WWAMI ::$0, th 40Anniversary
WWAMI: 1950 CELEBRATING 40 YEARS OF PARTNERSHIP First class of 50 students graduates from the University of Washington School of Medicine. 2011 marks the 40th anniversary of the WWAMI regional medical education program. The acronym WWAMI stands for the participating states: Washington, Wyoming, Alaska, Montana and Idaho. Throughout WWAMI’s history, thousands 1965-72 of participants—including physicians, universities, medical societies, hospitals and UW class grows from 81 to 106 legislators—have partnered to advance regional excellence in medical education students, with 4 to 8 women in each class. and to meet physician workforce needs in the Northwest. The University of Washington started WAMI in 1971 (Wyoming joined in 1996) to help Northwest states that were struggling with insufficient healthcare resources and physician 1970 training opportunities. Commonwealth Fund of New York City grants nearly $1 million for proposal, “Regionalization of Medical Education in the Pacific Northwest,” that secures the start The program was founded with five goals for the region: of the WAMI program. WAMI becomes a national model for decentralized medical • Provide publically supported medical education education and cooperation among states to conserve scarce resources. • Increase the number of primary-care physicians and address maldistribution of physicians • Provide community-based medical education UW SOM joins with Alaska to contribute to federally legislated “regional medical • Expand graduate medical education and continuing medical education programs to bring scientific advances in medicine through continuing education of physicians • Provide all of these in a cost-effective, high-quality manner and other health professionals.”
In 2011, WWAMI is recognized nationally as a model program for training Robert Van Citters named Dean of the UW SOM. physicians and other health professionals for rural areas.
First-year students at WWAMI sites rave about the outstanding classroom teaching they receive at their home state university, with small student-to-teacher ratios. 1971 John N. (Jack) Lein, head of UW SOM postgraduate education travels across WAMI WWAMI clinical training for third- and fourth-year medical students has grown to lobby nearly every state legislator in the four-state area. UW SOM partners with four tremendously—there are more than 165 teaching sites across the region. UW Northwest states to admit students who will complete their first year of medical school residency training programs have WWAMI regional sites and rotations in internal in their state of origin: University of Alaska, Fairbanks; Washington State University, medicine, pediatrics, psychiatry, obstetrics & gynecology, and anesthesiology. Pullman; University of Idaho, Moscow; and Montana State University, Bozeman. The UW Family Medicine Residency Network has 18 programs across the five- state region. The result is dramatic. More than 50 percent of WWAMI graduates become primary-care physicians—higher than the national average—and many University of Alaska-Fairbanks welcomes its first WAMI choose to practice in rural areas. students: 9 students for a single semester. Alaska is first home- state university site for WAMI Program. WWAMI’s future is very bright. WWAMI is deeply committed to the success of our five-state medical school. Thank you for your part in making WWAMI a success. WAMI endorsed by UW SOM medical school faculty.
Roy Schwarz is named first director and organizer of WAMI.
1972 WAMI then... Family Medicine Residency Network established by the UW Department of Family Medicine. By 2011 there are 18 Family Medicine Residency Programs across WWAMI. Family Medicine Programs established in Washington as follows: 1969 - Group Health Cooperative Family Medicine Residency Program; 1970 - Swedish Family Medicine - First Hill Residency Program; 1972 - University of Washington Family Medicine Residency Program; 1974 - Swedish Family Medicine - Cherry Hill Residency Program, all in Seattle, WA. 1972 - Spokane Family Medicine Residency Program; 1973 - Madigan Family Medicine Residency Program on the Fort Lewis Military Reservation south of Tacoma, WA; 1978 - Tacoma Family Medicine Residency Program; 1986 - Valley Family Medicine Residency Program in Renton, WA; 1989 - Puget Sound Family Medicine Residency Program at the Naval Hospital in Bremerton, WA; 1991 - Providence St. Peter Hospital Family Medicine Residency Program in Olympia, WA; 1993 - Central Washington Family Medicine Residency Program in Yakima, WA; 1995 - Family Medicine of Southwest Washington Residency Program in Vancouver, WA.
Family Medical Center in Omak, Washington, and Yakima Valley Clinic in Grandview, Washington, officially become the first community clinical training sites in the WAMI Program. By 1974 Anacortes and Whidbey Island sites are added. 1970: 1991: •A $1 million grant from Commonwealth Fund of New York City secures WAMI program pilot •Spokane Advanced Clinician Track of the UW Psychiatry Residency Program is established 1971: •University of Alaska-Fairbanks joins WAMI 1993: •Surgery residency rotation established at the Wenatchee Valley Clinic/Central Washington Hospital •A first: UW medical school grads matching into primary-care residencies exceeds 50 percent 1972: •Montana State University joins WAMI 1994: •University of Idaho joins WAMI •New program ‘Student Providers Aspiring to Rural and Underserved •Washington State University-Pullman joins WAMI Experiences’ (SPARX) initiated and provides interdisciplinary experiences 1969: •Family Medicine Residency Network established to encourage practice in rural or urban underserved communities •MEDEX Northwest physician assistant 1975: : training program •MEDCON, a toll-free communications network, starts; community physicians can consult faculty at the 1996 •Montana Family Practice Residency established in Billings, MT established UW School of Medicine via phone • Wyoming becomes fifth state to join WWAMI •Family Medicine Residency of Idaho established in Boise, ID. Rural training track starts later in Caldwell, ID in 1995 and in Twin Falls/Jerome, ID in 2009 •University of Wyoming Family Medicine Residency Program established in Casper, WY 1997: •WWAMI Rural Telemedicine Network is funded by the federal Office of Rural Health 1977: Policy to explore the use of telemedicine consultations for rural communities •Internal Medicine Primary Care Track established in Boise, ID by the UW Department of Medicine
1998: 1978: •First class participates in WWAMI Rural Integrated Training Experience (WRITE) program •WAMI is self-sustaining; each participating state provides support •Alaska Family Practice Residency established in Anchorage AK 1970 1990
“Even from day one, there’s quite an emphasis placed on primary care. I think it’s because of the WWAMI program and the fact that they’re encouraging those 1980 students to practice primary care in their home states.
It really serves those states.” 1980: •University of Wyoming Family Medicine Residency Program established in Cheyenne, WY
1985: “Today was amazing. I was •WAMI Area Health Education Centers (AHECs) funded to train, recruit and retain health personnel for medically underserved areas. •WAMI Center for Health Workforce Studies funded by Bureau of Health Professions to conduct policy-relevant humbled and privileged to health research and provide guidance to policymakers on health workforce issues witness a new diagnosis of
1986: cancer. I performed my first •Graduate medical education (GME) training grows in WAMI region to include 9 combined student-resident family medicine teaching units supporting the training of 149 residents. Internal Medicine offers a primary-care track in Boise, ID and rotations in Montana and full history and physical on a Washington. Pediatrics, obstetrics and gynecology, and psychiatry add community-based residency rotations hospital patient. I witnessed
1989: the kind of hard-pressed rural •Minority Medical Education Program starts: guidance for underrepresented minority college students interested in careers in medicine hospital patient care dilemmas •Rural/Underserved Opportunities Program (R/UOP) launched that initially brought me here.” 2000: •UW residents have completed 2,766 clinical rotations at WWAMI sites since 1970
2002: •WWAMI program receives Outstanding Community Service Award from AAMC
2005: •Institute for Simulation and Interprofessional Studies (ISIS) is initiated to enhance procedural skills training, medical teamwork and patient safety
2006: •Idaho Track of the UW Psychiatry Residency Program is established in Boise, ID.established in Pocatello, ID
2008: •Washington State University-Spokane joins WWAMI •Targeted Rural Underserved Track (TRUST) starts in Montana. The program expands to eastern Washington in 2009 and into western Washington in 2010 “There’s a definite camaraderie and
collegial feeling among physicians and
students. Among the faculty that I’ve 2000 run into in Seattle and at regional sites, they treat you as one of their own.” “We took a little four-seater prop plane to a remote part of the island – this really isolated little town, with about 150 people – and saw patients there for a couple 2010 of days. It just blew my mind.”
2010: • First WWAMI Graduate Medical Education Summit held in Spokane • UW SOM clerkship sites grow to 165
2011: •Boise Internal Medicine Residency established. The three-year training program is sponsored by the Department of Medicine •Wyoming adds 4 medical school seats to bring its class to 20, and total number of UW SOM students to 220.
“A Lancet commentary called the WWAMI program “perhaps the best academic model” of a multi-faceted approach to recruitment and retention of physicians in underserved communities.”
photo credit: Clare McLean/UW Medicine 1972 1997 Regents of Montana University system vote to WWAMI Rural Telemedicine Network is funded by the federal Office of Rural Health participate in WAMI Program and make Montana Policy to explore the use of telemedicine consultations for rural communities. By 2000, State University site of first-year classes. more than 320 consultations have taken place within diverse specialties.
1975 1998 MEDCON, a toll-free communication network, is First medical student class participates in WWAMI Rural Integrated Training Experience started; service enables physicians in any community to (WRITE) to obtain several months of clinical education in a small town. Libby, Montana; seek medical consultation via telephone with members of Othello, Washington; Hailey, Idaho, and Sandpoint, Idaho become first WRITE communities. the full-time faculty at UW SOM.
The clinical training site for obstetrics and 1970-2000 gynecology officially opens in the Treasure Valley as UW residents complete 2,766 clinical rotations at WWAMI sites. part of Idaho WAMI Program. 2005 Institute for Simulation and Interprofessional Studies (ISIS) is initiated to enhance 1976 procedural skills training, medical teamwork and patient safety. WAMI rotations grow: OB/GYN has programs in Boise and Pocatello ID; Anchorage AK; and Spokane and Tacoma WA. Pediatrics is in Mary Bridge Children’s Hospital and Madigan Army Medical Center, Tacoma WA, Spokane WA and Great Falls, MT. 2008 Targeted Rural Underserved Track (TRUST) starts in Montana. The program expands Psychiatry is in Anchorage AK. Internal Medicine is in Billings and Missoula, MT, Boise to eastern Washington in 2009 and into western Washington in 2010. ID, and American Lake and Wenatchee WA. First class of 20 students begins at WWAMI-Spokane at the Washington State University Riverpoint campus. 1979 UW SOM class size grows to 180, with 40 women admitted. ISIS presentation is held via telemedicine between Seattle, Wash. and Boise, Idaho using the X-box as a tele-simulation tool.
2011 1985 Wyoming adds 4 medical school seats to bring class to 20, and total number of UW SOM WAMI Area Health Education Centers (AHEC) program are funded to train, recruit students to 220. and retain health personnel for medically underserved areas.
WWAMI Center for Health Workforce Studies is funded by Bureau of Health 2010 Professions to conduct policy-relevant health research and provide guidance to policymakers Total number of UW SOM clerkship sites: 165. Total number of medical student on health workforce issues. Center emphasizes research on state workforce issues in clerkships completed in one year: 731 underserved rural and urban areas.
1986 WWAMI now... Graduate medical education (GME) for residency training grows in the WAMI region to include 9 combined student-resident family medicine teaching units: 8 in Washington and 1 in Idaho, supporting the training of 149 residents. Internal Medicine offers one primary care track in Boise, ID with rotations at 3 affiliated sites: 2 in Montana, and 1 in Washington. Pediatrics, obstetrics and gynecology and psychiatry add community-based residency rotations.
1989 Minority Medical Education Program starts. The program provides guidance to talented underrepresented minority college students interested in medicine.
Rural/Underserved Opportunities Program (R/UOP) sends first medical students to small towns during summer to acquaint them with practice in physician shortage areas. WHERE IS WWAMI HEADED?
WWAMI offers high-quality, cost-effective medical training across the five states of Washington, Wyoming, Alaska, Montana and Idaho without the expense (financial, 1993 resources, curriculum development) of building new medical schools. WWAMI For first time, percentage of UW graduating medical school students matching to primary- introduces: care residencies exceeds 50 percent. • Cost-effective and high-quality medical education;
• Sharing of resources, expertise and knowledge; 1994 • Collaboration and partnership that lead to innovation and stability; Student Providers Aspiring to Rural and Underserved Experiences (SPARX) • A solution to the region’s physician healthcare workforce shortages. provides interdisciplinary educational experiences to encourage health professionals and WWAMI continues to expand and innovate. In 2011 - 2012, work is underway students to practice in rural or urban underserved communities. to explore options for providing all four years of WWAMI medical education in the region, expanding the Colleges program to the region, and modeling regional small-group teaching across the five states. Unique programs, such as the WWAMI Rural Integrated Training Experience (WRITE), Rural/Underserved Opportunities 1996 Program (R/UOP), and Targeted Rural/Underserved Track (TRUST) succeed in Wyoming becomes fifth state in bringing students to the region to learn and later to return as practicing physicians. UW medical school’s regional medical WWAMI remains dedicated to training physicians for rural areas and will continue education program by joining with to improve and innovate to meet the changing needs of communities across the five- long-time partner states Washington, state region. Alaska, Montana and Idaho; acronym changes to the WWAMI program.