston Extension Program, and Baylor University’s Janet Malek, who is also director of the Houston Methodist Biomedical Ethics Program. We have incredible resources of people here who can assist Perkins professors in teaching specialized courses without having to travel.

I believe that offering training in hospital chaplaincy will open up additional job opportunities for Perkins graduates. Many churches are no longer hiring ordained persons, so graduates need to find places where their ministries can flourish.

Q: What natural connections do you see between theology and health?

A: It’s imperative to understand that there are certain social determinants of health that get in the way of healthy living. Wesley’s understanding of theology is that we’re all to live healthy lives. A hospital is not just a place you go when you’re ill; it’s a place you go to stay well. We are constantly looking at ways to help people find ways to remain well. Part of that is educating ourselves on having regular checkups, understanding what it is to combat these social determinants of health, such as the lack of transportation, the lack of food, the lack of medication, as well as providing spiritual and emotional support when a person is going through a trial of some kind. So, we see the very two as very closely related.

Q:  Talk about how COVID has affected the H-G program and how it might change the program going forward.

A: Since the pandemic began, we have ministered to more than 17,000 COVID-19 patients. At the peak of the pandemic, Houston Methodist had more than 800 COVID patients in the hospital. During the pandemic, in-person classes were suspended for H-G students. We had hoped to be able to resume face-to-face classes at the hospital in the fall, but the Delta variant of the coronavirus made that impossible, unfortunately. Instead, H-G students are meeting in person this fall at St. Paul’s United Methodist Church in Houston.

Interestingly, very few people have had the flu during the last 18 months or so. That’s because they have been social distancing, wearing a mask and keeping their hands clean. When I started working here, I kept catching colds. A medical colleague asked me, “How often are you washing your hands?” Apparently, not often enough! I started washing them often, and it really makes a difference.

Q: Do you see opportunities for further initiatives in the partnership between Perkins and the hospital?

A: We’re looking into creating a program for a doctorate in clinical theology that would be open to social workers and physicians who have a lifelong desire for learning. Many people who work here have a desire to understand how spirituality can be researched — how to do research with faculty and with students.

We also hope to offer additional courses and seminars down the road for physicians and other hospital staff with an interest in spirituality and medicine. Houston Methodist is part of Texas Medical Center; the complex is home to 50 different medical agencies — hospitals, clinics, medical and nursing schools — and employs 100,000 people. People who work in the hospital setting love to learn. We have many people here who are interested in exploring their spiritual side. Perkins can offer opportunities to talk about culture, purpose, mission and philosophy in a high-quality academic education.

Q: Many low-income people have no access to good healthcare (or health care). How can hospitals ensure care is extended to all who need it?

A: I’m proud of how Houston Methodist Hospital has worked to make medical care more accessible to more people. We understand that once we have a patient, they are a patient for life. Every patient at the hospital is given a doctor and an appointment within 30 days after leaving the hospital. We make sure they have a medical home outside of our medical departments.

Houston Methodist also has a very robust charity program, where we donate more than $1 billion in medical care for patients who cannot pay their bills. Roughly 20% of our budget goes to charity care. We also partner with federally qualified and charity clinics in Houston neighborhoods. During COVID-19, for example, we brought the vaccinations to these clinics to help our vulnerable neighborhoods.

Q: What “fruits” do you envision will result from the partnership in the future?

A: Collaboration and partnerships work best when you’re in the church and in ministry. There are several things that Houston Methodist could learn from SMU, and that Perkins could learn from us.

This hospital is a parish. We can do things united that we possibly never could have done separately. For Perkins to be conjoined with one of the country’s top hospitals for patient care, research, and education helps pastors cope and learn and work with people who excel in the medical industry.

I’m proud that Houston Methodist is connected with Perkins in Dallas, and we’re proud to contribute to the success of SMU.