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OHSU School of Medicine Expansion Update

Oregon Health & Science University (OHSU) School of Medicine is moving forward in developing satellite campuses as part of plans to expand its medical education program. The first satellite site is planned for Eugene and is being developed in collaboration with the University of Oregon (UO) and PeaceHealth, Oregon Region.

Driving OHSU’s move toward regional education is the strong motivation to avert any compromise in the quality of Oregonians’ health care due to the state’s looming physician shortage. Compounding the physician work force shortage in Oregon — predicted to peak in 2020, but evident by 2010 — is the mal-distribution of physicians within the state and the reality of underserved populations throughout rural Oregon.

“As Oregon’s only medical school, it is imperative that OHSU graduate more physicians to meet Oregon’s future needs. It’s not about more specialists in Portland; it’s about training providers who will meet the health care needs of people throughout the state. Thirteen percent, some 1,255 physicians, will leave Oregon’s physician work force by the end of 2006 due to retirement, relocation and career changes — we’re nearing a crisis situation,” said OHSU School of Medicine Dean, Joseph E. Robertson, M.D., M.B.A., a nationally recognized expert regarding physician work force issues.

The School of Medicine hopes to increase its entering class size from the current 112 to 160 students during the next six years and will enroll 120 students on OHSU’s Marquam Hill Campus in fall 2006. But the school is facing obstacles to addressing Oregon’s physician shortage, especially the lack of state support. The 2005 state appropriation to the School of Medicine was unchanged from the 2003 level of support, and current state funding to the school reflects a 38 percent decrease since 2001. In the Association of American Medical Colleges 2004 report on medical school funding through state appropriation, Oregon ranked in the bottom five of the 75 publicly supported medical colleges. Regional education developed through key partnerships offers the most cost-effective option for training more medical students.

Satellite sites such as the one in Eugene require collaboration among OHSU, the medical school, the state’s university system, local health systems and the Area Health Education Centers (AHECs). Currently, about 40 percent of OHSU School of Medicine’s clinical training occurs outside OHSU facilities, and a rural outreach program has been well established through the AHEC program, a partnership between OHSU and Oregon communities. The prototype program in Eugene, developed in partnership with the University of Oregon and PeaceHealth’s Sacred Heart Medical Center, will provide resources for both medical students’ preclinical and clinical training. In addition, the regional site will offer expanded opportunities for students in health-related graduate programs and for collaborative research.

The satellite focus in Eugene will not be a second medical school; rather, medical school course work at the University of Oregon will be offered under OHSU School of Medicine’s accredited status with the Liaison Committee on Medical Education (LCME), and curriculum and admissions program oversight will remain the responsibility of the OHSU School of Medicine.

The Eugene site will offer some clinical clerkships within the PeaceHealth system beginning in 2006–2007, and, subsequently in 2008-2009, the first-year medical school curriculum is expected to begin at UO. The Eugene campus will provide a first-year curriculum with the second-year of the medical school curriculum only offered at the OHSU Marquam Hill Campus. This will ensure timely and appropriate progression of all students to the clinical curriculum through coordinating clinical skills development and assessment, solidifying class identity, and providing effective career planning and services for students.

“Having second-year medical students in Portland is essential,” said Edward J. Keenan, Ph.D., OHSU Associate Dean for Medical Education. “Students must be at an academic medical center for the second-year curriculum and related experiences. In addition, we want all graduates of the OHSU School of Medicine to experience the benefits that come with a shared experience of the medical school.”

Third- and fourth-year medical students will have an opportunity to pursue some rotations at Sacred Heart Hospital and potentially at the PeaceHealth Oregon Region’s facilities in Cottage Grove and Florence. These clinical rotations will be the first step in developing the Eugene site by summer of 2006. By 2008, plans call for a class of 10 first-year medical students to matriculate at the regional program at the UO and grow to 40 students per class by 2010.

Dave Frohnmayer, President of the University of Oregon, is strongly supportive of the regional partnership and the connections to UO’s academic excellence in the biosciences. “Having a satellite campus will enhance the University of Oregon’s pre-med and graduate science programs, provide opportunities for OHSU’s M.D./Ph.D. students in Eugene, and foster collaborative research, including biomedical translational research programs.” In addition, medical students would benefit from the opportunity to pursue graduate programs at either OHSU or UO.

According to Dean Robertson, the regionalization of medical education in Oregon opens new opportunities for recruiting a larger population of qualified Oregon applicants to medical school and graduate programs.

“The issue of physician distribution and assuring access to care in rural areas is best addressed in first recruiting the right applicant pool and then motivating them to practice in the right locations. Regionalized medical education offers opportunities for both recruiting and for promoting rural practice. By coupling financial assistance with regional training, the impact of student debt and potential income upon specialty and practice choice can be lessened. Even when the long-term goal of a new medical school facility on the Schnitzer Campus at the South Waterfront is realized and an increased enrollment of medical students can be trained in Portland, the regional campuses will remain an important element in educating Oregon’s future physicians.”

In February representatives from OHSU, UO and PeaceHealth met in Eugene to consider the next steps for forming an effective educational collaborative on a statewide basis. The group focused on consensus items, governance, guiding principles, and developing a sustainable financial model. The collaborative  is committed to meeting regularly to implement the first steps in regionalization of medical education.

In 2005 the School of Medicine received a $1.5 million grant from the James F. and Marion L. Miller Foundation to support program development for the Eugene initiative and the regionalization of medical education through a collaborative process. This grant will provide essential support enabling all partners to establish a unique education collaborative dedicated to meeting the health care needs of Oregon’s citizens.

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