Educating physicians is an important mission for the University of Idaho. The Association of American Medical Colleges is concerned that current physician training may not produce enough doctors to meet the national needs in the 21st century — a concern I share. Idaho ranks 49th in physicians per capita. In a state with a critical need for physicians, understanding how medical education is delivered is necessary for making informed decisions about the future of such programs in Idaho — planning for smart and sustained growth.
Physician training is complex and requires universities, medical schools and residency programs. Most physicians begin with pre-med education during a bachelor’s degree. Few colleges offer pre-medical majors, but Idaho’s four-year institutions, including U of I, offer appropriate prerequisite coursework for medical school. GPAs and MCAT scores show that Idaho students are well-qualified for medical school, but we must bolster the number of pre-med students.
The Idaho WWAMI program is the primary M.D. training program in Idaho, and the next step for many aspiring doctors from Idaho. WWAMI stands for “Washington, Wyoming, Alaska, Montana and Idaho” — a partnership between those states and the University of Washington, the medical school for the five-state region. It offers Idaho students access to a top-ranked medical education: No. 1 for primary care, No. 1 for family medicine and No. 1 for rural medicine.
Idaho WWAMI students complete their first 18 months of physician training in Moscow, facilitated by U of I faculty and area physicians. Clinical clerkships then take place in 178 locations across Idaho and other WWAMI states. Students all complete an eight-week clinical rotation in one of the University of Washington’s sophisticated quaternary care hospitals. Most Idaho WWAMI students complete the bulk of their M.D. training in Idaho.
After completing an M.D. program, almost all physicians pursue residency training, typically three to six years, to establish a specialty. Many residencies are at academic medical centers, but they can also be at community hospitals. Idaho has residencies in family medicine based in Boise, Coeur d’Alene and Pocatello; in internal medicine in Boise; and in psychiatry in Boise. Many physicians practice where they complete residency. Despite limited residency opportunities currently available in Idaho, more than half of all Idaho WWAMI graduates have practiced or are practicing in Idaho, a much higher rate of return than the national average. Careful, well-planned growth will ensure our residency programs can keep up and we don’t end up exporting medical students to other states.
In sum, for its population, Idaho has a low number of practicing physicians and a small, but growing M.D. pipeline. To strengthen that pipeline, U of I plans to expand its role in pre-medical education. We will also build upon the Idaho WWAMI program’s strengths and expanding capacity. For three decades, Idaho had 20 WWAMI seats, which limited Idaho students’ access to medical education. Last year, that number rose to 35 Idaho students, including a track reserved for students hoping to work in rural and underserved communities. This year, U of I requested state support to enroll 40 students in the Idaho WWAMI program. Measured and steady growth has eased access to the M.D. degree for Idahoans and can lead to a healthier state — a proven return on the state’s investment.
We have a long history and exciting future in training Idaho’s next generation of physicians. Throughout the pipeline, we must work collaboratively to find solutions for access to medical education. Together, we can overcome our state’s health care challenges and lead Idaho to a healthier tomorrow.
Chuck Staben is president of the University of Idaho.