Healthy exposure

Rachel Sufran was elated at being admitted to medical school. But it was a different emotion altogether when she learned that she’d spend her first year in Spokane.

“I was devastated,” said the Salt Lake City native and University of Puget Sound graduate. “It didn’t help that my friends in Seattle never had anything good to say about Spokane,” a place none of them had visited.

Classmate Mackenzie Craik had the opposite reaction upon reading the word “Spokane” on his paperwork.

“I want to be a rural dentist. I’m from Eastern Washington; it’s perfect for me,” said Craik, from Walla Walla.

On Aug. 11, Sufran, Craik and 26 classmates became the first crop of medical and dental students to take first-year courses at Spokane’s Riverpoint campus.

The eight dental students are here under a newly created state program called RIDE, a joint venture of University of Washington and Eastern Washington University. Open only to Washington residents, it’s designed specifically for those interested in practicing in rural areas – an attempt to solve a critical shortage in isolated communities.

After their first-year classes the Spokane dental students must serve a four-week summer rotation in a rural community.

The 20 medical students are here because the Legislature last year expanded Washington’s participation in a med school program called WWAMI – the first such expansion in the program’s 37-year history. It was something Spokane business leaders and health professionals started pursuing four years ago, said Rich Hadley, president and CEO of Greater Spokane Inc.

The timing was right, Hadley said. The state budget had not yet gone sour, and politicians in Olympia had committed to helping regions develop their economic strengths – health care, in the case of Spokane.

Hadley calls the state’s $25 million investment for WWAMI and RIDE “one of the most exciting projects ever” for Spokane and a step toward developing a four-year branch of the UW School of Medicine. As a model, he looks to the University of Minnesota, which has a big med school in Minneapolis and a smaller one in Duluth, for training rural doctors.

“We’re not very many steps short of it,” though it may take several years to accomplish, Hadley said.

Under WWAMI, Washington, Wyoming, Alaska, Montana and Idaho pay to reserve medical school positions. Students pay in-state tuition and take their first-year courses at participating universities in each state, with identical curriculum and final exams as those offered at UW in Seattle.

In addition to the new spots at WSU-Spokane, there are 40 WWAMI positions on the Palouse. Those students take some first-year courses at Washington State University and some at the University of Idaho.

In Spokane, medical and dental students attend classes together, including anatomy, where last week they began examining the human skull under the direction of professor Steve Lampa. He also teaches anatomy to the Palouse WWAMI students and at WSU’s College of Veterinary Medicine.

“Here, you only have to know one species, so it’s a little easier,” said Lampa, who commutes from Pullman to Riverpoint four days a week.

All second-year WWAMI students go to UW. But they could end up anywhere in the region for their third- and fourth-year clinical rotations. In Washington, that includes Spokane, which has been a rotation option for years.

States participate because UW is the only medical school in the region. More critically, rural Northwest communities often have trouble attracting doctors. The American Medical Association says that’s a problem nationwide, with 20 percent of Americans living in rural communities, where they have access to only 9 percent of physicians.

Doctors often establish practices where they serve their residencies. So it can pay to train them in university towns like Moscow, Bozeman and Laramie.

Exposing future doctors to Spokane’s medical community has the potential to create “a pipeline phenomenon,” said Ken Roberts, director of the WWAMI program for WSU-Spokane. “Give them a great first-year education and make them want to come back and do their third and fourth years in Spokane.”

Medical students typically aren’t sent to places like Spokane or Pullman unless they’ve indicated it as a preference or an option, Roberts said.

Among this year’s students who made Spokane their first pick: Elizabeth Stuhlmiller, who grew up on a farm near Reardan; Nathan Gay, whose wife likes being able to visit relatives in Coeur d’Alene while he’s tied up with studies; and Katie Wysham, who attended Spokane’s St. George’s High School.

“I’m like a welcoming committee, showing people around,” said Wysham, who did her undergraduate studies at Tufts University near Boston. “When we have time to go out, we locals pick the spot.”

But there are always some students who are surprised – unhappy, even – with their placements, as with Sufran, who unsuccessfully appealed to UW officials to have her Spokane assignment changed. A Husky might end up in Pullman, or a confirmed Seattleite might have to spend a year in Spokane.

Med students call that “being WWAMI’d.” And it doesn’t always end up being a bad thing.

“I wasn’t super excited to come back here,” said Greg Sexton, a Lewis and Clark High School graduate who attended UW before getting WWAMI’d to Spokane.

But Sexton is saving money by living with his South Hill grandparents, and he’s learning that the small classes are an advantage.

He’s been surprised by the size of the medical community in his hometown and doubts Seattle doctors would be as welcoming when students show up for weekly “preceptorships,” when they spend four hours paired with a doctor in a clinical setting.

“The docs seem really excited to see us,” he said. “The community’s excited to see us.”

Liam O’Sullivan hadn’t given Spokane any thought when he marked Seattle as his first choice. But now he’s thinking that a practice on the east slope of the Cascades might be a good match for his interest in mountaineering.

“I’d definitely say that this exposure will increase the odds of us practicing on this side of the state,” said O’Sullivan, an English major from Western Washington University.

“Just like anything else in life, if you’re not exposed to it, you’re not going to think about it.”