AHEC Happenings
Connecting Students to Careers, Professionals to Communities and Communities to Better Health
Volume 2, Issue 1: Winter 2010

Upcoming Events

Health Careers Exploring Post
Post 141
Tuesday, February 9th
Des Moines University

Post 2603
Monday, February 15th
Allen Hospital, Waterloo

Mini Medical School
February 9th – March 9th
Des Moines University

In This Issue

Introducing the Rural Medicine Educational Pathway

When Des Moines University's AHEC Program started in 2007, one of the first goals was to provide more education on rural medicine and encourage DMU graduates to practice in Iowa's underserved areas. Working closely with DMU faculty, they helped to initiate the Rural Medicine Educational Pathway (RMEP), an innovative curriculum designed to train osteopathic students for careers in rural medicine.

Students participating in the Rural Medicine Educational Pathway

This year, almost twice as many Des Moines University D.O. students elected to participate in the rural track program.

RMEP is an elective course open to all D.O. students interested in rural practice. It prepares students for the unique opportunities and challenges of practicing medicine in a rural setting by incorporating key concepts of rural healthcare with a variety of speakers, including: rural physicians and their spouses, public health professionals and family medicine residents. One of the unique features of the program is a summer preceptorship in an underserved community that takes place after the first year of medical school. Initially, this clinical experience was only offered to scholarship recipients, but with the help of AHEC, it is now open to all RMEP students.

One of the major components of RMEP is the scholarship, offered annually to six first-year DMU D.O. students with a strong interest in practicing in rural Iowa. Scholarship recipients are awarded full tuition throughout med school in exchange for four years of primary care practice in a rural Iowa community.

In just its second year, interest in the program is growing dramatically. The number of students participating in RMEP has nearly doubled, increasing from 13 students last year to 24 this school year.

Program Highlight

Northeast Iowa AHEC Takes On EMT Clinical Coordination

Building on the success of their clinical training program, this year, Northeast Iowa AHEC is giving a new group of students the AHEC treatment. Emergency medical technicians are educated in a handful of locations throughout the Northeast Iowa service area. As such, there are plenty of students in need of clinicals as they work toward completion of their EMT certification.

As AHEC often does, they are filling a service gap, working with colleges and hospitals to identify and coordinate opportunities for students to complete their EMT clinicals. One hot spot for student experience so far is Northeast Iowa AHEC's host site, Allen Hospital. The EMT students spend time in the newly constructed Pauline Barrett Pavilion. Their time on site includes training in the intensive care unit and cardiac catheterization lab. They are given the opportunity to see multiple aspects of the responsibilities of an EMT by having their clinical experience stretch throughout the emergency department and heart and vascular center.

Northeast Iowa AHEC is excited about the opportunity to assist yet another group of future healthcare providers in obtaining their training. They look forward to seeing participation grow and are grateful to the many healthcare professionals who welcome the students for such experiences. For more information about getting involved as a student, educator or clinical preceptor, contact Brienna Decker, clinical outreach coordinator.

Primary Care Career Choice: Medical Schools Can (and Should) Make a Difference

by Kendall Reed, D.O.

Declining interest in primary care is a complex problem. Lifestyle, payment inequity, perception of less prestige and educational debt are just some of the factors which affect student career decisions. The role of the medical school in helping solve this problem has not received the scrutiny it deserves. It is clear that simply increasing student enrollment will have little, if any, effect. We must re-examine the primary care recruitment pipeline as well as the culture and educational environment of every medical school.

It is impossible to begin too early to plant the seeds of interest in primary care. One mechanism is through our state Area Health Education Centers (AHECs). Our three current (and one planned) AHECs are ideally situated in rural/underserved areas in Iowa to make that important first contact with potential students. These students can then begin to understand the critical role primary care providers play whether it be as a physician, physician assistant or nurse practitioner.

For far too long, grade point averages and MCAT scores have played a dominant role in admission to medical school. Undoubtedly, this has resulted in excellent and qualified potential students being left on the sidelines of American medicine. Admission committees must develop other metrics which can predict success in the curriculum and an interest in primary care. Medical schools need to disengage from the annual U.S. News and World Report, which ranks medical school quality according to a matriculant's entering GPA and MCAT. There is little, if any, correlation with that ranking and the ultimate competence of a physician.

Medical student debt has been addressed in previous columns (February 2007) in Iowa Medicine. The annual increase in educational debt is unsustainable (average debt now exceeds $155,000). The rationale for medical school tuition increases must be justifiable and transparent. Initiatives to offset debt and control costs are critical to each medical school's mission and societal responsibility. Innovative scholarship programs and service-repayment opportunities need to be carefully explored.

Medical schools should re-examine the environment and curricular offerings that can focus attention on primary care. Early and frequent interaction with primary care physicians in the first two years of the curriculum as well as more required primary care during the clinical years may be a critical determinant. The influence of a single mentor (positive or negative) can have a decisive impact on a student's career choice. We must provide students with the tools necessary to take leadership roles in the patient-centered medical home as well as better preparation in population based medicine. The current initiatives directed toward primary care in U.S. healthcare reform set the stage for action now.

Medical schools need to work closely with primary care residency programs to demonstrate the value and rewards of a career in primary care. Initiatives that allow students and residents to obtain a master's in public health or healthcare administration are just one example of how that transition can be promoted. The importance of community support and involvement in the recruitment and retention of primary care physicians has not been appreciated fully and should begin in the pipeline phase prior to matriculation into medical school.

Medical schools can and should have a major impact on a student's choice to enter primary care. However, this influence cannot be maximized without first addressing the significant payment inequity that exists between primary care and specialty care. Our students must be able to look down the road into primary care and see a future that is not only intellectually rewarding and family oriented but financially secure.

Kendall Reed, D.O. FACOS, FACS, is the professor of surgery and dean of the college of osteopathic medicine at Des Moines University.

This article was originally published in the November/December 2009 issue of Iowa Medicine, a socioeconomic magazine for Iowa doctors published by the Iowa Medical Society.

AHEC Attends NAO Fall Conference, Visits Capitol Hill

Representatives of DMU AHEC get a photo opp with Iowa Governor Chet Culver.

From left: Kristin Wentworth, Sharon Meyers, Governor Chet Culver, Wendy Gray and Jill Whitson.

The National AHEC Organization (NAO) held its annual fall conference in Washington, D.C., November 4-6. Des Moines University's AHEC Program was represented by Wendy Gray, AHEC program office director; Sharon Meyers, West Central Iowa AHEC executive director; Kristin Wentworth, Northeast Iowa AHEC executive director; and Jill Whitson, Central Iowa AHEC executive director. The conference provided an opportunity to connect with representatives from the Health Resources and Services Administration, American Academy of Family Practice, National Rural Health Association, National Health Service Corps, Macy Foundation and other AHEC programs.

While in the capital, the DMU AHEC Program was able to advance its advocacy efforts through meetings with the offices of every member of the U.S. Congressional delegation from Iowa: Senators Tom Harkin and Charles Grassley and Congressmen Leonard Boswell, Dave Loebsack, Tom Latham, Steve King and Bruce Braley. Conversations were focused on securing support of AHEC reauthorization and the corresponding report language as part of the national healthcare reform efforts. The trip was enhanced by a chance meeting with Iowa Governor Chet Culver at the airport!

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