Vacancies in Spokane medical education program raise worries amid UW, WSU quarrel

Sparring between the state’s two largest universities over medical education may be causing some future physicians to walk away from plans to study in Spokane.

There are nine students enrolled in the second-year medical program on the WSU Spokane campus, fewer than half of the 20 students sought.

The low number is a disappointment after the community rallied to attract second-year University of Washington medical students to participate in a pilot program to study in Spokane rather than follow decades of tradition and return to Seattle.

The goal is to teach and train primary care doctors outside of Seattle in hopes of them practicing in rural areas that have physician shortages.

The effort arrived with the promises of a stellar education in Spokane backed by a supportive community that put down money to underwrite the cost.

As the pieces came together, including a report that medical students in Spokane were performing admirably when compared to students at UW’s Seattle campus on specialized tests, hopes ran high.

Yet medical education and students can be fickle.

The cost of a UW medical education will put most students into six-figure debt. The students fortunate enough to be admitted to the prestigious school want the professional mentoring, training and connections. And many want to pursue the lifestyle and intellectual rigors that come from living and studying as a UW medical student in Seattle.

What they are not seeking is controversy and disruption.

“I think any amount of tension, perceived or blown up in the media, if I were making the decision … it would make me a little bit nervous,” said Scott Hippe, former WSU Spokane student body president. Hippe just finished the second-year pilot program in Spokane. “I think when people start getting nervous then it’s sort of contagious.”

During the past year, the presidents of WSU and UW have exchanged barbs as they take steps toward expanding medical education in Spokane.

WSU officials this spring announced they want to build their own medical school. They have since commissioned a feasibility study to build on statistics that rural Washington needs more doctors and UW is not reacting with the kind of urgency needed to address the shortage.

WSU is looking to a cheaper, community-based model that uses local clinical partners.

UW launched a series of meetings this spring to hear from Eastern Washington leaders about expanding medical education in Spokane to 320 students over the next few years.

Such growth depends upon state funding.

The competing initiatives present a choice: Will the two universities mend their differences to present a united front, or will they adhere to their own vision? The recession hindered further expansion, said Dr. Paul Ramsey, dean of UW’s School of Medicine.

UW and WSU were ready to go to the Legislature next year, “but then WSU announced its plans to seek a medical school,” he said.

Spokane leaders have been asking UW to expand medical education in Spokane for more than a decade, without much success.

Not until 2008 did UW add a 20-student branch of its five-state medical school program, called WWAMI (an acronym for Washington, Wyoming, Alaska, Montana, Idaho), to Spokane’s WSU campus.

“We realized that we couldn’t come to agreement with (UW) on the model for expansion,” said WSU Spokane Chancellor Lisa Brown. The current model has flaws and “doesn’t allow for any autonomy around faculty, curriculum or admissions on the Spokane campus.”

Brown added: “Despite the community’s and WSU’s investments in medical education, under the WWAMI model, Spokane would continue to be just a satellite with no control or potential for realizing our goal of increasing medical education and research, or for capitalizing on the economic benefits four-year medical education brings to cities that have it.”

Though the second-year medical school program underway is partially state funded, about $2.3 million in seed money to start the program was raised by Spokane businesses and philanthropic organizations.

Medical students often stay to practice in the areas where they went to school. There’s a high need for doctors in Eastern Washington, especially most rural counties where there are fewer than 10 physicians per 10,000 residents, according to the U.S. Census Bureau. Nationally, the average is 26 doctors per 10,000 residents. Spokane County has between 22 and 25 doctors per 10,000 residents.

UW’s admission rates, where 235 students are accepted from more than 6,000 medical school applicants, are troubling to areas that turn to the school to train their doctors.

UW recently surveyed students for a report examining the future of WWAMI. Asked about the second-year program in Spokane, the survey found that “the current dynamic and events in Spokane made students uncomfortable and uncertain about the program’s future,” UW reported on Wednesday.

Students also voiced concerns about synchronization of courses between Spokane and Seattle.

“Some departments in Seattle were forward-thinking with respect to collaborating with us in Spokane, and other departments in Seattle were not,” Hippe said. “At every step of the way our instructors in Spokane have been up to speed with what is happening with classes in Seattle.”

Initially, 14 students committed to staying in Spokane. Within two weeks, five of them pulled out.

That’s “what’s disconcerting,” said Ken Roberts, assistant dean of medical school education at WSU Spokane. Two of them are a married couple.

UW officials say they are doing everything they can to encourage students to go to Spokane for the second year, including sharing high test scores and sending letters.

“Students tell us they are really prepared to work in clinics as part of a team, they feel like they’ve learned lifelong learning skills, they feel like they can solve clinical problems,” said Dr. Suzanne Allen, UW School of Medicine vice dean for regional affairs. “All the types of skills they’re learning in Spokane are ones we want them to be learning. So we really want to fill it up.”

School starts in mid-August.

“The more time that goes by, the less likely I think they’ll be joining us,” Roberts said.

Investors who donated money to grow medical education in Spokane are disheartened about this new shortage of students.

“I would hope that UW would be very aggressive about promoting Spokane, and be more proactive rather than passive,” said Michael Senske, Greater Spokane Incorporated board chairman.

The commitment UW President Michael Young appears to have to Spokane seems genuine, he said.

Senske noted that investors “not only advocated for it but opened their pocketbooks for it.”

The low enrollment is concerning, said Antony Chiang, Empire Health Foundation president. The nonprofit is the single largest investor, at $850,000. But as an investor on behalf of the community, he said the question that needs to be asked is: What’s the best way to create a pipeline of physicians to this region and to this state?

“It shouldn’t be about a logo,” he said. “If they both get what they want, we still won’t have enough doctors. We are turning away so many qualified medical students from this state. We are not training even a fraction of the doctors we need.”