Download - TRUST: Targeted Rural UnderServed Track
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CREATING AND IMPLEMENTING A NEW RURAL / UNDERSERVED MEDICAL STUDENT TRAINING TRACKTRUST AT THE UNIVERSITY OF WASHINGTON
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TRUST: Targeted Rural UnderServed Track Introduction TRUST Admissions TRUST Year 1 TRUST Year 2 TRUST Years 3 & 4 Challenges Discussion
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The WWAMI Program 1971-2009
66%61% 70%
59%
17%
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Rural/Underserved Programs4
R/UOP: 1988 WRITE: 1996 Underserved Pathway: 2006 Rural required third-year clerkships
(Family Medicine, Internal Medicine, OB/GYN) Rural clinical electives
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TRUST Continuum5
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TRUST Admissions: A Separate Process
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Where have you lived/worked from birth until
present? How do you imagine your personal and professional lives intersecting ten years
from now? What obstacles have you overcome in
your life to get to the point of applying for medical
school? Why have you applied to participate in
the TRUST program?
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Pre-Matriculation Experience7
Grand Coulee, Washington
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Pre-Matriculation Experience
2 weeks before starting 1st year8
Hospital First observation of a birth First mentor experience
created
EMS Public Health Shadowing
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TRUST: The Students’ First Year Experience
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TRUST rural health class addressing: Rural social life Scope of practice Benefits/pitfalls Economics
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Continuity with the Pre-Mat Site10
Hands on experience with visits
to Pre-mat site Growth in skills becomes
evident to student and preceptor Mentorship continues Continuity of care
manifests
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Journal Club11
Focus on health policy discussions High student interest evident from lively
discussions Open to other interested students
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R/UOP12
Month long immersion clinical experience Approx 120 of 216 students will participate in Summer 2010 Most students complete a community-oriented scholarly project Highly rated
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The Students’ Second Year Experience in Seattle: Building TRUST Scholar Cohesion
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All TRUST students are together in Seattle for their
second year where they: Continue participation in the Underserved
Pathway Participate in the Rural Health Class Continue and build relationship with School
of Medicine college mentor
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Underserved Pathway Diagram
Pre-Clinical Electives, Selectives, RUOP, Preceptorships in underserved sites
ClinicalBlock Rotations, Core Clerkships, Electives in underserved sites
Web Module
Service Learning – CHAP, SITC, Volunteer activities
Mentorship – Quarterly contacts with mentors, faculty/staff support
Web Module
Web Module
Web Module
Independent Investigative Inquiry
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Year I Year II Year III Year IV
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Underserved Pathway Core Curriculum (web-based)15
Teaches fund of knowledge in underserved
medicine 12 web-based modules with interactive
elements Pathway students complete two modules
per year In person/video conferencing sessions to
build community with mentor and others
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UP Provides Core Support for TRUST Scholars Pathway as curricular base Pre-matriculation Mentor’s role New courses (rural health) Community building and support Journal Club across years “Face to face” module completion Social gatherings
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Mentorship: TRUST Scholars Have Many Opportunities17
Pre-matriculation site mentor Regional Dean - home state mentor School of Medicine College mentor with underserved service background Underserved Pathway faculty
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Mentorship Purposes18
To establish a long-term mentoring relationship
between student and healthcare provider working
in an underserved setting To nurture the student’s career goals To provide career and educational
counseling To introduce students to working in an
underserved setting
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TRUST: The Students’ Third Year Experience 15 WRITE (WWAMI Rural Integrated
Training Experience) sites across the region 20 weeks of integrated training Immersion experience - Significant
clinical responsibilities Significant outcomes
Two thirds of students choose primary care
One third of students choose rural practice
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15 WRITE Sites in 5 WWAMI States
Note: Alaska not to scale
WSandpoint
Libby
McCall
Hailey
Powell
Wasilla
Ellensburg
WLewistown
Grand Coulee
Juneau
Boise
Anchorage Cheyen
ne
Spokane
Lander
WRITE SiteWWAMI Regional Office
W
W
W
W
Whitefish
WPort Angeles W
Moses Lake
Chelan
Helena
W
WW
W
W
W
W
W
W
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TRUST:The Students’ Fourth Year Experience21
Work on career development
Participate in sub-internships
Establish links with regional
residency programs Explore integrated
residency
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Challenges22
Funding Program administration costs Student scholarships and/or loan
repayment Student travel costs Program evaluation
Faculty Development Regional challenges - students across four
years, faculty across four states
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Challenges
Pipeline starting with K-12 Connections with communities including
training site support Balance of rural and urban opportunities Engaging other medical specialties Linkages with regional residency
programs
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