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The Rent vs. Mortgage Analogy Why should Idaho create a medical education program? Doesn’t buying seats do the job? Providing medical education is a lot like putting a roof over your head. You can rent or you can buy . One provides shelter on a month-to-month basis ; the other adds the benefits of autonomy and equity . One is buying a service; one is making an investment. In times of economic downturn, growing medical education (professors, staff, clinicians and students) in state makes even more sense and will have a substantial economic payoff.
Idaho’s Matured Health Care Education WWAMI has worked up to this point. Why not expand it? We have matured since that arrangement began more than 30 years ago. During that time, Idaho has made investments in its own health profession programs and partnerships. We have what it takes to build our own program now. Students who complete their education here are more likely to set up practice here helping to improve one of the lowest physician-to-population ratios in the nation.
Cost to Start Up What would it cost to start our own medical education program?
Roughly $11 million of one-time funding , and about $21 million in interim financing. This would allow for:
hiring some additional faculty
a dean and other administrators
investing in some facility expansion and equipment
Interim financing is the funding required to pay upfront operating costs, separate from startup costs. This financing could come from any combination of three sources:
gifts and donations
Getting Accreditation What does it take for medical program accreditation?
A medical education program requires:
faculty to teach
administrators to operate
locations for students to undertake:
The accrediting agency estimated this model could be in place in Idaho by 2012 and ready to accept 60 medical school students by 2014 .
Ongoing Funding What would it cost to continue to fund the medical education program? If students were charged the same tuition as WWAMI currently charges, state support would total $6.6 million annually for 60 students per class, with a total enrollment of 240 students. Students could bear the full cost by paying a $46,952 annual tuition , or pay half the expense at $23,476 annual tuition. Of course, other proportions of student-to-state cost burden could be proposed.
ISU as a Lead Institution Why should ISU lead the state in a medical education program? Education in the health professions (which includes medical education) is ISU’s State Board of Education (SBOE) assigned area of both unique and primary emphasis in the state. (BSU has public policy and urban regional planning; UI has agriculture, architecture, law, and natural resources.) ISU offers 75% of the health professions degrees offered in Idaho . BSU offers 16%, and UI offers less than 9%.
Idaho’s Educational Planning How has the State Board of Education indicated Idaho State University as the right institution to lead the medical education program effort? The SBOE asked for medical-education-experienced applicants when hiring for ISU’s current presidency . Each of the four finalists had medical-education experience. The SBOE also included a medical degree (MD) in ISU’s eight-year plan.
State Board of Education-approved statewide health professions mission
“ The university … has specific responsibilities in delivering programs in the health professions.
"Idaho State University will formulate its academic plan and generate programs with primary emphasis on health professions, the related biological and physical sciences, and teacher preparation.”
SBOE-approved eight-year plan includes MD degree
Begin offering in 2010-2011 academic year (p. 58)
SBOE-Approved Missions Institution Unique Programs Statewide Primary Emphasis “ Regional” or Continuing Emphasis Idaho State University Health Professions Health-Professions-related Biological and Physical Sciences Teacher Preparation Business Education Engineering Technical Training Boise State University Public Policy and Urban Regional Planning Business and Economics Engineering Social Sciences Public Affairs Performing Arts Teacher Preparation Health-Professions-related Biological and Physical Sciences Education University of Idaho Agriculture Architecture Law Natural Resources Agriculture Natural Resources Metallurgy Engineering Architecture Law Foreign Languages Teacher Preparation International Programs related to Primary Emphasis areas Responsible for Regional Medical and Veterinary Medical Education Programs in which the State of Idaho participates Business Education Liberal Arts Physical, Life and Social Sciences
29 video conferencing configurations, ranging from 8-200 students
Pocatello - 13 classrooms
Boise - 9 classrooms
Idaho Falls – 8 classrooms
Twin Falls – 2 classrooms
Coeur d’Alene – 1 classroom (shared with University of Idaho)
Meridian – At least 3 classrooms planned
Inventory: ISU Residencies Family Medicine Dentistry Pharmacy MD and DO: 3 years DDS: 1 year PharmD: 1 or 2 years (8 total residencies) 65 Graduates 43 Graduates 116 Graduates Started in 1992; full GME accreditation. Started in 2000, expanded to Boise in 2005; Accreditation with ADA, Council on Dental Accreditation in 2001. Expansion site is pending. Started in 1992, full American Society of Health-Systems Pharmacists accreditation.
ISU Medical Residencies: Idaho Sites for Graduate Practice
Where appropriate, create courses to be shared by existing health-medical education programs, such as:
Joint faculty appointments between medical education and appropriate campus departments
How a Medical Education Program Will Benefit Practicing Health Care Professionals and Organizations
For Practicing Professionals: What Med Ed Can Build
Idaho referral network across health care providers for education, research and services
Stronger political alliances to improve health care
Idaho Academy of Medicine to recognize Idaho advances in rural medicine
Idaho clinical faculty with the greatest retention and recruitment of physicians who desire teaching, better workload distribution and research
Improved reputations and recognition
Endowments, clinical trial access and other resources to improve clinical salaries and facilities
Stronger base for expanded residencies and opportunities to sub-specialize within scopes of practice
network for better IT and medical record system, reducing overhead for private practice groups
Enhanced Opportunities for Practicing Professionals
Practice across state lines by building political alliances in rural border areas for coverage
Qualification for clinical trials from government and private industry
Participation in entrepreneurial efforts
Build preventive medicine programs that improve healthcare and reduce emergency room needs
Build rural Idaho extended care by networking with physicians and other health professionals
For Practicing Professionals: What Med Ed Can Enhance
Provide an Idaho source of continuing medical and health professions education
Partnership access for building new infrastructure from government, philanthropy and/or private sources through grants, contracts and/or donations
Get national attention/recognition to invest in Idaho medical opportunities and programs
Federal funding for health professions which requires medical education as a component
Strengthen the quality of existing health professions programs
Provide for structured interdisciplinary education opportunities as recommended by the Institute of Medicine
How a Medical Education Program Will Benefit Research and Associated External Funding
Examples of Medical Research Collaborative Projects * All examples taken from collaborations between U. of Indiana School of Medicine and the Indiana University-Purdue University Indianapolis. Medical Discipline Partner Discipline Research Area Neurosurgery Mathematics Mathematical modeling and real time analysis of brain activity in neurological disease (Center for Mathematical Biosciences) Pharmacology Chemistry Medicinal chemistry/new drug synthesis Anatomy Computer and Information Science Analysis and modeling of facial features in fetal alcohol syndrome Medical Records Computer and Information Science Health information database security and access Pediatrics Geology Correlation of soil lead content, weather patterns, children’s outdoor play activities, and blood lead levels in children (Center for Environmental Health) Radiology Physics, Chemistry Development of new medical imaging methods Radiology Nuclear engineering, Physics, Chemistry Medical isotope production for disease diagnosis
Examples of Medical Research Collaborative Projects * All examples taken from collaborations between U. of Indiana School of Medicine and the Indiana University-Purdue University Indianapolis. Medical Discipline Partner Discipline Research Area Medicine Philosophy Medical ethics/bioethics Public Health, Nursing Art, Computer & Information Science Contemporary digital videos to discourage young women from smoking Medicine History History of medicine Medicine Sociology HIV risk and behavioral choices Medicine Engineering Biomedical engineering, e.g. of heart devices or biocompatible materials Medicine Economics Health care economics Pathology Chemistry, Law Forensic Science Medicine Public Affairs Analysis of smoking behavior; smoking policy development (Center for Health Policy)
How a Medical Education Program Will Benefit Academic Programs
Examples of Interdisciplinary Medical Education Programs * All examples taken from collaborations between U. of Indiana School of Medicine and the Indiana University-Purdue University Indianapolis. Medical Discipline Partner Discipline Program Medicine Engineering Ph.D. in Biomedical Engineering M.D. Natural Science or Biomedical Engineering M.D.-Ph.D. Medicine, Biostatistics Mathematics Ph.D. in Biostatistics M.D. Business M.D.-M.B.A. Pathology, Pharmacology/Toxicology Chemistry, Biology M.S. in Forensic Science
Estimated Phased Cost Analysis of a Medical Degree Program
Idaho Medical Degree Program * Based on 60 students admitted annually MEDICAL EDUCATION BASE Administration $1,693,000 Faculty (full-time institutional faculty) 4,854,000
Total Personnel Related
$6,547,000 PROGRAM COSTS 1,045,000
$7,592,000 REGIONAL CLINICAL SITES Administration $753,000 Faculty (clinical affiliates, partial FTEs) Program Costs and Rotations 646,000 2,277,000
Operating Costs: First Years of Classes Year 1 Year 2 Year 3 Year 4 Administration 1,692,774 1,692,774 1,692,774 1,692,774 Faculty 4,438,558 4,854,489 4,854,489 4,854,489 Program 901,550 1,044,900 1,044,900 1,044,900 Clinical 603,357 1,636,386 3,676,386 3,676,386 TOTAL 7,636,239 9,228,549 11,268,549 11,268,549 Revenue 2,817,136 5,634,272 8,451,408 11,268,549 Net Difference -4,819,103 -3,594,277 -2,817,141 0
One-Time Startup Costs for Idaho MD Program 60 students per year; 240 total enrolled. PLUS: Facilities (leveraging existing facilities for didactic instruction) $3,502,000 Faculty startup packages 5,000,000 Additional instructional equipment 200,000 Faculty and staff recruitment and relocation 2,337,300 TOTAL $11,039,000 Interim Financing $21,000,000
Funding Options 60 students per year; 240 total enrolled. Option Student Tuition Level From Tuition State Support Total Funding Students pay all costs $46,952 $11,268,545 $0 $11,268,545 Students pay half of costs $23,476 $5,634,272 $5,634,272 $11,268,545