Medical students study in their home state

You can drive for a long time in Wyoming and see hardly anyone, says Jarod McAteer, M.D. ’09. Juneau, Alaska, says Cassie Iutzi, is accessible only by boat or plane. And KayCee Gardner, who spent some of her early years in a one-room schoolhouse in Montana, went from “having a backyard that stretched for miles” to having a few square feet of grass when she moved to Seattle.

McAteer, Iutzi, Gardner: all are from rural or remote areas, all are transplants to Seattle (albeit temporarily), and all share a special kind of WWAMI experience.

A central characteristic of the WWAMI program is the relationship between the UW School of Medicine and other academic institutions in the five-state region. While some students spend their first two years of medical school at the University of Washington in Seattle, others spend their first year at their WWAMI state university and their second year in Seattle. In their third and fourth years, all students travel to sites throughout the WWAMI region — in Seattle and outside it — to complete medical clerkships: hands-on training with patients, supervised by doctors.

The logic behind this educational plan is simple. WWAMI educators want students from those first-year WWAMI sites to return to their home states to practice medicine. The need for doctors in WWAMI — a largely rural area underserved by medical practitioners — is high. (In fact, according to the Association of American Medical Colleges, four out of five WWAMI states have fewer physicians than the national average: 254 doctors for every 100,000 people.)

After 82-year-old Margaret Engelhardt underwent surgery to mend a broken leg, Cassie Iutzi, a third-year medical student from Alaska, listens to her breathing and talks to her about osteoporosis medication and fluid buildup. Such interactions are par for the course in a medical student’s rotations; this one was conducted at Northwest Hospital & Medical Center.

Jarod McAteer, M.D. ’09, found it helpful that faculty and staff visited Laramie during his first year of medical school, dispensing advice on classes and life in Seattle. Now in residency, he’s shown here with a trout caught in Yellowstone Lake, Wyo.

Students find the first year in their home state helpful, even wonderful. One huge advantage, says McAteer, is getting to know the 20-some students in the local class. Even after you move to Seattle, he says, “you always have something in common with students from your first year.”

That kind of camaraderie is reassuring when finding your way in a new place. Iutzi remembers half of her Alaska class gathering at the Port of Seattle to unload the shipping container they’d rented to move their belongings. “It was like a small community in the late 1800s, packing up everything into their covered wagons and moving to a new town,” she says.

Still, the transition from the home state’s site to the Seattle site can be a challenge. The student-teacher ratio is vastly different (each second-year class has 220 students), and you have to learn the ropes all over again. But the School of Medicine steps in to help students from regional sites adjust.

Medical student KayCee Gardner comes from ranch country in Montana. She’s on the far left, one of a group of people gathering cattle for branding.

“The best thing [the School] did was build the College Program,” says Gardner. In the Colleges, students are assigned to small groups under the guidance of a mentor; they get to know that mentor from day one of medical school, no matter what their location. During the second year, they work closely with their mentor, learning clinical skills at the bedside and in small-group settings. And during medical students’ third and fourth years, they stay in touch with their mentor — by email, telephone and, when geography works in their favor, in person.

Although Gardner, McAteer and Iutzi have a shared WWAMI experience, their backgrounds are quite varied. Gardner grew up on a Montana ranch and spent part of the summer helping her family harvest hay. McAteer completed his undergraduate degree at Yale but found that he preferred living out west. Iutzi, who is working on a master’s degree in public health as well as an M.D. degree, volunteers in community-based clinics in Ecuador and Nicaragua.

Even so, the WWAMI program is attractive to them for similar reasons. It keeps them connected to their home state. “I really liked the idea of coming back to Montana to do clerkships,” says Gardner. She, McAteer, and Iutzi all hope to return home — or someplace very much like it — to practice.

SUCCESS RATES

If WWAMI is engineered to educate people from the region to practice medicine in the region, how’s it doing? The answer is: remarkably well. “WWAMI continues to be the model that people look to when they talk about regional medical education,” says Suzanne M. Allen, M.D., MPH, UW School of Medicine vice dean for regional affairs. Here are the statistics.

Do WWAMI students return to their home state to practice?
Yes
— and the four WWAMI states for which figures are available are above the national mean.

Do WWAMI students (regardless of their home state) return to WWAMI states to practice?
Yes.

Do residents return to the state where they did their residency to practice?

Yes — and four WWAMI states are above the national average in their return rates.