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July 5, 2011
SALINA Next month, the University of Kansas School of Medicine will open a four-year, fully accredited school – officials prefer to call it a campus – next door to the Salina Regional Health Center.
“This will be the smallest medical school campus in the country and Salina will be the smallest city in the country - outside of a few major suburbs - to have a medical school campus,” said Dr. Heidi Chumley, senior associate dean for medical education at KU Medical Center.
The first class will have eight students, seven of whom are from Kansas.
KU Medical Center officials said they plan to add eight students a year at the campus in each of the next four years.
More primary-care docs
“The goal is to develop more primary care doctors for rural Kansas,” Chumley said. “We’re shooting for 75 percent (of the new school’s eventual graduates) choosing primary care, and 75 percent rural.”
Much of the new school’s curriculum will be tied to the classroom offerings at the KU Medical Center’s campuses in Kansas City and Wichita.
“We completely redid our curriculum about six years ago. It’s very computerized now,” said KU Medical Center Executive Vice Chancellor Barbara Atkinson. “All the lectures are podcasts. They’re all going to be teleconferenced (in Salina), though some will be generated on-site.”
The cost of remodeling the three-story building has been picked up by Salina Regional Health Center. And the hospital’s foundation and several private donors are covering many of the operational costs and scholarship offers.
“So far, we’ve not asked the state for any money for this because we understand the financial situation the state is in,” Atkinson said. “But we have asked donors to support it and they’ve been very, very generous. Incredibly generous.”
Salina-area benefactors, she said, hope to raise $2.5 million over the next four years. They’ve already raised $1.5 million with $1 million coming from the salina hospital.
Salina Regional Health Center has hosted a residency program for KU Medical School graduates for about 30 years.
Most of its residents went on to start or join rural practices.
Model for other states
“What the University of Kansas is doing, I think, will be a template for having a positive impact on the number of medical practitioners in rural communities,” said Brock Slabach, senior vice president at the National Rural Health Association. “Other universities will be watching because, really, for a major medical school to commit itself to meeting rural-community needs like this is truly novel. It shouldn’t be, but it is.”
Slabach said he’s long been baffled by the fact that medical school officials in many rural states’ fail to see the connection between their states' shortages of health care providers and their students leaving for big cities in other states.
“I wouldn’t include Kansas in that group,” he said.
Last year, a national survey of how well medical schools were fulfilling their “social mission to train doctors…” ranked KU School of Medicine fifth in the nation.
The school was ranked eighth for its percentage of graduates (44 percent) practicing in underserved areas.
Earlier this year, a Kansas Department of Health and Environment survey found that 51 of the state’s 105 counties had less than one physician per 2,695 residents and were considered medically underserved.
“The shortage of health care professionals has been a critical issue for a long time,” said Dr. William Cathcart-Rake, a Salina oncologist and director at the KU-Salina campus. “It’s not new, but what is new is that now we have a number of physicians who are nearing retirement age, and a good number of them are practicing in the rural communities.”
Generating enough new doctors to replace those who are retiring – especially in rural areas - will be difficult, he said.
“We have to do something,” Cathcart-Rake said. “We can’t keep doing what we’ve always done. It’s not enough.”
The Salina campus, he said, will be geared toward allowing students from small towns to complete their studies and residencies in a small-town environment.
“There is evidence that shows that if someone is trained in a rural area they are more likely to stay in a rural area,” he said. “So the idea is that from day one we’ll be training our students in in non-metropolitan settings and exposing them to all the good and the bad that comes with life in rural Kansas. After that, we’ll hope for the best.”
Cathcart-Rake, who grew up in small town in Orange County, Calif. (“…back when there was still a small town in Orange County”), has been practicing medicine in Salina for 32 years.
“The perception is that if you go to a small town you’ll work yourself to death, you’ll never get a vacation and you won’t get to spend time with your family,” he said. “The way to get around that is to be with a group of physicians so you can cover for each other so you don’t have to do everything for yourself.
“The days of there being a doc in every little town are gone. That’s not the model anymore,” Cathcart-Rake said, noting that in Clay Center, for example, the local clinic has eight physicians and four mid-level practitioners serving a large catchment area.
Similar models are in place in Tribune, Quinter, and Beloit.
Enjoying small-town life
Earlier this year, Aneisa Slack, 25, completed her second year of study at KU Medical School in Kansas City. She’s starting her third year on the school’s Wichita campus.
“I’ll be here for six months,” she said. “Then, in January I’ll go to Salina. I’ll be there for 18 months.”
Slack, who grew up on the family farm south of Oxford in Sumner County, said she wants to be a primary-care physician in a small town.
“I like the small-town lifestyle,” she said. “I know that a lot of people don’t. But that, I think, is because they’re not from a small town. I’ve had some classes with students from Wichita and Kansas City who’ve never been to a small town. They’re driven through them, but they’ve never spent any time in one.”
Slack last year was president of the KU Rural Medicine Interest Group, which is a student organization. She said she was leaning toward joining an existing practice or going to work for a small-town hospital.
Most of her fellow students, she said, are not interested in opening their own practices.
“The ones I know aren’t really interested in starting a business,” she said. “They don’t want to have to put up with all the paperwork. They just want to be a doctor.”