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July 20, 2006

Expanding in Spokane: Proposal presented to increase medical, dental education in Spokane

By Tina Mankowski & Leila Gray
News & Community Relations


The University of Washington, Washington State University and Eastern Washington University plan to expand Spokane’s medical and dental education programs to meet the need for physicians and dentists locally and in nearby rural towns. A formal joint announcement by the institutions’ presidents is scheduled for Friday.


If funded by the state Legislature, this would be the first increase in several decades in the number of Washington state residents admitted to the UW medical school and dental school. A budget request for WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) and RIDE (Regional Initiative in Dental Education) expansion is a key element in the legislative proposals for 2007.

The plan includes the addition of up to 20 seats in medical education through the WWAMI program, and eight seats in dental education through the RIDE program. First-year students in both programs will take classes at the Riverpoint campus in Spokane.

WWAMI is a 36-year-old regional medical education program started and coordinated by the UW School of Medicine that trains medical students from the five states. Throughout the five-state region, designated universities, physician offices, hospitals and community health care settings serve as teaching sites for UW medical students and residents pursuing advanced clinical training.

Spokane and its neighboring towns have been part of the WWAMI program as clinical training sites since the early 1970s. WSU was one of the original members of WWAMI, and has had a cohort of WWAMI students at the Pullman campus each year since the program was founded. The current cohort includes 20 students, with another 18 students from University of Idaho.

While UW dental students have also participated in community-based rotations at WWAMI sites, the Spokane effort will mark the beginning of a more comprehensive regional program for dental students.

“The success of Spokane’s clinical training programs for medical students, residents and physician assistants is due to excellent teaching by Spokane physicians and other health professionals, and to the high standards of the hospitals, clinics, mental health centers, and other medical facilities where students and residents train,” said UW President Mark Emmert. “The expansion of the WWAMI program in Spokane will build on this strong medical and educational foundation. We are able to add dental students to the mix because of the academic strength of EWU and WSU and the support of local dentists.”

Under the proposed expansion, the WWAMI program in Spokane will offer the full, first-year UW medical school and dental school curriculum at the Riverpoint campus, which is operated by WSU. Current WSU and EWU faculty, as well as newly recruited faculty members, will teach the courses. Twenty medical students and eight dental students will study basic science and certain additional topics together. While medical students complete their prescribed curricula, dental students will receive their additional courses from EWU dental hygiene faculty and local dentists. Distance learning using Web-based resources also will be a part of the regional curriculum.

WSU offers programs in a number of health professions in Spokane, including nursing, pharmacy, health policy and administration, speech and hearing sciences, and exercise physiology and metabolism.

The proposal would further connect the shared WSU/EWU campus to the community through health-related education and research. EWU offers several allied health professions programs at Riverpoint, and is exploring the possibility of adding more.

The current entering class size for the UW medical school is 184 students.

Under the proposed expansion, 20 additional applicants each year would be admitted who would take their first year of classes in Spokane, and their second year in Seattle, along with students from all other first-year sites throughout the WWAMI region. The third- and fourth-year clinical training is conducted in hospitals, clinics and physician office settings throughout the WWAMI region. Additional clinical training capacity would come from involving more Spokane-area physicians and other health professionals in instructing medical students.

The UW School of Dentistry class size would increase by eight students. After taking their first year in Spokane, the students would return to Seattle for the second and third years of dental school. They would spend a substantial part of their fourth year in Spokane and other eastern Washington sites under the supervision of community dentists who are UW-affiliated faculty.

In 2003, Spokane looked at the possibility of creating a new medical school, but costs were prohibitive. At the same time, a doctor shortage is looming: about one-quarter of local physicians are nearing retirement. Thirteen surrounding counties do not have enough primary-care physicians. This past year, a feasibility study for expanding the WWAMI program in Spokane and adding a new RIDE program in the city was conducted with the support of Spokane leaders.

The estimated costs for the expansion of the medical school will be about $5.5 million in annual operating costs, $4.9 million in start-up costs and $7.5 million in capital costs at the Riverpoint campus and UW. The average annual expenditure per medical student is estimated at $68,500. The estimated incremental costs for the expansion of the dental school, which assumes that the medical school expansion is fully funded, will be about $2.2 million in annual operating costs, $1.3 million in start-up costs and $2.8 million in capital costs at the Riverpoint campus and UW. The average annual expenditure per dental student is estimated at $69,000.

“To address its health workforce shortages, Washington state needs more publicly funded students in the health professions, and the state has a proven training program in the WWAMI approach,” said Emmert. “The collaboration among the state’s private and public universities and colleges, hospitals, clinics and medical and dental professionals conserves resources and makes this a cost-effective way of meeting the demand.”