CARBONDALE — The SIU School of Medicine is planning major additions to its curriculum that would bring more medical students, physician assistants and doctors to Carbondale and areas of rural Southern Illinois where they are desperately needed, administrators announced Wednesday.
Currently, SIU med students receive the majority of their education in Springfield. But under the Lincoln Scholars program, a select group of students would be trained entirely in Southern Illinois, with new classes at SIUC, and new clinical rotations and residency opportunities at area hospitals.
The goal, administrators say, is to groom the next generation of rural caregivers, as health care becomes increasingly concentrated in urban areas.
“We think this will spawn an entirely new type of medical education,” Jerry Kruse, dean of the medical school, said Wednesday. “There’s a significant need for better healthcare and medical training in rural areas, and there’s need for comprehensive primary care across the United States.”
The program will take years of planning, new approvals from regulatory agencies, and a big helping hand from area hospitals, administrators acknowledged. But the rural health care shortages plaguing the U.S. demand that the med school try a new approach, said Dr. James Daniels, SIU School of Medicine's assistant dean for student affairs.
Currently, the medical school has over 500 graduates in 66 counties of central and Southern Illinois, the region the school was created to serve.
But a recent School of Medicine analysis found those doctors are heavily concentrated in metropolitan areas. Some 236 alumni are located in Sangamon County, home of the med school’s Springfield offices. Meanwhile, at least 16 downstate counties have just one practicing School of Medicine alum, and 11 others don’t have a single SIU doctor or physician assistant.
“We’re tired of people writing off rural medicine. (Rural) hospital CEOs are tired of recruiting doctors only to have them leave,” Daniels said. “We need to find and train special people, people who want to be here, and who are going to be community leaders.”
All SIU med students must be Illinois residents, but the eight med students chosen each year as Lincoln Scholars will be students “connected and committed to rural areas,” Kruse said, especially those hailing from the southern half of the state.
Eventually, the school hopes to offer scholarships to attract the region’s best candidates to the program.
“We know they won’t all stay in the region, stay at SIU, or do the kind of medicine that they’ll learn here. But data tells us a higher percentage of them will” with this program in place, Kruse said.
While taking the same anatomy, physiology, biochemistry, and other basic science classes as their cohorts, SIU’s Lincoln Scholars will also build experience working in rural hospitals and clinics from Day 1, according to a plan presented to medical school faculty and local hospitals on Wednesday.
They’ll make themselves useful almost immediately, working alongside physicians, physician assistants and nurses to complete electronic medical records, take vitals and record patients’ medical histories. By their second year, they could be giving vaccinations and performing strep tests and urinalysis, lightening some of the workload of the doctors and PAs that will mentor them.
Throughout this hands-on training, each Lincoln Scholar med student will be teamed with a Lincoln PA scholar from the Physician’s Assistant Program.
“This is the biggest step we’ve taken yet in interprofessional education with our PA program,” Kruse said, encouraging physician assistants to help train the next generation of doctors they’ll be working with.
A collaborative team of doctors, PAs, mental health professionals and public health experts “really does save lives more effectively,” said Cheri Kelly, a professor in the PA program.
“Team-based, mission-centered medicine is a big push in medical education.”
Plans are also in the works for a student-run clinic, where students would create the kind of comprehensive environment the med school believes is the future of primary care: One location offering many services and a broad approach to healthier patients, from nutrition, to lifestyle choices, to mental health and self-care.
Lincoln Scholars won’t ultimately be obligated to practice in a certain region, or choose a certain specialty. But administrators hope many will become primary care physicians specializing in versatility.
“The comprehensive nature (of primary care doctors) has waned,” Daniels said, thanks to the increasing push to pick narrow specializations, which are perceived to be more profitable.
Gone are the days of the country doctor who set bones, delivered babies, and treated the diseases of the elderly, all under one roof.
By the same token, the growing opportunities for specialized doctors in Southern Illinois is one of the main reasons a program like this is now possible.
“Fifteen years ago, we didn’t have the volume of doctors and specialties necessary” to offer the same variety of clinical rotations in Southern Illinois as in Springfield, Daniels said.
Now, Southern Illinois Healthcare, one of the largest employers in the region, houses neurosurgery, cardiothoracic surgery, and other services rarely seen in rural areas, according to Darrell E. Bryant, SIH Medical Group’s chief operating officer.
But counties like Pulaski, which has no hospital, could benefit from a new generation of Swiss Army knife rural doctors.
“Our students need to know when to refer something to a bigger hospital or another doctor, but we want them to be able to sort out those real world situations, and to think about wellness and keeping people well,” Daniels said.
Medical school leaders stress their program is still in development.
The curriculum will not take effect until at least 2020 and still needs approval by the Liaison Committee on Medical Education, the Accreditation Council for Graduate Medical Education, the faculties of the School of Medicine and SIU Carbondale, and the Illinois Board of Higher Education, Kruse said.
In the last 15 years, universities around the country have taken similar steps. There are rural medicine and physician assistant programs at state universities throughout the Midwest, from the Indiana University, to Michigan State, Ohio State and the University of Kansas.
In February, the University of Kentucky College of Medicine announced the creation of three “satellite campuses” across the state, in collaboration with Western Kentucky University and several Kentucky regional hospitals.
Like SIU, UK is using its new reach to create a four-year Rural Physician Leadership Program that will increase enrollment and provide specialized training in a rural setting.
Though SIU is still ironing out the details of its program, administrators at several local hospitals have already expressed enthusiasm for working with the university.
“This is an innovative way to ensure that hospitals serving rural areas can attract physicians,” said Don Hutson, the president and CEO of Harrisburg Medical Center, who attended an unveiling meeting Wednesday on the Carbondale campus.
“It acknowledges that many physicians will wind up practicing close to where they train,” Hutson said. “If we can establish a good pipeline into rural areas through onsite training I think it will be a win-win for everyone.”