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Developing Wisconsin’s Medical Workforce Medical College of Wisconsin

Developing Wisconsin’s Medical Workforce Medical College of Wisconsin. Presentation to the Legislative Council Special Committee on Health Care Access John R. Raymond, Sr., MD │ President and CEO Kenneth B. Simons, MD │ Associate Dean, Graduate Medical Education

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Developing Wisconsin’s Medical Workforce Medical College of Wisconsin

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  1. Developing Wisconsin’s Medical WorkforceMedical College of Wisconsin Presentation to the Legislative Council Special Committee on Health Care Access John R. Raymond, Sr., MD │ President and CEO Kenneth B. Simons, MD │ Associate Dean, Graduate Medical Education Alan K. David, MD │ Chairman, Department of Family and Community Medicine

  2. Overview • MCW Education Mission • Motivating Factors for Medical Students • Pipeline Programs • Admissions Process and Criteria • Focus on Wisconsin Students • Focus on Diversity • Primary Care Graduate Medical Education • Family Medicine Training • Future Vision 2

  3. Medical College Education Mission Be a national leader in the education and development of the next generation of physicians and scientists Over 15,000 alumni caring for Wisconsin / SE region citizens • Current enrollees • 820medical students • 439 graduate students • 644physicians in residency training • 127physicians in fellowship training • 180post-doctoral scientists* • 7,000continuing health professionals 3 *Includes Blood Research Institute post-docs

  4. The Physician’s Journey Specialty Fellowship Training Workforce Residency Training (graduate medical education) Medical School Higher Ed Continuing Medical Education K – 12 specialty choice 4th year Pipeline 18 years 4 years 3 – 7 years 2 – 4 years 4 - 5 years career 4

  5. 2010 Matriculating Student Perspective When did you definitely decide that you wanted to study medicine?* MCW % 5 *Source: AAMC Matriculating Student Questionnaire 2010 - MCW

  6. 2010 Matriculating Student Perspective How did the following factors influence your decision to study medicine rather than pursue another career?* Science course Health-related work experience Competitiveness / challenge of medicine Parent / Relative / Friend / Physician Experience with illness/accident Professor / teacher Particular book, article, film, TV Anticipated future salary Health professionals advisor Career / guidance counselor Anticipated lifestyle balance Anticipated financial debt Negative Positive 6 *Source: AAMC Matriculating Student Questionnaire 2010 - MCW

  7. Six MCW Pipeline Programs High School Programs Apprenticeship in Medicine (AIM) (12 students) Research Opportunity for Academic Development in Science (ROADS) (7-10 students) Sickle Cell Summer for Science Program (3 students) American Chemical Society – Project SEED (2 students) Undergraduate Programs Diversity Summer Health-related Research Education Program (DSHREP) (14 students) Environmental Health Sciences Training Program (EHSTP) (3 students) 7

  8. Summer Pipeline Programs – High School 66% graduated high school 65% attended college 6 physicians 1 graduate student (Epidemiology) 1 Associate Director DeVry University 34% high school graduation N/A 74% graduated high school 60% attended college 5 physicians 2 nurses 2 graduate students 26% high school graduation N/A Research Opportunity for Academic Development in Science (ROADS) 77 trainees since 1996 Apprenticeship in Medicine (AIM) 170 trainees since 1996 8

  9. Summer Pipeline Programs - Undergraduate Diversity Summer Health Related Education Program 121 total trainees since 1996 27 (22%) are physicians 19 (16%) are in medical school 14 (11%) are completing undergraduate studies 12 (10%) are health/science professionals 2 are in graduate school for a PhD 1 has a PhD 75 (62%) are now in health-related fields 9

  10. Medical School 5-Step Admissions Process & Criteria Initial Review Grade Point Averages (GPAs) and Medical College Admissions Test (MCAT) Screening Review by Committee application, personal statement, letters of recommendation and activities Selection of Candidates to Interview based on outcome of two previous reviews Interview pre-determined intrinsic qualities sought in a medical student and future clinician Committee Decision 10

  11. Medical School Admissions Summary 2010 11

  12. Commitment to Wisconsin Students: Wisconsin Capitation Appropriation State Appropriated Capitation(tuition assistance to in-state students) Amount of aid to student is pro-rated annually depending on number of in-state applicants that year 10% cut 10% cut 50% cut 12

  13. MCW Student Enrollment & Capitation Appropriation Trend Capitation Appropriation MCW Enrolled Students 13

  14. Diversity and Underrepresented in Medicine (URM) • MCW + AAMC • Growing up in poverty or in a disadvantaged socioeconomic status • Being the first person from one’s family to attend college or graduate school • Overcoming educational disadvantage (graduating from a high school with little resources or with a high dropout rate) • Having primary language other than English • Living in a rural area • Overcoming a significant handicap • AAMC • Association of American Medical Colleges • Native Americans (American Indian, Alaska Natives, Native Hawaiians) • African Americans • Mexican Americans • Mainland Puerto Ricans • Current AAMC shift in defining “underrepresented” 14

  15. MCW Commitment to Diversity • Senior Associate Dean, Diversity • Associate Dean, Student Affairs and Diversity • Dean’s Diversity Advisory Committee • Graduate Medical Education Diversity Committee • Diversity Scholarships • 6 Pipeline Enrichment Programs • Milwaukee Academy of Science 15

  16. Graduate Medical Education: Keeping our Graduates in Wisconsin • 977 physicians have graduated from MCWAH* residency programs in the last 5 years • 45% of MCWAH graduate trained physicians stay in Wisconsin to practice • 41% of those who stay in Wisconsin practice in primary care fields 2006 – 2010 2006 – 2010 16 *Medical College of Wisconsin Affiliated Hospitals Residency Programs

  17. Family Medicine: Forging Primary Care Training • Adaptability of family physicians • Infant  Geriatrics • Procedural  Behavioral • Rural  Suburban  Urban • Longitudinal Experience • Academic Enrichment Electives • Urban Community Pathway • Family Medicine Student Interest Groups • Clerkships in clinical years • Rural medical student placements 17

  18. Family Medicine Graduate Training: A Wisconsin Partnership • Partnership = MCW + Community Hospitals + State of Wisconsin • Since 1975 the Department of Family and Community Medicine has educated over 961 Family Physicians. • 58% of Family physician graduates stayed in Wisconsin. • Each Family physician employs, on average, 4.5 FTE staff. • Thus over 2,484 Wisconsin jobs have been created since 1975 in addition to the physicians. 18

  19. MCW Family Medicine Physicians in Wisconsin 1976 – 2010 Of the 961 Family Medicine Residency Program Graduates since 1976, 552 (57%) entered practice in Wisconsin. 19

  20. MCW Family Medicine Graduates Staying in Wisconsin 60% Average in-state retention since 1995 20

  21. MCW Family Medicine Graduates Born in WI who Practice in WI 84% Average 21

  22. MCW Family Medicine State Appropriation Trend 1998 $3,371,900 State Appropriation 5 programs ■ 108 residents 20038 $3,371,900 State Appropriation 4 programs ■ 96 residents 2010 $3,165,000 State Appropriation 3 programs ■ 54 residents 22

  23. MCW Family Medicine State Support 1993 – 2012 Projection 23

  24. Expansion Proposal: MCW Family Medicine Residency Training • Proposal: Expand residency program capacity through increased State appropriation of • $1.5 million / year • 2 new residents/class/program/year (priority to applicants with WI connections/roots) • New faculty/program • Timeline: 3 years – will result in an increase of 6 graduates/year •  new program within 5 years • End Result: Creation of a new program – less costly output and shorter time-frame • Benefit:If paired with Capitation increase, great likelihood of increasing family • physicians in Wisconsin 24

  25. Future Vision Restore Capitation Capture the students Wisconsin is losing to other states and careers Increase Family Medicine Residency Training Expand current residency program capacity Expand Pipeline Programs Develop and grow enrichment opportunities for high school and undergraduate students Increase Number and Scope of Practice Judiciously review expansion of allied health professional care Expand Medical Education in Wisconsin Statewide team approach to medical and allied health professional education 25

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