The study prepared by Washington State University consultant MGT of America to make the case for a WSU medical school contains a number of deep flaws.
Many of the key justifications cited for starting, funding and accrediting a second public medical school in Washington are based upon faulty assumptions, omissions and erroneous data that draw into question many of the report’s central conclusions.
These flaws raise significant concern about the actual feasibility of a WSU medical school and are important questions that require answers.
Spokane is poised to become America’s next great academic health science center — not only to educate Washington’s next generation of physicians, but also to serve as an economic engine that establishes Spokane as a center of healthcare excellence.
Our state’s aging population, the pending retirement of primary care providers and federal healthcare reform necessitate that we rapidly increase Washington’s access to high-quality healthcare by developing more primary care physicians and health practitioners — especially in Eastern Washington.
If we are going to meet the healthcare needs of Spokane, Eastern Washington and our state, we need to rapidly expand on our current success and work with the Legislature to increase the total number of students at Spokane’s Medical School to 320 (80 students per year).
The University of Washington, through its nationally acclaimed medical education program, is committed to working with our partners to achieve that expansion and to increase research opportunities in the Spokane area.
What is WWAMI?
The University of Washington serves as the medical school for a five-state region through an innovative medical education program that began 42 years ago called WWAMI (Washington, Alaska, Montana and Idaho – Wyoming joined in 1996).
In 2008, the University of Washington, Washington State University, the state Legislature and a united Spokane community brought 20 first-year medical students to Spokane with a goal of educating doctors in the Spokane community to serve Eastern Washington.
The WWAMI model was developed as a way to train primary care and family physicians for under-served areas in rural Eastern Washington.
The program’s strengths are in its partnerships. By partnering with local state institutions to offer medical education, the University of Washington is able to provide students with the highest quality medical education in the nation, and at lower cost than independent medical education programs.
WWAMI students who return to Washington
Myths and Facts
The University of Washington is committed to expanding the superior medical education Eastern Washington enjoys now by admitting more students to Spokane’s Medical School and creating more research opportunities.
A new WSU medical school will increase the number of physicians who practice in Washington state.
The greatest single predictor of where students will practice is where they complete their residency after four years of medical school.
Building another medical school in Washington will not increase the number of doctors who serve our region. The greatest single predictor of where students will practice is where they complete their residency after four years of medical school. Creating more seats in medical school, without a concurrent increase in residency opportunities, will cause more future physicians to leave our state for residency positions elsewhere. What’s needed is a smart growth strategy that includes expanding the number of residency programs and increasing the number of medical school seats for Washington students. The number of residency positions in Washington state has not grown in almost 20 years. This has to change. The University of Washington is working at the federal level to remedy this situation.
The WWAMI program will not be able to admit enough Washington residents to address current and future physician shortages.
With state support to grow WWAMI, Spokane’s medical school will be able to admit more exceptional students to meet Washington’s physician workforce demand.
It is much more cost-effective and seamless to build on the UW’s current successful medical education program than to create a new medical school from the ground up. By increasing the number of seats in Spokane’s medical school, we can provide access to more of Washington’s students, and we can do it at a fraction of the cost of creating a new stand-alone medical school.
The cost differential between WWAMI expansion and a new medical school will likely not be that large, given the investment that has already been made by the state in WSU Spokane.
The funding needed to expand WWAMI is a fraction of what it would cost to build a new medical school.
The resources allocated by the state to UW/WSU Spokane for medical education have been provided to support the expansion of the WWAMI program. The cost to build a new medical school is estimated at between $50 million and $100 million. The funding needed from the state Legislature for Next Generation WWAMI is a fraction of that amount.
A fully accredited WSU medical school is the best way to bring economic development to the greater Spokane area.
A report estimates that expanding WWAMI-Spokane would contribute up to $1.6 billion in local economic impact and create 9,000 new jobs in greater Spokane over the next two decades.
The University of Washington is the No. 1 federally funded public research university in the United States. The UW’s School of Medicine alone received more than $600 million in research awards in 2012. A report commissioned by Greater Spokane Incorporated and community partners estimated that expanding WWAMI-Spokane would contribute up to $1.6 billion in local economic impact and create 9,000 new jobs in greater Spokane over the next two decades. The UW also has a successful record of translating its research into new startup companies. As part of our growth plan for Spokane, we have made a commitment to expanding biomedical research in the Inland Empire.
If WSU creates its own medical school, it could accept its first class of students as early as 2017.
It’s estimated that a new medical school in Spokane would take, conservatively, 10 years to produce its first M.D.
The Liaison Committee on Medical Education (LCME) — the organization that accredits medical education programs leading to the M.D. degree in the United States and Canada — says the accreditation process can take from several years to a decade to reach full accreditation. Rigorous standards must be met before the first charter-class can even be recruited and admitted. To consider a program for preliminary accreditation, the LCME expects to see elements of institutional organization, operation and resources in place. Preparing for the accreditation process alone can take several years. Considering the time-intensive process involved, a new medical school in Spokane would take, conservatively, 10 years to produce its first M.D.
Other states of similar size to Washington have more than one medical school so Washington should too. Another medical school would create more physicians.
It’s true that other states of similar size to Washington have more than one medical school; however, they don’t have more physicians.
Washington has more physicians per capita and more primary care physicians per capita than many states of a similar size with more medical schools. In fact, in May 2014, the National Center for Health Statistics (NCHS) reported that Washington is one of only four states (others are Massachusetts, Rhode Island and Vermont) to significantly exceed the national average for the number of primary care physicians.
The WWAMI program is too small and does not have the capacity to meet the needs of Washington.
It’s true – the WWAMI program needs to grow. Our current proposal to expand it in Spokane was jointly developed by UW/WSU and the Spokane community.
Our current proposal was developed to ensure there is more access to medical education in Eastern Washington. The assertion that WWAMI cannot grow beyond our proposed expansion is false. The WWAMI program is cost-effective and scalable. It can grow to meet the needs of our entire state — rural and urban environments alike. Nationwide by 2017, the number of students graduating from medical schools is projected to exceed the number of available residency openings. WWAMI could triple in size or every university in our state could build a medical school, but we will still have a physician shortage if there aren’t open residency positions and enough openings for clinical rotations. If our state is going to pay to educate physicians, we need to ensure they have the opportunity to stay and practice in Washington.
There is very little desire at the UW School of Medicine to expand.
The WWAMI program has a long history of expansion. Each WWAMI state pays for a certain number of seats: no out-of-state students are “taking” Washington seats.
As the healthcare landscape changes, so does our strategy for growth. We have worked to grow the WWAMI program in Spokane since 2003. The legislature approved the addition of 20 students in 2005. We moved our second-year program to Spokane in 2012 to create a four-year medical school in Spokane. This fall, the Pullman program will move to Spokane, adding 20 students and growing the overall class by 40 additional students per year. With funding from the Legislature, the UW School of Medicine plans to quadruple the number of medical students at WWAMI Spokane to 320 students across all four years at full enrollment.
The UW decided to expand its program only after WSU announced it was studying the feasibility of its own medical school.
For more than a year, the UW has been engaged in planning with WSU to expand the WWAMI program and bring all four years of medical school to Spokane.
In September 2013 at the annual meeting of Greater Spokane Incorporated and long before WSU announced plans to study the feasibility of its own medical school, Dr. Paul Ramsey, dean of the UW School of Medicine, and Lisa Brown, WSU chancellor, each pledged to ask legislators to allocate funds to increase the number of permanent students studying medical education in Spokane by 40 students. They also voiced their joint support for expanded graduate medical education at Spokane’s Riverpoint Campus. In November 2013, UW President Michael Young and WSU President Elson Floyd held a joint meeting of the regents for both universities to further solidify the goal of growing the WWAMI program and developing Spokane’s medical school.
Research is not the focus of the WWAMI program.
The University of Washington is the country’s top federally funded public research university, and the UW School of Medicine alone received more than $600 million in research awards in 2012. Research is not only a core element, but also a primary strength.
The School of Medicine hires a variety of faculty to teach in the classroom, train in clinics and do research. An example of how research is integral to WWAMI is the WWAMI region Practice & Research Network (WPRN), a collaborative group of primary care practices committed to research and practice improvement. The WPRN’s diversity of geography and practice type allows it to conduct research among many rural and underserved populations.