Regional Solutions to the Physician Workforce Shortage: The WWAMI Experience

Abstract

With major medical organizations predicting a national shortage of physicians in coming years, a number of institutional models are being considered to increase the numbers of medical students. At a time when the cost of building new medical schools is extremely expensive, many medical schools are considering alternative methods for expansion. One method is regional expansion. The University of Washington School of Medicine (UWSOM) has used regional expansion to extend medical education across five states without the need to build new medical schools or campuses. The WWAMI program (the acronym for Washington, Wyoming, Alaska, Montana, Idaho), which was developed in the early 1970s, uses existing state universities in five states for first-year education, the Seattle campus for second-year education, and clinical sites across all five states for clinical education. Advantages of regional expansion include increasing enrollment in a cost-effective fashion, increasing clinical training opportunities, responding to health care needs of surrounding regions and underserved populations, and providing new opportunities for community-based physicians to enhance their practice satisfaction. Challenges include finding basic-science faculty at regional sites with backgrounds appropriate to medical students, achieving educational equivalence across sites, and initiating new research programs. UWSOM's successful long-term regional development, recent expansion to Wyoming in 1997, and current consideration of adding a first-year site in Spokane, Washington, indicate that regional expansion is a viable option for expanding medical education.

Supply of doctors to a rural region: Occupations of Tromsø medical graduates 1979–2012

“…This ambition was embedded in a medical curriculum created by the visionary leadership of the founding dean Peter F. Hjort (1924Hjort ( -2011, (Medical curriculumTromsø 1971). A major innovation was that students should train nearly a year outside campus engaged with rural general practices and local hospitals all over Northern Norway (Nordøy 1985;Fønnebø Knutsen et al 1986;Aaraas & Halvorsen 2014 ).This constituted a socially accountable profile of the Tromsø programme, which has been internationally acknowledged, and developed into innovative and comprehensive models across the world (Rabinowitz et al 2005;Norris et al 2006;Strasser et al 2013;Sen Gupta et al 2014).…”

Match Rates into Family Medicine among Regional Medical Campus Graduates, 2007-2009

“…Because these states are mostly rural, they contain significant underserved regions but lack the funds to build their own instate medical schools. 19 The University of Alabama School of Medicine developed the Huntsville Campus with the belief that community-based branch campuses would produce more primary care physicians for the region. 17 Assessments of RMCs, thus far, have focused on campuses affiliated with a single parent institution, and few that we know of have assessed their impact on career paths.…”

Effect of Regional Medical Campus Education on Student Pursuit of Primary Care Specialties

“…For instance, even though a significant proportion students spend their first two years at the non-RMC in Seattle, many of those students choose to complete their clinical clerkships at one or more of the 170 available community education sites. 10 The UWSOM is also notable for its implementation of the Colleges system, a system of mentorship through which a small group of students is mentored by a physician, typically in a primary care specialty, with the goal of developing clinical skills. 21 This system likely has an influence on specialty choice, as exposure to role models has been shown to strongly associate with residency program choice among medical students.…”

“…7,8 The development of RMCs has become an attractive option to medical schools interested in expanding enrollment due to their cost-effectiveness and potential to improve health care access in areas of need. 9,10 The University of Washington School of Medicine (UWSOM) has long been recognized as one of the nation's leaders in producing primary care physicians. Additionally, it was one of the earliest adopters of the RMC education model in the early 1970's when the Washington Alaska Montana Idaho (WAMI) program was first conceived, with the addition of the Wyoming campus in 1996 to form the WWAMI program.…”