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Featured Story Written by Breann Lujan-Halcon

Made In Wyoming

The WWAMI program, in partnership with Ivinson, is cultivating the next generation of Wyoming doctors.

For the first year ever, the WWA­MI Research Sym­po­sium, fea­tur­ing sec­ond year med­ical student’s research was held at Ivin­son Memo­r­i­al Hos­pi­tal. Stu­dents pre­sent­ed research posters of orig­i­nal inves­ti­ga­tion and pre­sen­ta­tions about local health assess­ments based in the com­mu­ni­ties they worked. 

Inves­tiga­tive pre­sen­ta­tions cov­ered top­ics such as genet­ics, car­diac remod­el­ing, DNR’s and pro­ton vs pho­ton ther­a­py. While many of the health assess­ments were based in Wyoming com­mu­ni­ties such as Buf­fa­lo, Ther­mopo­lis, Pow­ell and Sun­dance, there were projects that came from as far as Kenya.

The event that had pre­vi­ous­ly been held in Seat­tle, gave stu­dents the oppor­tu­ni­ty to present their rur­al based research to rur­al health physi­cians here at Ivinson.

A Long­stand­ing Partnership

Ivin­son has been a WWA­MI edu­ca­tion site since Wyoming joined the WWA­MI pro­gram in 1996. Every year, 20 spots are reserved for Wyoming res­i­dents at the Uni­ver­si­ty of Wash­ing­ton School of Med­i­cine (UWSOM). Recent cur­ricu­lum changes at the UWSOM have extend­ed the time stu­dents will spend in Wyoming. Instead of com­plet­ing their first year of med­ical school in Wyoming and then head­ing for Seat­tle, stu­dents will now com­plete their first and sec­ond years in state. The change means Ivin­son could to see up to 40 WWA­MI stu­dents a year. 

The oppor­tu­ni­ty for WWA­MI med­ical stu­dents to get qual­i­ty per­son­al­ized med­ical edu­ca­tion in a rur­al set­ting is unmatched,” said Ivinson’s Chief Oper­at­ing Offi­cer, Hol­ly Zajic. Our part­ner­ship with WWA­MI is inno­v­a­tive and suc­cess­ful because of UW, Ivin­son and our physi­cians’ pride of own­er­ship in the WWA­MI program.” 

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Dr. Paul John­son, an Oto­laryn­gol­o­gist at Ivin­son, is a Laramie raised doc­tor that grad­u­at­ed from the WWA­MI pro­gram in 2003. From med­ical stu­dent, to teacher, his expe­ri­ence with the WWA­MI pro­gram has come full cir­cle. Dr. John­son has been work­ing with 3rd and 4th year stu­dents on an ENT rota­tion since com­ing back to Wyoming in 2010. This year, he took his teach­ing to the class­room, instruct­ing sec­ond year students.

Ivin­son is a strong part­ner with WWA­MI.” Dr. John­son said. Stu­dents spend a sig­nif­i­cant amount of time at the hos­pi­tal and work­ing with our physi­cians and staff dur­ing their first 18 months. This allows us to devel­op rela­tion­ships with these future physi­cians, hope­ful­ly encour­ag­ing them to come back and work with us in the future!”

There are approx­i­mate­ly 25 physi­cians in Laramie that are involved with the WWA­MI pro­gram teach­ing in some way. The major­i­ty of those providers can be found at Ivin­son. Upon the cur­ricu­lum change, extend­ing stu­dents time in Wyoming to 18 months, WWA­MI saw about two to three times more physi­cian participation. 

Ivin­son has real­ly been a big part of cre­at­ing that infra­struc­ture,” WWA­MI Direc­tor Tim Robin­son said. Not only on host­ing the research sym­po­sium, host­ing the wel­come to med­ical school event where stu­dents get their stetho­scopes, and with the on-site class­room at Ivin­son, but real­ly in recruit­ing physi­cians to get involved with WWA­MI and find­ing physi­cians inter­est­ed in teaching.”

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In the past three years, Ivin­son has ded­i­cat­ed a class­room to the WWA­MI pro­gram and annu­al­ly co-hosts the white coat cer­e­mo­ny with WWA­MI. Ear­ly in the part­ner­ship, one of the found­ing adjunct fac­ul­ty mem­bers and a provider in the com­mu­ni­ty for sev­er­al years, gift­ed oto­scopes and oph­thal­mo­scopes sets to the first year stu­dents – as the pro­gram has grown, Ivin­son has stepped up and part­nered with WWA­MI to pro­vide this gift to all first year med­ical students.

The WWA­MI med­ical stu­dents have the oppor­tu­ni­ty to expe­ri­ence Laramie and Ivin­son from day one in their jour­ney,” Zajic said. Our part­ner­ship allows WWA­MI stu­dents to meet our com­mu­ni­ty, providers and staff. They expe­ri­ence first­hand Ivin­son and the Laramie community’s com­mit­ment to the health and well­be­ing of patients – who are also our neigh­bors. Ivin­son Memo­r­i­al Hos­pi­tal has been rec­og­nized for two years in a row as one of the Top 20 Rur­al Hos­pi­tals in the coun­try by Nation Rur­al Health Asso­ci­a­tion, which speaks to our com­mit­ment to qual­i­ty for our com­mu­ni­ty and to our com­mu­ni­ty part­ners like WWAMI”.

Wyoming Doc­tors, Made in Wyoming

The WWA­MI pro­gram was cre­at­ed to answer the physi­cian short­age in rur­al states like Wyoming. 

Nation­al­ly, 20 per­cent of indi­vid­u­als reside in a rur­al area, but only 11% of physi­cians nation­wide prac­tice in those areas,” Robin­son said. 

Pro­grams like the Rural/​Underserved Oppor­tu­ni­ties Pro­gram (R/UOP) and the Tar­get­ed Rur­al Under­served Track (TRUST) are key exam­ples of cul­ti­vat­ing Wyoming stu­dents to become Wyoming physicians. 

R/UOP is an elec­tive immer­sion pro­gram that pro­vides ear­ly expo­sure in rur­al med­i­cine to stu­dents between their first and sec­ond year. Stu­dents spend four weeks in rur­al and under­served com­mu­ni­ties work­ing along­side local physi­cians. TRUST stu­dents spend the first three years of their med­ical school career prac­tic­ing at a WWA­MI Rur­al Inte­grat­ed Track Expe­ri­ence site.

In a rur­al health set­ting you see stronger social net­works, greater shared social expe­ri­ences and a qual­i­ty of life that is unmatched in urban com­mu­ni­ties,” Robin­son said. Rur­al care is more per­son­al­ized care, physi­cians take the time to get to know their patients, their fam­i­ly and their friends.”

Adam Blaine, a sec­ond year stu­dent from Gillette, is a TRUST schol­ar that plans to prac­tice Fam­i­ly Med­i­cine when he grad­u­ates. Hav­ing ded­i­cat­ed his med­ical school career to the rur­al track, his clin­i­cal expe­ri­ence will be car­ried out in Dou­glass, WY.

Pri­or to enter­ing med­ical school, I had the oppor­tu­ni­ty to work with sev­er­al physi­cians around the state who prac­ticed in a rur­al set­ting,” Blaine said. What I noticed about these physi­cians is that they had strong per­son­al rela­tion­ships with their patients while prac­tic­ing a wide vari­ety of med­i­cine. That expe­ri­ence moti­vat­ed me to one day serve in the same capac­i­ty, where I could build con­nec­tions with my patients and the community.”

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Research shows inte­grat­ing rur­al health expo­sure ear­ly in a student’s edu­ca­tion­al career increas­es the chances that they will choose a rur­al area for prac­tice. This prac­tice gives stu­dents the oppor­tu­ni­ty to work close­ly with an estab­lished provider in a rur­al com­mu­ni­ty and learn what rur­al med­i­cine real­ly looks like.

Robin­son attrib­ut­es WWAMI’s suc­cess in Wyoming to the fact that stu­dents are spend­ing time with rur­al physi­cians indi­vid­u­al­ly and rur­al physi­cians are shar­ing their pro­fes­sion­al net­work with these stu­dents. Wyoming’s reten­tion rate is one of the high­est in the WWA­MI pro­gram — 70 per­cent of Wyoming WWA­MI grad­u­ates return to the state, of that per­cent­age, 85 per­cent stay over three years.

After grow­ing up and grad­u­at­ing from high school in Gillette, I enrolled in an out of state uni­ver­si­ty. While attend­ing col­lege in anoth­er state, I real­ized what I was miss­ing.” Blaine said. The peo­ple of Wyoming are down to earth with a strong sense of com­mu­ni­ty. Their sup­port for each oth­er with a neigh­bor-like con­nec­tion sets them apart from oth­er states. I look for­ward to the day when I fin­ish my med­ical edu­ca­tion and I am able set­tle in a rur­al com­mu­ni­ty in Wyoming.”

Robin­son looks to the num­bers and reports that the biggest fac­tor in recruit­ing providers to rur­al areas is where they were trained in med­ical school. Stud­ies show, stu­dents with expe­ri­ence in rur­al com­mu­ni­ties come back to rur­al areas to prac­tice. The longer they train in rur­al com­mu­ni­ties, they form rela­tion­ships with physi­cians and patients and they want to come back.

Wyoming is a rur­al state and like oth­er rur­al states, has his­tor­i­cal­ly expe­ri­enced dif­fi­cul­ty in recruit­ing physi­cians,” Dr. John­son said. WWA­MI allows us to grow our own’ well trained physi­cians to return to take care of their communities!”

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