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9/13/2017

1

Current and Future State of the Healthcare Workforce in

Montana

Cindra Stahl, Assistant Director

Montana Area Health Education Center/

MT Office of Rural Health

MHA Fall Convention

September 20, 2017

Panel Presenters

• Cindra Stahl: Statewide Strategic Plan Update

• Amy Watson: Department of Labor and Industry, Labor Market Outcomes for Montana Colleges

• John Cech: Office of the Commissioner of Higher Education, Healthcare Education and Workforce coordinating Council

• Mike Spinelli: Montana WWAMI, Program Updates

Who are we?

• AHEC Program office at MSU, College of Nursing• Statewide Office

• Five regional centers:• University of Montana (Western)

• RiverStone (Eastern)

• Montana Health Network (Northeastern)

• MT Health Research and Education Foundation (North Central, South Central)

• Healthcare Workforce Advisory Committee• Active group for 11 years

• Open forum for discussion and strategic panning on healthcare workforce issues

• Membership is voluntary and broadly representative of the state

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Montana’s healthcare workforce

• Added over 2150 jobs over the last year, ~7300 during the last five years. Projected to add 1300 new jobs per year

• Tight labor markets across the state, all sectors. Healthcare is competing for new workers with other employment sectors.

• Large Baby Boomer generation is retiring, but not enough young people to replace them

for example, MT has 3rd oldest physician population in the US

• Healthcare jobs typically require post‐secondary education, the pipeline is looooong.

Statewide Strategic Planning

• 2007‐2008: Version 1.0• Council appointed by Governor’s Office and OCHE• Staffed by AHEC• Recommendations made to the Board of Regents:

• Medical Education

• Nursing

• Allied Health

• 2011: Version 2.0• Broad representation of nearly 100 voluntary participants, depending on topic area

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Statewide Strategic Planning

• Chapters are written by profession/sector “experts”

• Chapters are reviewed by full Workforce Advisory Council

• Revision/edits

• Chapter is adopted for the plan

Current Version 3.0• Research and writing followed same collaborative process

• Same format as 2011

• Published early 2017

• Widespread recognition and utilization of the plan across the state• HealthCARE MT

• OCHE Healthcare Coordinating Council

M

MONTANA HEALTHCARE WORKFORCESTATEWIDE STRATEGIC PLAN

Overall Strategies• EngageMontanans in understanding and addressing the State’s healthcare workforce needs• Increase capacity to analyze the state’s healthcare workforce and develop data sets to provide clear, comprehensive and actionable information about Montana’s healthcare workforce.

• Educate and Train Montana’s healthcare workforce• Develop and support the healthcare workforce pipeline in order to “Grow Our Own.” Support our own residents to become the healthcare workforce of the future.

• Recruit health professionals to Montana’s health professions shortage areas• Develop a “culture of learning” in rural/frontier healthcare communities

• Retain a skilled healthcare workforce• Develop career ladder and skill development programs that allow rural healthcare workers to obtain degrees and certificates or to advance in their careers

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Profession/Sector specific

• Allied Health/Therapists

• Behavioral Health

• Care Coordination

• Community Health Workers

• Dental/Oral Health

• Direct Care Workers

• Healthcare Workforce Diversity

• Emergency Medical Services

• Health Care Administration

• Health Information Technology

• Medical Laboratory Scientists and Technicians

• Nursing

• Pharmacy

• Physician

• Physician Assistant

Appendix

• HealthCARE MT

• Workforce maps

• Additional resources

• Used for grant writers

Monitor progress and accomplishments

• For example…

• WWAMI and GME expansion in the state

• Move to develop Dental School

• OT program in development between UM and MSU Billings

• Development of MLT program in Miles City (associated with ND)

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Triple Aim (not the one you’re used to seeing…)

Education/

Training

EmployersDepartment of Labor

What’s next?

• Unprecedented synchronicity between workforce sectors—recognition that sectors must work together, siloed efforts can’t accomplish as much as coordinated

• HealthCARE MT

• Apprenticeships

• Pathways programs (OPI)

• Move to multi‐disciplinary or inter‐professional learning and experiences.

Work based learning

• “workers with an existing connection to a Montana business during their school years through an internship or other work‐based learning activity are more likely to remain in Montana after graduation.”

• Career pathways in high school, dual credit, HOSA

• Can be as simple as job shadow to as complete as apprenticeship.

• Don’t overlook existing staff. Distance learning opportunities.

9/13/2017

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Statewide College Workforce Report

Presented at the MHA Convention

September 20th, 2017

AMY WATSON

Economist

MT Dept. of Labor and Industry

[email protected] | 406‐444‐3245

Forecasted Labor Market Tightness

Source: MT DLI Labor Force and Employment Forecasts, 2016 to 2026

Statewide College Report

Pilot project for Missoula College met with rave reviews.

Involved cooperation across three state agencies, 16 public colleges, and 2 private colleges.

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Graduates from 2001‐02 to 2014‐15

~ 100,000 graduates

~ 113,000 degrees

18 Montana colleges

Data on Graduates

What’s in the Report?

Student Data Trends

Measuring Worker Demand

job openings due to growth

Growth

Demand Range

Retirements Job‐to‐Job

Colleges may also need to train

existing workings looking to change

careers.

Minimum training needs =

+ retirements

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Supply and Demand Analysis

Are there needs that aren’t met by Montana

Colleges?

Most are high‐level healthcare jobs

of high‐demand jobs requiring a college degree cannot be filled by graduates from MT colleges

of high‐demand jobs are undersupplied

New Program Development Areas

Supply and Demand Analysis

Are the existing programs producing enough

graduates?

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Supply and Demand by ProgramHealthcare Programs

Source: MTDLI 2015‐2025 occupational employment projections. OCHE, RMC, and CC graduate data. Demand is sum of all occupations a graduate from the program could fill. Supply is average over last three academic years.

0 200 400 600

Health Science, Other

HIT and Medical Coding

Health Care Office Management

Medical Admin Assistant

Allied Health Diagnostic, Intervention, Treatment

Respiratory Care

Surgical Technology

Physician Assistant

Health Tech/ Assistant

Pharmacy

Physical Therapy

Registered Nursing

Practical Nursing

Number of Graduates

Undersupplied

Meets Demand

Oversupplied

Demand Range

1. Only 56% of Montana College RN graduates hold a BSN• $2,000 income premium for bachelor’s degree attainment

Source: Montana Department of Labor and Industry (MT DLI) 2015‐2025 employment projections.

OCHE MUS, Rocky Mountain and Carroll College graduate data. Income data from Montana

Department of Revenue (DOR).

May Still be Difficult to Hire Nurses

Wage Premium for Bachelor’s DegreeDifference in wage earnings for associate vs. Bachelor’s

Source: MTDLI, OCHE MUS, RMC, and CC graduate data wage match. Allied health excludes

surgical technology and respiratory care. *= Certificate of Applied Science graduates.

Inform

ation Technology

Construction Enginee

ring

HIT and M

edical Coding*

Secondary Education

Early Childhood Education

Transport/M

aterial Moving

Hea

lth Tech/ Assistant

Visual &

Perform

ing Arts

Registered Nursing

Enginee

ring Tech, Other

Public Safety

Allied Hea

lth Diagn

ostic,

Interven

tion, Trea

tmen

t

($20,000)

($10,000)

$0

$10,000

$20,000

$30,000

$40,000

Wage Premium Five Years after Graduation Associate’s Earns

Same or More

Bachelor’s Earns More

$36,370

$1,460

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2. Geographical distribution mismatches





Program Supply and Demandby Region

Source: MTDLI 2015‐2025 occupational employment projections and OCHE, RMC, and

CC graduate data.

Program Category Program NW SW NC SC E

Health Professions

Health Science, Other

HIT and Medical Coding

Health Care Office Management

Medical Admin Assistant

Allied Health Diagnostic, Intervention, Treatment

Respiratory Care

Surgical Technology

Physician Assistant

Health Tech/ Assistant

Pharmacy

Physical Therapy

Registered Nursing

Practical Nursing

Migration Helps Fill Gaps

Source: MTDLI, OCHE MUS, RMC, and CC graduate data wage match. Excludes years prior to 2010 due to lack of region 5 data. Arrows show net migration between regions.

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2. Geographical distribution mismatches

3. Backlog of unfilled openings from years of undersupply• RN capacity only exceeds demand since 2011‐12





[SERIES NAME]

Bachelor's Degree

Associate Degree

0

100

200

300

400

500

600

Number of Registered Nurses

Meets Demand


OCHE MUS, Rocky Mountain and Carroll College graduate data.

Growth in College Capacity for RNs

Workforce Outcomes by Program

Source: DOR, OCHE, RMC, and CC income data match summarized by MTDLI. Earned income is defined as lines 7, 12, 17, and 18 on the Montana income tax return, not including farm income.

[CELLRANGE]

[CELLRANGE]

[CELLRANGE]

[CELLRANGE]

[CELLRANGE]

[CELLRANGE]

[CELLRANGE]

[CELLRANGE]

[CELLRANGE]

[CELLRANGE]

[CELLRANGE][CELLRANGE]

[CELLRANGE][CELLRANGE]

[CELLRANGE]

0

10,000

20,000

30,000

40,000

50,000

50% 60% 70% 80% 90%

Median Real In

come One Year After Graduation

Percent Filing (Resident and Non‐Resident)

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Workforce Outcomes by Program

Source: DOR, OCHE, RMC, and CC income data match summarized by MTDLI. Earned income is defined as lines 7, 12, 17, and 18 on the Montana income tax return, not including farm income.

More Information at lmi.mt.govAMY WATSON

Economist

MT Dept. of Labor and Industry

[email protected] | 406‐444‐3245

9/12/2017

1

HealthCARE MONTANATransforming college healthcare education

into a statewide workforce system

$14,998,597• 18 Consortium Partners• 39 Employer Partners signed LOC

• Currently over 200 employer partners

October 1, 2014—September 30, 2018

A Homegrown Solution for Montana’s Healthcare Workforce

HealthCARE MONTANA Consortium College Partners

• Bitterroot College UM, Hamilton

• Blackfeet Community College, Browning

• City College at MSU‐Billings, Billings

• Chief Dull Knife College, Lame Deer

• Flathead Valley Community College, Kalispell

• Gallatin College‐MSU, Bozeman

• Great Falls College‐MSU, Great Falls

• Helena College‐UM, Helena

• Miles Community College, Miles City

• Missoula College UM, Missoula

• Highlands College of Montana Tech, Butte

• University of Montana‐Western, Dillon

• Montana State University‐Northern, Havre

• Salish Kootenai College, Pablo

• Stone Child College, Box Elder, MT

HealthCARE MT Consortium Colleges

9/12/2017

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HealthCARE Montana Employer Partners

HealthCare Montana Current Employers

Student SupportHealthcare Industry

EngagementCurriculum

Development

Accelerated pathway:

CNA – BSN; separate LPN

track

Health professions

career coaches

Common Core

curriculum

Apprenticeships

Statewide assessment –

credit for prior learning

Online tutoring,

EdReady, MCIS

Statewide clinical

placement

Distance Education

Healthcare Workforce

Transformation

Nursing curriculum redesign

Desired Outcomes1. Improve healthcare training

opportunities in Montana with particular focus on rural

2. Secure successful employment for students with attention to adult learners and veterans

9/12/2017

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• Practical Nurse Certificate of Applied Science• 5 colleges offering PN

• Associate of Science Registered Nurse

• ASN to post‐licensure BS Registered Nurse

OutcomesReduced time to completion and reduced cost

Quicker entry into the workforce

Increased utilization of distance learning

Increased access for adult learners

Nursing curriculum redesign

Accelerated pathway for CNA

to BSN with a separate LPN

track

5 Regional Workforce Coordinators

Initial needs assessment‐125 from a wide variety of employer types

WFCs coordinated regional Advisory Councils

Utilized the rapid response survey system for immediate employer input on critical HC MT activities

Maintain and sustain relationships with over 200 MT health care employers

Employer Requested Webinar—52 Attendees

Meanwhile…..

Provided the ‘foot in the door’ for apprenticeship program and help lay the foundation with interested employers

Local employer

engagement

• Creating Access to Rural Education & Employment

• WFC, AS, CC, Employers critical to have distance education (Plentywood to MCC 210 miles 3.5 hours to CC 355 miles 5.5 hours)

• Distance PN Process

• PN,CNA specialties, CNA Success Skills Modules, CNA, Behavioral Health, Community Health Worker

Distance Education

9/12/2017

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• Pilot with Kalispell Regional Medical Center and 3 schools

• FVCC, SKC, MSU‐B in Kalispell

• Program went live Spring semester 2017

• Discussion began to add Missoula Community Hospital & Saint Patrick Hospital and three area nursing programs

Statewide clinical

placement

•All available with active enrollment

• Students can engage via a Career Coach or directly

•CC outreach to target audiences• Career planning• Obtaining resources• College enrollment

Health Professions

Career Coaches

EdReadySmarthinking

MCIS

• Board of Regents passed prior learning assessment (PLA) policy

• Campuses developed a PLA process

• Campuses agreed on a common transcripting policy

• PLA Council created to provide guidance to campuses.

•Military Crosswalk Committee • Nursing Military Crosswalk Guide

• Template for other healthcare

education programs

Statewide Prior LearningAssessment

9/12/2017

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The Numbers101 healthcare apprenticeships as of 08/29/17

39 apprenticeship sponsor employers

14 registered healthcare apprenticeship occupations:

CNA; Advanced CNA; CNA Dementia; CNA Restorative; Medication Aide II

Assisted Living Facility Administrator; Long Term Care Facility Administrator

Computed Tomography Technologist; Pharmacy Technician; Emergency Medical Services

Practical Nursing

Medical Claims; Medical Scribe; Pre‐Coder

Apprenticeships

You might have to work hard to get an apprenticeship but so many jobs open up to you(MurdoMacleod for the Guardian)

Apprenticeship Program Locations

• Alignment of pre‐requisite courses and Allied Health Core Curriculum across ~150 academic programs. Emphasis on laddering and latticing.

• Four faculty/employer committees met bi‐weekly to identify core competency areas, crosswalk to courses, identify innovative curricular delivery and implementation, and identify career ladders and pathways.

• Through a series of Healthcare Summits, convened over 75 Montana healthcare employers, faculty, and industry representatives to review and provide input and feedback on the Allied Health Core Curriculum Model and competencies. Employers provided input into stacking credentials.

• Conducted campus site visits with Allied Healthcare faculty for feedback on final competency model, common pre‐requisites and core curriculum courses and identified existing lattices. This led to development of 2 healthcare math courses and a restructuring of the Anatomy and Physiology sequences.

Common Core

Curriculum

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Desired Outcomes1. Improve healthcare training

opportunities in Montana with particular focus on rural

2. Secure successful employment for students with attention to adult learners and veterans

Tribal College Accomplishments

Highlands‐Online Behavioral Health

Certificate or Endorsement

CNA Restorative, Dementia,

Advanced Caregiving for CNAs

GFC‐Medical Scribe MHN—Distance CNA

Gallatin‐Surgical Technology in

Collaboration with GFC

LEAD

Helena College‐Ongoing Preceptor and

CRRN Training

Separate and distance PN

SKC‐MA, CNA, EMT, Phlebotomy Allied Health Career Essentials

Bitterroot‐‐Phlebotomy MSU B BSN

MSU Northern—Phlebotomy, EMT Aaniiih Nakoda—ASN

Western—Phlebotomy City College—CNA, MOU with

Missoula College to offer Pharm Tech

Additional or Enhanced Programs

HealthCARE Montana Developed 43 New or Enhance Programs

24 New Programs

Additional or Enhanced Programs

HealthCARE Montana Developed 43 New or Enhance Programs

19 Enhanced Programs

GFC‐Pharmacy Technician: Hybrid Delivery, Dental Assistant Hybrid Delivery,

Medical Assistant in Collaboration with Missoula College

FVCC‐Patient Relation Specialist Apprenticeship, Online Math 094, Online

Transition Course from LPN‐RN, Pre‐coder

Miles‐Medical Lab Technician Distance Delivery & Apprenticeship, Phlebotomy

Distance Delivery & Apprenticeship

Montana Tech‐Recruiting ASNs into the BSN Completion Programs

ASN at 9 colleges

Distance BSN Completion at 2 colleges

Bitterroot College—CNA

Missoula College—Distance Pharmacy Tech (Apprenticeship), Surgical Technology

Apprenticeship, Medical Claims Apprenticeship, Computed Tomography

Technologist

City College—Paramedic Apprenticeship, PN Apprenticeship

9/12/2017

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Healthcare Education & Workforce Coordinating CouncilPurpose:

• Advise Commissioner, Board of Regents, Governor, & legislative entities on healthcare education and workforce issues and policy

• Ensure the Montana Healthcare Education and Workforce Strategic Plan is adopted and a work plan implemented

• Ensure healthcare educational programs and workforce entities cooperate in addressing workforce issues

• Identify resources to support healthcare education and workforce initiatives

• Evaluate annually the performance of key healthcare education and workforce initiatives

What’s left to do?• Continue to recruit students and support them thru to graduation and eventually employment

• Continue work with rural facilities assisting in their efforts to grow their own health care workers

• Phase out strategy• Allied Health Core Curriculum – complete module development, approval, implementation

• Expanding Student Clinical Tracking Database• Distance

• Complete CNA Specialty programs• Find homes for non‐campus online programs to live on after the grant

• Finalize Sustainability plan

9/11/2017

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Mike Spinelli MD, FACPAssociate Director, MT WWAMI – MSU

A WWAMI Update

The WWAMI Program:Founding Goals (1971)

1) Access to Publicly Supported Medical Education

2) Avoid excessive capital costs by using existing educational infrastructure

3) Create Community-Based Medical Education

4) Expand GME and CME across WWAMI

5) Increase the number of primary care providers (MD) /address maldistribution of physicians

9/11/2017

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Improving the health of Montanans by educating future physicians dedicated to providing care for communities across the state.

Montana WWAMI Mission Statement

Montana WWAMI figures:• About 100 students/year apply; must be MT residents• 55-75 are interviewed by a committee of MT physicians with some

UW representation• 30 students are admitted per year (increased from 20 in 2013)• Students spend the first 18 months in Bozeman (starting 2015)• New facility at Bozeman Health opened Aug. 2016• Students now start clinical clerkships in March of 2nd year• ~25/30 do most of the required clerkships in MT• 350 clinical faculty teach 40 required clerkships in 17 communities• 150 students from all WWAMI states do clerkships in MT each

year• Historically 41% of graduates have practiced in MT (57% return if

counting those from all WWAMI states)

Clinical Training Options in WWAMI for required clerkships

• WWAMI safari: 5-state region to choose from for clerkship sites (at least 3 of 6 required clerkships outside of Seattle)

• Tracks – 4 of 6 clerkships done in one area

• Missoula, Billings, and Bozeman (new in 2014)

• Spokane, Anchorage, Idaho, Olympia

• WRITE : 5 month longitudinal clerkship in one rural or underserved site; in MT this option is only for students in the TRUST program (starting 2017, 12/30 students are in TRUST)

All students spend minimum of 12 weeks at UW hospitals (required or elective clerkships)

E15 WWAMI students – first class in the new curriculum

9/11/2017

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The New WWAMI Curriculum

Goals:• Introduce clinical skills earlier

• More clinical relevance to basic science content

• Integrate courses to avoid duplication, highlight connections between disciplines and organs

• Shorten time before Step 1 to allow more time for clerkships and career exploration

• Replace lecture time with active learning

• Teach lifelong learning skills

• Make content more uniform across sites

Foundations Phase Vocabulary

Blocks• 3-10 weeks long• Integrate material from old 1st and 2nd year courses

Threads (throughout 18-month Foundations Phase)• Foundations of Clinical Medicine• Primary Care Preceptorship• Anatomy and Imaging• Histology & Pathology• Pharmacology

Themes (through all years of curriculum)• Lifelong Learning• Ethics & Professionalism• Health Equity, Diversity, & Population Health

College Faculty

• Physician-mentors that “define” the profession– Commitment to academics, community, clinic, co-

workers and most importantly, their patients• Teach Foundations of Clinical Medicine

curriculum (clinical skills) alternate Tuesdays• Wed. or Thurs. morning rounds with their

group of 5• Mentor 5 students from each class for their

entire 4 years of med school • Keep preceptors in the loop (5 preceptors

each) and help with faculty development• 30 volunteer primary care preceptors spend

every other Tuesday with one student each

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Clinical Guides

• Help teach the Block material, lead case studies and other small group activities

• In most blocks class is separated into 3 small groups for ~2 hours/day

• Most Guides teach in multiple blocks throughout the year

• Some also act as Block Leaders or Co-leaders and deliver lecture material (1-2 hours/day)

E-17

Approved UW SOM Curriculum Committee TBD

Academic Year 2017 – 2018 First Year Foundations Schedule

*HFF will include: Dissection, Prosection, Ultrasound, Embryology, Imaging, Surface Anatomy†Themes will include Lifelong Learning, Health Equity, Diversity, Population/Global Health, Ethics, Professionalism, IPE/Communication, Health

Systems, Systems Improvement, and Social Determinants of Health‡Foundations of Clinical Medicine will include: Immersion, Primary Care Practicum, Clinical Skills andHospital Tutorials.§Ecology of Health & Medicine is required course content.

2w

k9/5-10/20, 2017

7 wks

1w k

10/30-12/15, 2017

7 wks

2w k

1/2-3/9, 201810 wks

1w

k

1w k

3/26 – 5/4/20186 wks

1w k

5/14-5/25/18

2wks

5/29-6/15/2018

3 wks

Imm

ersion

; Fo

un

datio

ns

of

Clin

icalM

edicin

e&

O

rientatio

n, S

ea. 8/21-9/1/17

Molecular & Cellular Basis of

Disease

Eco

log

yo

f Health

& M

edicin

e§

(10/24-10/27/17)

Invaders & Defenders

Win

terB

reak(12/18

–1/1/17)

Circulatory Systems (CPR)

Sp

ring

Break

(3/12–

3/18)

Eco

log

yo

f Health

& M

edicin

e§

(3/19-3/23/18)

Energetics & Homeostasis E

colo

gy

of H

ealth &

Med

icine

§(5/7-5/11/201

8)

MSKBlood & Cancer

• Cell Physiology & Function

• Genes, Molecules, and Signaling

• Genetic Diseases

• ImmuneSystem

• Microbial Biology

• Infectious Diseases• Inflammation&

Repair

• Skin

• Cardiovascular System

• RespiratorySystem• Renal-Urinary System• Multisystem Fluid Balance

• Metabolism & Nutrition

• Obesity & Diabetes• Gastrointestinal

Physiology• Endocrinology

Musculo-skeletal Systems: Anatomy & FunctionRheumat-ologic Diseases

• Cancers

• Heme/

Lymph

Human Form & Function* Pathology/ Histology

Pharmacology


Pharmacology


Pharmacology


Pharmacology

Human Form

& Function* Pathology/ Histology

Pharmacolo

gy

Human Form &Function*Pathology/

Histology Pharmacology

Themes† Themes† Themes†Themes† Themes† Themes†

Foundations of Clinical Medicine‡ Foundations of Clinical Medicine‡ Foundations of Clinical Medicine‡

Approved UW SOM Curriculum Committee TBD

Academic Year 2018-20192nd year Foundations Schedule

*HFF will include: Dissection, Prosection, Ultrasound, Embryology, Imaging, Surface Anatomy. †Themes will include Lifelong Learning, Health Equity, Diversity, Population/Global Health, Ethics, Professionalism, IPE/Communication, Health Systems, Systems Improvement, and Social Determinants of Health ‡ Foundations of Clinical Medicine will include: Immersion, Primary Care Practicum, Clinical Skills and Hospital Tutorials.§Ecology of Health & Medicine is required course content.

1w

k 6/25-9/3, 2018

11 wks

9/4-11/2, 2018

9 wks

1w k 11/13-12/14, 2018

5 wks

3

w

k

s

1/2-3/22, 2019

12 wks

Break

6/18/2016-6/22/2018

Research Methods, Summer Experience, & Breaks

Mind, Brain & Behavior

Eco

log

yo

f Health

& M

edicin

e§

(11/5-11/9)

Lifecycle

Win

terB

reak(12/15-1/1,

2019)

Consolidation and Transition

Research Methods Course

Epidemiology & Biostatistics

Independent Investigative Inquiry (Triple-I)

RUOP Literature Review Research Simulation Lab GHIP

• Neuroscience/Neuro anatomy

• Neurology

• Neurosurgery/Trauma

• Sensory Systems

• Psychiatry• Anesthesia/Pain

management

• Reproductive System

• Developmental

stages of life

• Aging/End of Life

• Foundations Capstone• Prep for USMLE Step 1• ResearchCompletion• Transition to Clerkship• Vacation


Pharmacology


Pharmacology

Themes† Themes†

Foundations of Clinical Medicine‡ Foundations of Clinical Medicine‡

E-17

9/11/2017

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Montana WWAMI Program - sites

TRUST Pipeline-Targeted Rural/Underserved Track

Targeted Admissions

Separate Admissions Process

• Rural background• Prior career

experience, especially health-related

• Significant volunteer experience in rural or underserved medical settings

• Strong commitment to service

18 MonthFoundations

Phase

Foundations Phase

• Underserved Pathway

• TCC visits• Rural Health

Course• TRUST mentors

FSE: First SummerExperience• Assignment:

TCC and physician mentor

• 7 to 14 day immersion at TCC prior to start of Foundations Phase

Foundations Phase(continued)

• 3 four-day TRUST focused intercessions at TCC

• WWAMI TRUST four-day leadership retreat

• Attend National or Regional meeting

• On-line journal club

Rural Underserved Opportunities Program (RUOP)4 weeks at TCC completing community-oriented scholarly project

Patient Care Phase

Patient Care Phase

• WRITE (WWAMI Rural / Underserved Integrated Training Experience) LIC for 22 weeks

• Attend National or Regional meeting

• On-line journal club

CareerExploration Phase

Career ExplorationPhase

• Electives at TCC• Residency

Linkage• Attend National or

Regional meeting• On-line journal

club

Residency

UWSOM Underserved Pathway & Mentors

Residency(including Rural Training Tracks)• TRUST graduates

choose Primary Care Residency program or residency in needed regional specialty oriented to rural or underserved settings.

• TRUST develops connections with regional residency programs

• Continue TCC linkages during residency

TRUST Continuity Community (TCC) Linkages

Starting 2017, 12 of the 30 students are in TRUST/WRITE

WWAMI Rural Integrated Training Experience (WRITE)

WRITE provides a 22 week, longitudinal integrated clerkship in the third-year in one rural/underserved site located in the WWAMI Region

• Mix of ambulatory and hospital experiences• Rural/underserved primary care • Provides outstanding opportunity for

continuity• Student becomes part of the community

Lewistown

Livingston

Miles City

9/11/2017

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WRITE Practice Outcomes

• 89 graduates into practice

• 60/89 (67%) into primary care– 38 FM

– 12 IM

– 10 Peds

• 28/89 (31%) into rural practice

Changes mandated by 2017 legislature:

• Payback!• Students admitted starting 2018 will have 2 options:

A. Sign a “clawback” agreement to practice 3 years in MT after completing residency. If you don’t return, you must pay back all “state support” (currently ~$190,000) over 10 years.

B. Pay a 2.5X higher MRPIP fee (~$13,000/yr vs. $5,224/yr currently and in Option A) to be free of the service obligation.

Great Falls

Billings(4)

Miles City

Butte

Missoula(4)

Browning

Livingston

Wolf Point

Helena

Choteau

Hamilton

Medicine Lake

Bozeman(2)

2017 MT WWAMI Acceptances–Home Towns

Glendive

Int

Surg - Surgery

InM ernal Medicine

Plevna

Whitehall

Glasgow

Gardiner

Ryegate

Polson

Charlo

Chinook

Where do Montana WWAMI students come from?

9/11/2017

7

Where do they go? 2017 Residency Match Results:Name Residency Specialty Location Hometown Totals

Cale Heather U Nevada SOM-Reno Internal Medicine Reno NV Whitefish 9 FamMed

Campbell Julie U Washington Affil Hosps Pediatrics Seattle WA Bozeman 5 IntMed

Chaloux Tiffany St. Mary's Hospital Family Medicine Grand Junction CO Bozeman 3 Peds

Cornish Daniel U Washington Affil Hosps Family Medicine Seattle WA Butte 5 Gen Surgery

Gaul Corey U Arizona COM at Tucson Emergency Medicine Tucson AZ Missoula 1 IM prelim; wants Psych

Goldes Matthew Mt Sinai Med Ctr-Miami General Surgery Miami Beach FL Helena 1 EmergencyMed

Hansen Orin Ventura County Med Ctr Family Medicine Ventura CA Ekalaka 1 Interventional Radiology

Hatcher Megan U Illinois COM-Chicago Family Medicine Chicago IL Bozeman

Hubbard Anna St Joseph Hospital SCL Hlth General Surgery Denver CO Helena

Lackman Kena Family Medicine Res of ID Family Medicine Boise ID Hysham

Loomis Nick Tacoma Family Medicine Family Medicine Tacoma WA Anaconda

Mansch Abigail VA Medical Ctr-Boise-ID Internal Medicine Boise ID Missoula

*McNulty Bridget U Washington Affil Hosps Medicine-Preliminary Seattle WA Great Falls

Middleton Julia U Wisconsin SOM Family Medicine Wausau WI Billings

Miller Helen U Michigan -Ann Arbor Internal Medicine Ann Arbor MI Great Falls

Nelson Melanie U Utah Affil Hospitals Pediatrics Salt Lake City UT Kalispell

Ness Tara Baylor Coll Med-Houston Pediatrics Houston TX Missoula

Pihl Caroline North Colorado Med Ctr Family Medicine Greeley CO Pray

Scranton Cameron North Colorado Med Ctr Family Medicine Greeley CO Missoula

Semmens Ashlea Central Iowa Health System General Surgery Des Moines IA Glendive

Steffens Joseph Hennepin Co Med Ctr-MN Internal Medicine Minneapolis MN Helena

Stringam Jeremiah U Texas Med Sch-Houston Interventional Radiology Houston TX Belgrade

Wilson Ida Virginia Mason Med Ctr General Surgery Seattle WA Bozeman

Wright Whitney Virginia Mason Med Ctr General Surgery Seattle WA Butte

Young Scott Univ of Vermont Med. Ctr. Internal Medicine Burlington VT Alberton

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