Category Archives: Medical School

by Ken Alltucker - Apr. 24, 2012 11:17 PM The Republic | azcentral.com

Medical schools in Arizona more than doubled their enrollment in the past decade, but most of those young doctors won't establish a practice in your neighborhood or work at a local hospital.

That is because most students who graduate from Arizona medical schools train out of state, and physicians are more likely to establish careers where they complete their residency training during those pivotal years after medical school.

One key reason that medical-school graduates leave Arizona is that the state does not have enough residency slots at hospitals or community health centers that allow doctors to train and practice their craft after graduating. The shortage has been made worse by a federal limit on Medicare-funded slots, state funding cuts to graduate medical education and some hospitals' reluctance to start or expand training programs.

Medical-school representatives and business leaders say the physician training crunch is an issue that affects health, quality of life and the economy in Arizona, where there is an ongoing physician shortage. With two new medical schools planned, the problem could grow even larger.

"We talk about importing physicians, but we are exporting graduates," said Lori Kemper, dean of the Arizona College of Osteopathic Medicine at Midwestern University of Glendale.

Kemper and other medical-school representatives met Tuesday at the University of Arizona College of Medicine-Phoenix to discuss a newly released report funded by St. Luke's Health Initiatives, a health-policy foundation, about Arizona's medical education challenges.

The report shows that Arizona ranked 20th in the nation in medical-school enrollment but 37th in the number of residency slots. The report suggests the state needs to add 848 to 885 residency slots at a cost of $89 million to $93 million to meet national averages.

If medical-school students train in Arizona, they are much more likely to practice medicine here. The St. Luke's report shows that 75 percent of active physicians who graduated and trained in Arizona stayed, while only 28 percent of Arizona medical-school graduates who completed training out of state returned to Arizona to practice.

Most residency slots are paid by the federal government through agencies such as Medicare and the Department of Veterans Affairs. The Medicare program, which provides about two-thirds of government funding for residency slots in Arizona, has capped funding of most new residency slots since 1997. Since then, Arizona's population has grown more than 25 percent.

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Exodus of medical graduates in Arizona stirs concerns

BUIES CREEK - Campbell University's medical school has been cleared to recruit students.

The Commission on Osteopathic College Accreditation decided Saturday to give Campbell's School of Osteopathic Medicine provisional accreditation status. The accreditation, which becomes effective July 1, allows the school to admit students and offer medical instruction with an approved osteopathic curriculum.

Medical school officials can recruit students before the accreditation status becomes effective.

Dr. John Kauffman, the medical school's founding dean, said the school will begin accepting student applications June 1. Classes are expected to start in August 2013.

Campbell officials say the medical school will eventually graduate about 150 doctors a year. Many will go on to practice in rural areas of North Carolina, they say.

Students will spend their first two years training in a 96,500-square-foot medical school being built on U.S. 421. Third and fourth year medical students will train in community hospitals across the state, Kauffman said.

Jerry Wallace, president of Campbell University, said the accreditation is exciting for Campbell, the medical school, Harnett County and North Carolina.

"This medical school will train primary care physicians to address a critical shortage of healthcare professionals throughout our state," he said.

- Steve DeVane

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Campbell University's medical school cleared to recruit students

University of Miami President Donna Shalala announced Tuesday that the medical school will take difficult and painful but necessary steps next month to reduce costs, including staff cuts.In a letter to employees, she called the cuts significant but provided no details about how many employees might be laid off.

The process will take place in stages, and affected employees will be notified during the month of May, Shalala wrote. Reductions will not impact clinical care or our patients and will primarily focus on unfunded research and administrative areas.

Shalala said the cuts were necessary because of unprecedented factors including the global downturn of 2008, decreased funding for research and clinical care, plus cutbacks in payments from Jackson Health System. The Jackson reductions have had a profound effect on our finances, she wrote.

UM is not alone. Many medical schools are having to make difficult decisions, particularly because of the growing difficulties in getting research grants, said Ann Bonham, chief scientific officer of the Association of American Medical Colleges.

Sal Barbera, a former hospital executive now teaching at Florida International University, said UM created many of its own problems when it bought Cedars Medical Center in 2007 for $275 million. Paying off that debt is a significant financial responsibility, he said.

Jackson Health System, which has lost $419 million the past three years, cut its payments to UM by $16 million this year, and next fiscal year is working on a new operating agreement with UM that could mean far more drastic reductions.

In her letter, Shalala wrote that UM reaffirmed our continued commitment to our partnership with Jackson.

Since the arrival of Pascal Goldschmidt as medical school dean in 2006, expansion has been swift. UHealth, the clinical enterprise , now employs more than 8,200 employees, according to the UM website. Employees are working on 1,500 research grants, funded by $200 million in outside private and public grants.

The schools financial problems have been exacerbated by the shrinking of federal research dollars, and UM researchers, like those elsewhere, have found themselves battling for grants.

A number of medical schools are having serious conversations and looking hard at medical research, said Bonham, the AAMC officer. She said the National Institutes of Health, the primary funding source for research, is now only granting about one in every six applications, a historical low.

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‘Significant’ UM medical school cutbacks coming in May

Campbell Universitys medical school took an important step toward becoming the fifth medical school in the state.

The Commission on Osteopathic College Accreditation awarded Campbells School of Osteopathic Medicine provisional accreditation status, which allows the school to begin recruiting applicants for its inaugural class for August 2013. The status was awarded Friday and is effective July 1, according to a Campbell University press release.

The school aims to eventually produce 150 primary care physicians each year, addressing an often-noted nationwide shortage. In particular, the school will look to aid rural and poor areas that experience the biggest shortfalls in medical care. After two years at the new facility, third- and fourth-year medical students will train in community hospitals across the state, according to the schools dean, Dr. John Kauffman.

This is an exciting moment, said Dr. Jerry Wallace, president of Campbell University. This medical school will train primary care physicians to address a critical shortage of healthcare professionals throughout our state.

Campbell joins established medical schools Duke, Wake Forest, UNC-Chapel Hill and East Carolina University as accredited med schools in the state. According to data from the American Association of Medical Colleges, those four schools currently enroll roughly 2,000 students, meaning that with an eventual goal of 600 students, the states capacity to produce doctors could rise nearly 30 percent.

That goal would give Campbell University the second-highest enrollment in the state after UNC.

The primary care physicians that Campbell intends to recruit will address a pressing need. The AAMC estimated in 2010 that the already-strapped field could face a nationwide shortage of 63,000 physicians in 2015 as millions of Americans acquire health care under the Affordable Care Act. Specialists also face a shortage, even while earning substantially more than primary care doctors.

Rural areas face the greatest shortages, and Kauffman said he hopes doctors will continue to live and work in such communities after they finish their two years earning their medical degrees there.

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Campbell medical school gets go ahead, hopes to address physician shortfall

The morning of my Board exams, my mother packed me a lunch comprising of seedless grapes, two Greek yogurts, a cheese sandwich, a bag of pistachio nuts, two cappuccinos, a diet coke, chocolate-covered coffee beans and a pouch of pretzels.

Mum, this isnt the Hunger Games, I joked.

Well no duh. You have absolutely zero hand-eye coordination, she said.

I gave her a sour look.

But if there was ever a nerd equivalent, this would be it, I said, compensating. Someone needed to deliver a pep talk, after all, and clearly mum wasnt stepping up. Today, I do battle.

Mum ignored my inquiries about whether we had any war paint lying around the house. But this was hardly overkill. The USMLE Step 1 exam, otherwise known as the Boards, is an eight-hour test, designed to test medical students of the completeness and depth of their preclinical learning. Commonly taken right at the end of the second year of medical school, before students transition from classrooms onto the hospital wards, the exams represent a months-long effort on our part to frantically cram mountains of information, from the basics of mitosis to the specifics of anti-diarrheals, in hopefully a systematic and organized way. The three-digit score that one receives four weeks later plays a part in determining a students competitiveness for certain residencies and such. To what extent no one can really say. And therefore no one wants to chance it.

Did I mention that its an eight-hour test?

Much this year has been about such numbers. The number of hours you can study a day. The number of practice questions. Percentages. Percentiles. Five-hour energy drinks. The number of times you looked over the glycolysis pathway and still forgot an enzyme. The number of simulated tests. The number of days you overslept and missed classes out of sheer exhaustion.

In late September, I met with an academic advisor at school for help in planning a study schedule. She pulled out a college-ruled notebook and drew a long horizontal line intersected with many little strokes. In neat print, she outlined the various books and web resources I might find helpful and the goals I needed to be reaching by various dates on the timeline. She had relationships with many a successful student in the past, she said. I nodded fervently. Surrounded on all sides by what I could do, I just wanted someone to tell me what I should.

I would advise you that as you move closer to test, to limit how much time you spend on other activities, she said.

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Step One: A Medical School Pivot Point

Over the past six years, the University of Colorado has more than tripled the number of racially and ethnically diverse students enrolled in its medical school on the Anschutz Medical Campus in Aurora.

Just 11 percent of the 144 students in the class of 2005 were minorities, compared with 33 percent of the 160 students in last year's graduating class.

The university has made a concerted effort to improve diversity among its students since its accrediting body the Liaison Committee on Medical Education cited the school for "noncompliance" in 2010, when just 106 of 614 students were minorities. The medical school is not scheduled for another visit until 2016-17.

"It was abysmal," said Dr. Rob Winn, associate dean for admissions at the medical school. "Part of the problem here had been the traditional approach that Colorado has mountains, and mountains attract people. That may be true, but it may not attract kids from inner-city Philadelphia."

While grades are important, Winn looks at much more, including standardized tests, life experiences, research activity, clinical participation and especially community service.

"We don't seek diversity, we seek excellence," Winn said. "They need to have the ability to articulate their passion for helping others. That's what taking the job of a doctor is."

Winn and his staff approached the job as a relationship-building exercise. They reached out to student advisers and faculty nationwide to make sure they were aware of CU's program.

The strategy has worked. Over the past decade, the number of applicants to the medical school has increased from 2,148 in 2001 to 5,425 so far this year for just 160 spots. The admissions department interviews 700 students to cull the number.

"If we could expand the class to 400, we'd get 400 amazing students," Winn said.

It's not just ethnic and racial diversity that's important to the university. The admissions department also is seeking geographic diversity. About a third of the school's students were from out of state last year, compared with just 10 percent a few years ago.

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University of Colorado medical school heals diversity gap