A new training program for doctors who want to learn how to care for patients with cancer and blood disorders will ensure a steady supply of cancer specialists in Springfield and give local patients easier access to experimental treatments, backers of the program say.
Southern Illinois University School of Medicine's oncology-hematology fellowship program -- the first of its kind in Illinois outside the Chicago area -- is scheduled to begin July 1 after receiving approval from the national Accreditation Council for Graduate Medical Education.
The program, which will enroll two doctors per year and last three years, has been in the works since 2014 and will receive major financial support from Memorial Medical Center and its parent organization, Memorial Health System.
"I felt this would secure the future of oncology care for our community," said Dr. Aziz Khan, executive director of the medical school's Simmons Cancer Institute.
At least 20 percent to 30 percent of graduates from oncology training programs remain in their host communities because of the professional and personal roots that are established, Khan said.
The addition of oncology fellows -- physicians who already have completed medical school and a three-year internal-medicine residency -- will bring new ideas for clinical care to Springfield, according to SIU oncologist Dr. Krishna Rao, director of the fellowship.
The trainees also will energize senior doctors who will have to remain well-versed on the latest treatments and techniques so they can teach effectively, said Rao, 51, who grew up in Florida and joined SIU's faculty in 2002 after training at the Fred Hutchinson Cancer Research Center in Seattle.
And the fellowship is expected to make SIU's internal-medicine residency program even more popular for graduating medical students, Khan said.
Candidates from across the country will be considered for fellowships, but doctors completing internal-medicine residencies in Springfield could have an advantage in securing one of the fellowship slots because they will be familiar to SIU's oncology faculty members, Khan said.
Rao said the fellows will provide the manpower needed to offer a wider array of clinical trials of new drugs and treatments in Springfield. As a result, patients will have access to more Phase 1 clinical trials in Springfield rather than having to travel to St. Louis or Chicago, he said.
An expansion of such clinical research locally and nationwide is essential to achieve long-term gains in fighting cancer, Rao said.
"Curing cancer will not work by just giving a bigger dose of chemotherapy," he said. "Even if the patient could tolerate it, it will not work. It will take 'smarter' drugs to ultimately cure cancer, and basically newer techniques and thinking 'out of the box.'"
Creation of an oncology fellowship has been a long-term goal of the medical school since the cancer institute was established in 2000, Rao said. The current cancer institute building at 315 W. Carpenter St. was completed in 2008 but didn't open until 2010 because of a lack of state funding.
Likewise, startup of the oncology-hematology fellowship was delayed for two years because of the two-year state budget impasse that ended in summer 2017, Khan said.
At its peak, the impasse created a $150 million backlog in unpaid bills to Memorial Health System for the care of state workers, state retirees, dependents and Medicaid patients, according to system chief executive officer Edgar Curtis.
The not-for-profit health system already was contributing about $40 million annually in "academic support" for SIU faculty salaries and other expenses, and continues to do so.
In 2017, the backlog made it difficult for Memorial to begin covering salaries and benefits for the oncology fellows, Curtis said. When all six fellowship slots are filled in three years, those salaries and benefits will total about $405,000 annually.
Once the budget impasse was resolved and most of the backlogged bills were paid, Curtis said Memorial had the financial flexibility to support the new oncology training program and also a new SIU cardiology fellowship program that's also scheduled to begin in July.
Khan is "an incredible academic leader," Curtis said, adding that the oncology training program will help the medical school fulfill its mission of serving central and southern Illinois and give the cancer institute "the nucleus to have a first-class program."
Khan said doctors in the fellowship program -- to be paid salaries of $58,000 to $62,000 -- will treat patients at both Memorial Medical Center and HSHS St. John's Hospital. The program likely will lead to more outpatients and inpatients being treated at both hospitals, he said.
The three-year cardiology program will enroll three cardiology fellows each year, and Memorial Health System will cover all of those fellows' salaries and benefits, estimated to cost about $600,000 annually when all nine slots are filled.
Both Springfield hospitals pay the salaries of medical residents and fellows whose positions don't qualify for additional Medicare payments to the hospitals to cover costs.
Caps established by the federal government in the mid-1990s for Springfield and communities across the country mean the two local hospitals can receive Medicare reimbursements to offset the costs of 157 slots in residencies and fellowships. SIU currently offers 21 residency programs and 10 fellowship programs in a variety of medical specialties.
The two Springfield hospitals cover salaries and benefits for doctors filling a total of 127 additional training slots that exceed the cap, according to SIU. Memorial funds 82 of those 127 slots over the cap, not including the new oncology and cardiology fellowship positions that will begin later this year, Curtis said.
Even though the number of medical oncologists to be produced by the SIU program appears small, the startup of the program is significant because so few new training programs are opening across the country, according to Dr. Michael Kosty, a San Diego-based oncologist who sits on the board of the American Society of Clinical Oncology.
There are eight oncology training programs in Illinois now. All are in the Chicago area.
There are about 12,000 practicing medical oncologists nationwide and chronic shortages of oncologists in many parts of the country, officials said.
Khan said he is having problems recruiting oncologists to fill the two openings on SIU's oncology faculty. There are five full-time physician faculty members and one part-timer, he said, adding that he is grateful to Springfield Clinic oncologists who have volunteered to help train the new fellows.
Khan, 62, said the fellowship program will create a pipeline of new specialists for Springfield as older oncologists retire and more cancers are diagnosed in downstate Illinois.
He and Kosty said the need for cancer care in Springfield and nationwide will only grow as the population ages and people live longer because of medicines and techniques for treating chronic diseases such as heart disease and diabetes.
The average annual pay for oncologists was $363,000, according to the 2018 Medscape Physician Compensation Report. That salary compared with $212,000 for pediatricians, $219,000 for family medicine doctors, $230,000 for internists, $300,000 for obstetricians-gynecologists, $423,000 for cardiologists and $497,000 for orthopedic surgeons.
Kosty said oncologists typically complete their training with $200,000 to $400,000 in debt to pay for their education.
Dr. Alexander Johnson, 29, a second-year internal-medicine resident in Springfield, said he plans to apply for one of the SIU oncology fellowship slots when he finishes his residency in 2020.
The North Dakota native completed medical school in his home state but said he enjoys living in Springfield and feels supported and valued in the residency program.
Johnson said he has been impressed by Springfield's "very advanced" medical facilities and the collaborative relationships he has observed among the city's hospitals and various physician groups.
He said he may decide to remain in Springfield for the long term and has enjoyed working with cancer patients during his internal-medicine training.
"You really can make a giant difference in their lives," he said.