A Knack NACHC for Partnership ATSUSOMA

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A Knack (NACHC) for PartnershipATSU/SOMA CHCs

• Thomas E. McWilliams, D.O.
• Assoc. Dean -- ATSU
• May 16, 2008

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The Problem

• Projections for physician shortage
• Outlook particularly severe for rural
• Definition of insanity

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Need for additional physicians

• Physician production level last 15 years while
  population has increased
• DO physician production growing at increasing
  rate, but still a small percentage of physician
  production

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Projected physician deficit

• Ed Salsberg deficit of 85,000 to 96,000 by
  2020
• Richard (Buz) Cooper deficit of 200,000
  physicians by 2020

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The Solution

• Target community health centers
• Utilize a different educational model

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We need to

• Train more physicians
• Target areas of need
• Train them differently

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Osteopathic Medicine

• 25 schools-three branch campuses
• Multiple residency programs
• Relatively rapid growth
• D.O.s 6 of nations physicians account for 15.3
  of physicians in small rural

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A.T. Still University
Mesa Based Schools
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A.T. Still Mesa Professional Programs
Also implementing Masters in Human Movement
Doctor of Health Sciences
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A.T. Still Mesa Organizational Culture

• Needs Based - Producing health professionals for
  underserved areas of our regions, nation and
  world.
• Student Focused Providing education and
  training to entry level and continuing health
  professionals in a format and locations effective
  and convenient for our customer.
• Collaboratively Campused - Sharing mutual
  resources, hard and virtual, to efficiently reach
  our vision.
• Technologically Innovative - Utilizing tomorrows
  technology to teach and equip future generations
  of health care professionals.
• Generationally Focused - Fostering cross -
  program tracts for expertise in older adult and
  school based functionality and care.
• Interdisciplinary Designed - Training care givers
  to provide seamless, coordinated care.
• Wellness Committed - Encouraging lifestyles
  patterns of care promoting self responsibility,
  prevention of disease, importance of body ,mind,
  and spirit and living a full, healthy life.

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ATSU/CHC Connections

• Physician Assistant
• ASDOH

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ATSU/SOMA - NACHC Request
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School of Osteopathic Medicine - Arizona
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School of Osteopathic Medicine in Arizona

• New and innovative medical school
• first class of 107 students Fall 2007

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New Model

• Partnership with NACHC
• Modified admissions emphasis
• Distributed National Campus for MS-2, 3, 4

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Contextual Learning Campuses

• Students selection linked to the communities
  served
• Only 1 year in Mesa
• Returned to community environment for MS 2-4
• Trained in an environment supportive of primary
  care

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ATSU Partnering with Community Health Centers for
Community Campuses

• HealthSource of Ohio, Milford, OH
• Lutheran Healthcare System, Brooklyn, NY
• Beaufort-Jasper-Hampton Comprehensive Health
  Services, Beaufort, SC
• Alabama Medical Education Consortium, Troy, AL
• North Country Community Health Centers Northern
  Arizona Health Education Center, Flagstaff, AZ
• An American Indian focused campus, Phoenix AZ
• El Rio Health Center. Tucson, AZ
• Family HealthCare Network, Visalia, CA
• Northwest Primary Care Association, Portland, OR
• Community Health Centers of King County, Seattle,
  WA.
• Waianae Coast Comprehensive Health, Waianae, HI

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Contextual Campus Locations
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Student Selection

• Hometown program
• Rural Selection Criteria
• Other ATSU/SOMA Criteria
• Community Service

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Hometown

• 5-6vs 80
• Student selection
• Older, poorer, minority, rural origin

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First-year Students by Ethnicity
SOMA class N 107
National 2005-2006 N 3908
American Indian 0.6
American Indian 5.6
Black 4.0
Black 2.8
Unknown 4.2
Hispanic 7.5
Hispanic 4.1
Asian/Pacific 17.7
Asian/Pacific 21.5
White 62.6
White 69.5
Prepared by Dr. Albert Simon, Asst. Dean for
Evaluation and Quality Innovation Ms. Trudy Kuo,
Data Manager and Dr. Ray Pavlick, Professor of
Osteopathic Medicine
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Sampling of Backgrounds(Average of 500 Hours
Volunteerism)

• Abused Childrens Home Volunteer
• Clinical Outreach to India, Indonesia, Malaysia,
  Mexico,
• Community Health Corps Volunteers
• CDC Microbiologist
• Elder Drop-In Center Volunteer
• Paramedic
• Professional Surfer
• Samoan Epidemiologist
• Special Olympics Mentor
• Tribal Epidemiologist
• Video Production Company Owner
• Etc.

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Targeted Outcomes

• 50 will practice in underserved sites following
  residency training
• 80 will select primary care careers

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Dr. Wood
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Facilities Small Group LR
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FacilitiesSmall Group LR - Dashboard
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Facilities
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Facilities Large Group Interactive Room
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Foundational Elements for the Curriculum

• Innovation
• Cognitive Sciences
• B.E.M.E.
• QA/CQI
• Technology
• Learning Centered Education

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Clinical Presentation Model

• Integration basic and clinical sciences
• Problem solving critical thinking
• Context learning

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Model bundles basic and clinical science
information

• No individual classes in anatomy, physiology,
  biochemistry, pharmacy, etc
• Can eliminate some information from the curriculum

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Clinical Presentation CurriculumYear - I
Year I Jul 2007 Jul 2008
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Year Two

• Didactics similar to year one-EXCEPT-students are
  now in CHCs in groups of 10
• Students half day didactic aspects-half day
  clinical

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Clinical Presentation CurriculumYear - II

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How Accomplished?

• Learning Facilitators
• CHC Preceptors (Adjunct Faculty)
• Community Faculty
• Distance Education
• Collaboration and Partnership

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The third year clerkships

• Students will gain experience in both ambulatory
  and in-patient settings as appropriate

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Clinical Rotations

• MS-3 
• Family Practice 8 weeks
• Internal Medicine 8 weeks
• Pediatrics 4 weeks
• OB/GYN 4 weeks
• Maternal/Child Health 4 weeks
• General Surgery 4 weeks
• Psychiatry 4 weeks
• Elective 6 weeks
• Primary Care Selective 4 weeks

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MS-4

• Critical Care 4 weeks
• Cardiology 4 weeks
• Emergency Medicine 4 weeks
• Neurology 2 weeks
• Selectives 16 weeks
• Pediatrics based 4 weeks
• Surgery based 4 weeks
• Medicine based 8 weeks
• Electives 12 weeks

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Optimal Preparation for Rural/Underserved
Environments

• Students better exposed in CHCs
• Wide range of primary care and preventive
  services
• Early exposure important
• Diverse patient population
• Excellent match to healthcare needs and
  disparities
• Volume of patient exposure

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Chances for Graduates Selecting Underserved/Rural
Practice Better

• Personal relationship with communities
• Acculturation
• Early exposure to unique challenges of these
  patient populations

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Service Learning

• Improved COPC

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Early Impact
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Request involvement

• Identifying Learners (Hometown program)
• Facilitating relationships
• Identifying collaborative partners
• Facilitating Hospital Affiliations
• Encourage MD/DO collaboration with existing
  residency programs
• Serving as an advocate

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Additional Appeal

• Endowed Chairperson Osteopathic Heritage
  Foundations
• Study the effect of this innovative program

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Contact Information

• Thomas E. McWilliams, D.O., FACOFP
• Associate Dean, Bio-Clinical Sciences
• A.T. Still University
• 5850 E. Still Circle
• Mesa, AZ  85206
• 480-219-6053 office
• 480-219-6159 fax
• TMcWilliams_at_ATSU.edu
• www.atsu.edu

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Questions

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