The Partnership: A T Still School of Osteopathic Medicine Arizona and NACHC
SOMA is actually the third health professional partnership between NACHC and A T Still. The first two were the physician assistant program and the dental school. SOMA will send their first graduates to residency programs with the class of 2011. This class includes 25 30% Spanish fluent, 30% who graduated from a rural high school (RUCA coding), 30% that are first generation to college, 50% that are 4 or more years older at graduation, 72% that have delivered some health care prior to admission and 42% that have delivered full time health care prior to admission. Prior to admission they have already delivered health care from inner city Detroit to rural Kazakhstan.
Admission for Health Access The focus on health access is demonstrated by selection of those who have demonstrated service. SOMA utilizes CHC and Primary Care Association professionals heavily in the admissions interview process, does not bias admission in favor of top scores and those of top status parents more likely to have top scores (interviewers blinded from scores), scoring for interview or admission includes focus on service orientation and orientation to the underserved, and students with minimal service efforts are rejected even with higher scores and grades (very different admissions). The HOMETOWN program also allows candidates associated with CHCs to receive additional consideration that can enhance their potential for admission.
Training for Health Access The NACHC partnership was essential to help select the 11 sites that had experience with medical education and significant interest in integrating medical education and graduate medical education with their service mission. The SOMA students spend their first year in Mesa AZ and then three years at a community center site. The first year has been termed on student internet sites one of the most intensive first year experiences. This is true as the new medical students adjust to the incredible intensity of first year medical training, receive detailed instruction to clinical skills not found in many medical schools, and train in the osteopathic principles with the hands-on, three dimensional, holistic approach They also move to Arizona and then back to their sites with their families.
Outcomes - Despite these challenges and despite the selection of students with more normal scores (not the most exclusive) and despite dealing with the challenges of a charter medical school class not only in the Mesa AZ site but also in the community sites, SOMA class of 2011 students have accomplished a first time pass rate of 90% on their first time board scores. This is equivalent to the same levels of established osteopathic schools. The ultimate outcome focus remains service to the underserved. Just as CHCs needed to bypass US policy for health access, bypasses will be needed for the students. Health policy in the United States actually drives medical students away from primary care and especially away from the permanent primary care choice of family medicine. Incentives will be important. NACHC help was essential so that SOMA students could apply for NHSC scholarships, but a key need is for career choice to be incented to primary care, family practice, and CHC sites to deliver primary care as practitioners and as SOMA faculty.
About the Presenter - Dr. Bowman continues a 26 year delivering, teaching, and research basic health access. As a professor at the School of Osteopathic Medicine Arizona, he helps shape the SOMA students admitted and trains small groups in clinical skills, clinical cases, and simulations. New responsibilities involve helping to develop graduate medical education efforts as center sites. He trained at Baylor College of Medicine in Houston and then the McLennan Co Family Practice Program in Waco Texas. He did rural practice in Nowata OK, developed rural programs and a rural faculty development program at East Tennessee State, and spent 15 years helping to coordinate Nebraska's rural workforce efforts within the UNMC Department of Family Medicine. His research involves common sense solutions for health care access, cost, and quality that all begin with better children (birth to admission), more normal children becoming physicians (not more exclusive), more normal in training, more normal career choice, and more normal distributions of health funding. Movement to more normal and less exclusive restores health access. He is the founding director of Priority Infrastructure focused on restoration of the front-line human infrastructure in America as lower and middle income children are most likely to become rural physicians, underserved physicians, family physicians, teachers, nurses, and public servants.
Robert C. Bowman, M.D., Professor at the
A.T. Still University School of Osteopathic Medicine in Arizona
5850 East Still Circle Mesa, AZ 85206 Phone 480-248-8174
Only those unaware, those who are ignorant, or those with another agenda fail to understand that solutions for basic health access have worked for over one hundred years.