The future need for increased numbers of physicians has been clearly demonstrated and the gap between demand and supply is growing. This gap is the largest, and is growing the fastest, in primary care specialties and in rural communities. To meet the need for physician workforce in our region we need to begin producing more physicians locally.
The medical education pipeline is a minimum of seven years long (up to 12 or 13 for some specialties). This lead time adds to the urgency of the medical education expansion effort.
The hallmark of the WWAMI program is its proven record of retaining a high percentage of the physicians its trains in the WWAMI region. This success is due, at least in part, to selecting students from all parts of the five state regions and offering them training opportunities in the region – in other words, training them where they come from and where we need them to eventually practice. In addition, the WWAMI program emphasizes the primary care specialties and has been successful in producing a relatively high percentage of students choosing primary care. Growing medical education in Spokane is growth to a part of the WWAMI program that will result in expanded primary care in the region, where this growth is most needed.
Medicine is a profession that has an established history of teaching its own trainees in the practice setting. Considering the entire medical education pipeline, all but the first two years of that education occurs in a practice setting. Thus, in places where much medicine is practiced, much teaching could and, I would argue, should occur. Should occur because when physicians teach, and the clinic or hospital becomes a teaching environment, the quality of care tends to improve. For many physicians, job satisfaction also improves when teaching is part of the practice environment. Spokane has a very large clinical practice community and a relatively small medical education enterprise. This is a natural place for medical education to grow.
All parts of the medical education pipeline affect the others. Having first year students in Spokane has increased interest in our 3rd and 4th year clerkships. Growing  numbers of students doing clerkships in Spokane will increase interest in our residency programs. Establishing the second year of medical education here will augment this affect. Growing our current residency programs, and establishing residency programs that we currently do not offer, is also important. Residencies are the key to teaching capacity for clerkships. All parts of the medical education pipeline affect all other parts. Most importantly, residencies and fellowships are the key to retaining physicians in our community because physicians tend to stay where they are trained.
Written by Ken Roberts, PhD, Director of WWAMI Medical Education Program
