WSU, UW at odds over possibility of expanded medical education programs in Tri-Cities

For some Mid-Columbia residents wanting to become doctors, there's a challenge greater than getting accepted to medical school -- getting into a school close to home.

Paula Jimenez of Sunnyside graduated from Washington State University Tri-Cities in May and is taking a year to prepare for the Medical College Admission Test.

The 24-year-old wants to study osteopathic medicine, taught at the private Pacific Northwest University of Health Sciences in Yakima. But she plans on applying to at least nine medical schools, many outside the Northwest.

"If I could stay local, that would be ideal," she said. "I like the small community and the opportunity to give back."

Jimenez and other aspiring physicians might have another option in the coming years: WSU is studying whether to start its own medical school based at its Spokane campus. And along with it could come a clinical program in the Tri-Cities.

But University of Washington officials are critical of WSU's proposal to compete with their medical school based in Seattle.

That program has served a five-state Northwest region for decades but has drawn increasing criticism from WSU that it's not filling a growing shortage of doctors in rural areas, including Eastern Washington, and there are too few slots for area students.

Mid-Columbia health care and community leaders seized the opportunity last spring to encourage a UW advisory group visiting the Tri-Cities to consider expanding some med school offerings here.

A few weeks later they made a similar pitch to WSU officials.

So far, neither university has announced its full intentions.

Health care officials and state lawmakers have declined to publicly take sides, saying their ultimate goal is to just bring and keep more doctors in the region.

"The reality is that neither university is going to build a new medical school here," said Carl Adrian, president and CEO of the Tri-Cities Economic Development Council (TRIDEC). "But as either university's medical program expands, there could be a tie to the Tri-Cities."

'Enough air in the room'

UW's Seattle-based School of Medicine and Pacific Northwest University of Health Sciences are the only two medical programs in the state.

UW's medical school, the only public medical school in the Northwest, is the base for the WWAMI Medical Education program, serving Washington, Wyoming, Alaska, Montana and Idaho.

Created in the early 1980s, the program offers a set number of student slots for each state's aspiring doctors. Washington is assigned 120 positions.

WSU has been a partner in WWAMI for years. Some first-year medical students are at the university's Pullman campus and others are at the system's health sciences campus in Spokane.

But WSU officials say UW and WWAMI have not increased the number of student slots in decades.

An increasing shortage of doctors statewide and the high number of in-state students who leave the region to study medicine helped drive the university to commission a feasibility study.

"I think there's enough air in the room for WSU to meet these needs," WSU President Elson Floyd told the Herald editorial board earlier this summer.

Private donors provided $250,000 for the study that has yet to be released.

The study is looking at data on where doctors are needed in the state, how WSU could potentially support a medical school, possible costs and other information.

WSU officials have said the Spokane campus, home to the university's pharmacy and nursing programs, would play a key role in any effort to start a medical school.

The system's urban campuses in Vancouver and Richland would serve as places for students to begin premed tracks and potentially where third- and fourth-year medical students could go for long-term clinical rotations at local hospitals.

"Any opportunity that opens more spots in the medical field in Eastern Washington specifically is good for our students, as well as the community in general," said Rigo Leon, president of the Associated Students of Washington State University Tri-Cities.

'Outside the conflict'

UW officials told the Herald editorial board recently it would be "odd" to have two public universities with medical schools in the same state.

They said it could lead to the WWAMI program seeking another university to partner with instead.

Competition with WSU also could endanger the network of clinical internships and training opportunities built up over the years.

UW officials admitted the need for more doctors and said they expect to add 40 more student openings at the medical school by 2020.

"You would be competing for clinical resources," said Randy Hodgins, vice president of external affairs at UW.

UW has long considered expanding clinical training programs connected to its medical school to the Tri-Cities, said Norman Arkans, the university's associate vice president of media affairs.

However, one month after WSU announced it was conducting its feasibility study, UW President Michael Young formed an Advisory Council on Medical Education Access and Affordability as part of a review of the WWAMI program.

The council is working with the medical program in Spokane and identifying potential locations to expand clinical training.

Council members visited the Tri-Cities in the spring, touring medical facilities and meeting with health care and community leaders.

Local officials then began asking UW about a medical school in the Tri-Cities.

"The message of the Tri-Cities' medical school ambitions was clearly heard by the council and met with interest (and) intrigue," Arkans told the Herald. "Council members were clearly impressed with the sophistication of the medical community in the Tri-Cities and with the community cohesion around the idea of a local four-year medical campus."

Adrian said he did not attend the meeting but was familiar with the presentations made by local leaders. They were similar to ones given at a meeting weeks later with WSU officials, he said.

He emphasized those efforts were not meant to play the universities off each other, but rather, they were to show how much support a medical school or related program would have in the Tri-Cities.

"The community has, in a sense, been Switzerland," Adrian said.

Lisa Teske, Trios spokeswoman, agreed.

"We're staying outside of the conflict," she said.

Lagging behind

WSU and Columbia Basin College have established nursing and other health sciences programs in Richland.

Trios Health in Kennewick already has a residency program and Richland's Kadlec Regional Medical Center will begin accepting residents next year and officials at both hospitals said there's plenty of space to expand capacity.

A medical program and more residencies are high on the wishlist for Mid-Columbia hospital officials and state lawmakers.

Residencies would bring other benefits such as the economic impact of highly paid professionals moving to the community and putting established doctors up against higher standards. Doctors also tend to stay and practice where they do their residency.

"If we can develop a medical school and residency program, there's a very high chance (resident doctors) will stay here," Kadlec CEO Rand Wortman said.

State Rep. Larry Haler said he and Mid-Columbia leaders are working to drum up support for more residencies and a medical school program in the Tri-Cities. Haler said he wants new "satellite" medical schools here and in town such as Vancouver and Bellingham.

He noted that Missouri, which has about 6 million people, has six medical school programs, compared to Washington state's two schools and 7 million residents.

"We're so far behind in this state -- let alone this region," he said.

But Haler said he still has to build support for his concept in the Legislature at a time when other issues, such as K-12 education, are straining state revenues.

'Still in the early stages'

Having the attention of UW and WSU officials doesn't guarantee either will bring medical education to the Tri-Cities or that it will lead to more residency slots in area hospitals.

WSU was supposed to have its feasibility study in hand this summer, but university officials sent it back to consultants after seeing a draft report in July because "it raised more questions than answers," said WSU spokeswoman Kathy Barnard.

"It didn't have to do with the data, it just didn't address all the areas we needed it to," she said.

The study is to be finished this month, and Barnard said it will be available to the public through the university's website.

How WSU would pay for a medical school hasn't been explained, and that includes whether additional money would be sought for the urban clinical campuses or if the chancellors at those campuses would have to fit it into their current budgets. Floyd said private donations would be needed if the university moves forward with the idea.

WSU leaders have emphasized that the Richland campus would play an important role within a potential medical school system, but haven't provided details about how that could affect the campus.

For example, classrooms, study areas and other services for Tri-City-based medical students could be on the campus, said WSU spokeswoman Lynne Varner. But she noted the university did not have its "clinical campuses planned with that degree of specificity yet."

"We're still in the early stages of building public and legislative support," she said.

The biggest impact likely would come with the demand for administrative space, said Ken Roberts, associate professor of WSU's school of medical sciences, because students likely would spend most of their time off campus working with cooperating hospitals.

"This is comparable to how our nursing program is (in the Tri-Cities) and Spokane," Floyd said.

The university moved its Tri-City nursing program in January to a freshly renovated building in central Richland provided by Kadlec.

The new space provided more room, better amenities and infrastructure and a closer partnership with the health care provider.

However, it also removed it from the north Richland campus, where most students and student services remain.

UW's advisory council meets this month and is expected to have a final report to Young later this month or in October, Arkans said.

He noted that while the council was interested in what Tri-City representatives have had to say, UW is focused on program expansion in Spokane.

Both state universities also said they want more residencies in Eastern Washington, but those function separately from four-year medical schools.

The federal government largely pays for residency programs around the nation.

Medical school graduates apply to programs they prefer and those programs than select the students they want.

That means graduates of a medical school in the Tri-Cities aren't guaranteed a residency at Trios or Kadlec, even if they seek that slot.

The medical school tug-of-war has been an issue that the Tri-Cities has been mostly on the sidelines for but Tri-City leaders say they are now trying to position the area to get in the game.

"It's just amazing to finally be paying attention to this," Wortman said.

This story was originally published September 6, 2014 at 10:10 PM with the headline "WSU, UW at odds over possibility of expanded medical education programs in Tri-Cities ."