PowerPoint Presentation

WWAMI 201240 Years of Medical Education in Idaho

Mary Barinaga, MDIHPEC PresentationJuly 23, 2012

WWAMI Founding Goals 1971Provide access for citizens of Northwest to publicly-supported medical educationIncrease number of primary care physicians and address maldistribution of physiciansCreate community-based medical education Expand GME and continuing medical educationAvoid excessive capital costs and duplication of resources by using existing educational infrastructure

2WWAMI Non-metro percent of population by state12%65%34%70%33%The 5 WWAMI states make up 28% of the US landmass, but only contains 3.4 % of the US population.3

Have done well in many of these things but can continue to improve on maldistribution there have been several programs that have worked on the exposure of students to rural and underserved care all of those programs are now part of the TRUST program

4

5Idaho Physician Workforce Data49th in nation for physicians per 100K population (182.2)48th in nation for primary care physicians per 100K population (67.2)Total active physicians in Idaho: 287223.3% (670) over age 6086% (2474) over age 40

Source: AMA Physician Masterfile 12/31/2010

Idaho WWAMI Workforce ProgressRate of return49% (national 39%)

Return on Investment72% (all WWAMI graduates practicing in Idaho)

Graduates selecting primary care specialties45% (five year average, 2006-2010)

What kind of outcomes are we having. Idaho WWAMI graduates return to practice at a significantly higher rate than the national average50% for Idaho students, national average of 39%. When looking at how many WWAMMI graduates from the region have returned to practice in Idaho (from Montana, Wyoming, Alaska, and Washington), we have a 72% return on our investment. Idaho WWAMI graduates choose primary care specialties (pediatrics, internal medicine, and family medicine) 45% of the time, compared w/ the national average of 32%7

This graph shows what specialties Idaho WWAMI graduates have chosen since the first Idaho WWAMI class graduated in 1976. Family medicine is the #1 specialty chosen by Idaho students, more than twice any other specialty. Other specialties that Idaho has shortages of, including internal medicine, surgery, pediatrics, and emergency medicine are also preferred by our graduates.8

Practice Sites 1976-2010This map demonstrates the distribution of Idaho WWAMI graduates practice sites within Idaho. Once again, WWAMI graduates are practicing in diverse locations throughout the state, many in rural and underserved communities. This map looks very similar to the map showing where our students are training, which shows how active past WWAMI graduates are in the education of our future physicians and colleagues.9UWSOMRural/Underserved Programs10R/UOP 1988 WRITE 1996Underserved Pathway: 2006Rural required third-year clerkships (Family Medicine, Internal Medicine, OB/GYN)Rural clinical electives

10

2008 in MT 4 year rural longitudinal medical school curriculum with 20 week rural longitudinally integrated clerkship experience in the third year all in one rural community. Expressed goal of choosing students with a background and predisposition to return and practice in a rural/underserved community. Immersing them in the TRUST curriculum and returning them to a rural/underserved community in the WWAMI region.

11TRUSTAdmissions: A Separate Process12Where have you lived/worked from birth until present?How do you imagine your personal and professional lives intersecting ten years from now? What obstacles have you overcome in your life to get to the point of applying for medical school?Why have you applied to participate in the TRUST program?

Rural and/or disadvantaged backgroundPrior career experience in health related workSignificant volunteer experience in rural or underserved medical settingsStrong commitment to serviceWWAMI rural high school graduate and Graduate of an instate public college/university.

12TRUSTThe Students First Year ExperienceRural Health ClassContinuity visitsJournal ClubEvening experiencesUnderserved Pathway

13R/UOP14Month long immersion clinical experienceOver 120 of 220 UWSOM students will participate in Summer 2012Most students complete a community-oriented scholarly projectHighly rated

WRITE SITES Note: Alaska not to scaleWSandpointLibbyMcCallHaileyPowellWasillaEllensburgWLewistownGrand CouleeJuneau

Boise

Anchorage

CheyenneSpokaneLander

WRITE SiteWWAMI Regional OfficeWWWWWhitefishWWMoses LakeChelanHelenaWWWWWWWWWWashingtonAlaskaWyomingMontanaIdahoWWWWWWWWWWWWNewportShelbyMiles CityDillonButteKodiakDouglasWWWWWPort AngelesSheltonLynden/Birch BayFerndalePort Townsend-20 wk rural/underserved immersion experience for 3rd year students-started in 1996 and modeled after Minnesotas RPAP program-purpose to help meet the need for rural physicians in WWAMI region-26 particpating communities, with several new ones in development phase

15WRITE Student ObjectivesBecome familiar with a rural communityBecome a member of the rural healthcare team20 week continuity experienceSocial integration into a rural communityInstill confidence and professionalismBecome independent learners

WRITE Practice Outcomes31 graduates into practice

23/31 (74%) into primary care15 FM6 IM2 Peds

WRITE graduates in Rural Practice12/31 (39%) into rural practice9 Family Medicine1 Internal Medicine1 Pediatrics1 Emergency Medicine

TRUST:The Students Fourth Year Experience19Work on career development Participate in sub-internshipsEstablish links with regional residency programsExplore integrated residencyBillings pilot

TRUST ContinuumChoose students with a background or interest in rural/underserved medicineEducate students within a longitudinal rural continuity experience throughout 4 years of medical schoolChoose GME with a rural/underserved emphasisReturn students to rural/underserved communities Success!!!

Questions?Mary Barinaga, MDbarinm@uw.edu