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00000176-d8fc-dce8-adff-faff71620001Idaho is one of four western states without a medical school. So, Idaho, Wyoming, Alaska and Montana have partnered with the University of Washington School of Medicine to provide in-state tuition rates for out-of-state medical students.The program -- known today as WWAMI (sounds like whammy) -- was created in 1971. Wyoming joined in 1996.According to the WWAMI webpage, these are the programs' five goals:Provide publicly supported medical education.Increase the number of primary-care physicians and correct the maldistribution of physicians.Provide community-based medical education.Expand graduate medical education and continuing medical education.Provide all of these in a cost-effective manner.The state of Idaho subsidizes the cost of attending the University of Washington for 20 medical students per year. Idaho pays about $50,000 per seat, per year, leaving the student to pay just in-state tuition and fees.Here's a look at the number of WWAMI seats Idaho has had over time:00000176-d8fc-dce8-adff-faff71620002The state also pays for a similar program with the University of Utah School of Medicine. There, Idaho subsidizes the cost of tuition for eight medical students per year.In fiscal year 2013, Idaho committed $3,986,900 to the WWAMI program and $1,257,200 to the University of Utah.

Rural Residency Shortage Means Doctors-In-Training Move Away

For decades, rural parts of the Northwest have found it difficult to lure doctors to small towns. Community leaders in Yakima, Wash. went so far as to found a small medical school to train doctors to practice in these underserved areas.

The Pacific Northwest University opened in 2006. But there is a problem. Small towns throughout the region just don’t have enough residency programs. And that means many of these doctors-in-training may move away.

Vaughn Bullfinch sits in the office of his supervising physician; they are discussing treatment for a patient. Vaughn was among the first class of medical students to graduate from Pacific Northwest University. It’s an osteopathic medical school. Now he is a resident -- getting real world experience -- at the Community Health of Central Washington clinic.

“I think it is very fortunate to have this additional residency spot here in Ellensburg because as far as what the community could do to pull in new doctors I don’t think there is anything better,” says Bullfinch.

Vaughn grew up in Washington and he and his wife plan to stay in the Northwest. But two-thirds of the graduates of Pacific Northwest University have to leave to find their residencies. Unlike other medical schools in the region, the one in Yakima is not attached to a teaching hospital.

Jeff Pryor is another graduate of PNWU. He and his wife also want to stay in the area, close to family. But for his residency Jeff had to relocate to Traverse City, Michigan.

And he is not sure he’ll come back.

“I think one of the draws is that it’d be easy to stay here," Pryor says. "I know who I’d do my referrals to because I’d worked with them, and it’s kind of comfortable because I’ve settled in here.”

Dr. Roger Rosenblatt says, "It’s unlikely that a very high proportion will come back.” He is a professor of Family Medicine at the University of Washington and studies medical issues in rural areas.

“The best predictor of where somebody will go into practice is where they will took their residency and a good proportion end up practicing within a 100 miles of where they finished their residency," explains Rosenblatt.

It’s a trend that leaders at Pacific Northwest University are hoping to buck.

“Now even if they go to Massachusetts for three years of residency I think there is a strong chance we could get them back here to practice," says Dr. Mike Maples, who chairs the Board of Trustees for the school. "I think the University is achieving its mission in terms of producing physician interested in primary care and in serving underserved populations.”

But the biggest challenge to starting new residency programs is money.

Dr. Don Weaver is Chief Medical Officer for the National Association of Community Health Clinics. He says the federal government does provide money for medical education but there’s been a cap on residency funding since 1997.

“There is going to need to be some sort of relaxation of the cap or people looking at alternative ways of funding residency training, and or both, if residency positions are going to be expanded,” Weaver says.

It’s a little like the chicken and the egg scenario. But Roger Rosenblatt at the University of Washington is hoping that equation will change when more people have access to health coverage under Obamacare.

“So lets be optimistic about this," Rosenblatt says. "We have the egg in the new healthcare system, so lets start building some really innovative chickens.”

In the meantime Pacific Northwest University has doubled its enrollment this year. And that means more osteopathic medical students will be looking for open residency spots.

On the Web:

Pacific Northwest University - official site

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