Influx of medical students could overwhelm Montana’s resources | Education


Opening two new medical schools in Montana would stretch and possibly overwhelm the state’s physicians who provide the clinical training students need to become physicians, according to leaders of a medical school program in Montana. the University of Washington which relies on these teaching physicians.

The WWAMI program at the University of Washington School of Medicine in Montana requires its students who have completed their academic work to complete internships and clinical placements to graduate, and then these graduates must be matched with residencies. WWAMI – an acronym for the five states participating in the program: Washington, Wyoming, Alaska, Montana, and Idaho – uses hundreds of Montana doctors for this hands-on training, in addition to doctors from the other four states.

This is why plans by the for-profit Rocky Vista University College of Osteopathic Medicine to build a campus in Billings and the non-profit Touro College and University System to build a school of osteopathic medicine in Great Falls worry WWAMI officials. .

“Everyone’s biggest concern is clinical resources,” said Dr. Suzanne Allen, associate dean of academic, rural and regional affairs at UW Medical School. “At some point, there aren’t enough of these clinical resources for everyone to have a good learning experience. “

The University of Washington is a school of allopathic medicine, graduates of which are MDs, while the proposed schools in Montana would train doctors of osteopathic medicine. Both types of physicians are fully licensed physicians. Students study the same program and participate in the same clinical training, but they take different licensing exams, and schools are accredited by different panels: the Liaison Committee on Medical Education for Allopathic Schools and the Commission on Osteopathic College Accreditation for Osteopathic Schools. .

Dr Jay Erickson, associate dean for regional affairs and rural health and associate clinical dean for Montana WWAMI, criticized the lax accreditation standards of osteopathic schools for creating a potential blockage for medical students Montana that could affect its program.

“The LCME which accredits allopathic medicine schools would never approve two new medical schools in a state of 1 million people with limited clinical teaching opportunities that are widely used by Montana WWAMI and existing residences,” said Erickson said in an email.

Rocky Vista, which has schools in Colorado and Utah, announced in May that the Commission on Osteopathic College Accreditation had approved its plan to build a Billings campus. Touro’s request, which has campuses across the country, for a facility in Great Falls is expected to be considered at the committee’s August meeting.

Opening new medical schools would provide more places for students in the state who might otherwise be rejected due to WWAMI’s thresholds. Montana WWAMI only accepts 30 students per year. In Alaska and Wyoming, it’s 20 students per year. In Idaho, it’s 40, and in Washington, it’s 160 split between Seattle and Spokane. All WWAMI students must be residents of the state to which they are applying.

These in-class slots do not necessarily guarantee more on-the-job training opportunities. This work represents about half of the training of a medical student.

During the first two years, students in the WWAMI program receive classroom instruction at affiliated universities, such as Montana State University in Bozeman. Then, in their third and fourth years, WWAMI students are required to complete internships and clinical placements with physicians the program uses as clinical professors or teaching physicians, statewide.

Approximately 230 WWAMI students from the five states participate in internships in Montana as well as internships in the other four states. Other medical schools, including the College of Osteopathic Medicine of Idaho and the College of Osteopathic Medicine at Pacific Northwest University, also use Montana for the clinical training of their students.

The concern of school officials and some of these teaching physicians is that the influx of students that the two new medical schools would bring could lead to increased competition and hamper the hands-on training that clinical placements are designed to provide.

Dr KayCee Gardner, a 36-year-old WWAMI graduate, practices family medicine in Miles City and trains WWAMI students.

“I just hope that with the construction of more medical schools, there will be enough teachers and enough places for them to get a good rotation and not just watch the back,” he said. Gardner said.

Another point of concern is how the new Montana schools will affect residencies, which all medical students must complete after graduating to become certified physicians. Internships in residence are already very competitive, depending on the hospital and the specialty. WWAMI students are encouraged to search for residences in the Five State area.

Since many physicians end up staying in the region where they perform their residency, it is important for the goal of training physicians for rural and underserved communities, such as Montana and Idaho, which schools encourage. students to perform residencies in the state.

Four years ago, Idaho went through the uncertainty that Montana is now going through. This was when the for-profit Idaho College of Osteopathic Medicine was founded, which raised concerns that the school would hamper the clinical training opportunities for WWAMI students there.

Dr Tracy Farnsworth, President of ICOM, said the school has created more than 50 clinical affiliations and hundreds of affiliations with private physicians to avoid conflict.

Now, Farnsworth and WWAMI Idaho Director Dr Jeff Seegmiller say their schools are united by a goal of increasing the number of physicians per capita in Idaho, the second worst ratio in the country.

“In our opinion, we need WWAMI, but we also need the Idaho College of Osteopathic Medicine. To become something other than the last in the nation for physicians, you need more resources, more ability to generate physicians, ”Farnsworth said.

ICOM has 486 students compared to 160 for WWAMI Idaho, and about three-quarters of the for-profit school’s students come from states outside of Idaho and the region.

Of the more than 800 physicians who have been trained through the Idaho WWAMI program, 51% of graduates return to practice in Idaho, according to Seegmiller.

ICOM’s first class will graduate in May 2022, so it’s unclear how many of its students will return to the state.

Touro University College of Osteopathic Medicine, which is awaiting approval from accrediting agencies, plans to accept 125 students each year and train them with affiliates in Montana, as well as send some students out of state for their internships and rotations, according to Dr. Alan Kadish, president of the Collegiate and University system of Touro.

He said Touro plans to give preference to Montana residents but does not have a quota on how many in-state and out-of-state students he will accept.

“With our [osteopathic] model and augment primary care residences, we believe we will encourage students to enter primary care and stay in the state, ”Kadish said.

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