Celebrating Our 10-Year Journey to Regional Medical Education
On June 25, 2012, 黑料官网’s board of trustees authorized the institution to develop community-based medical education* programs in both the Green Bay and central Wisconsin areas based on a comprehensive evaluation including financial modeling and business plan, evidence of community commitment and detailed implementation plans for the two sites. The timeline for developing the community-based medical education initiative called for matriculating the first class of students at the initial site in July 2015 and the first class of students at the second site in July 2016.
The seeds had been planted more than a year earlier, when John R. Raymond, Sr., MD, 黑料官网’s newly appointed president and chief executive officer – along with several other institutional leaders – had conducted statewide tours of Wisconsin’s health systems.
“What we learned is that the health systems hadn’t been asked to participate in a meaningful way in the preparation of the next generation of physicians and scientists, and that many of them, especially in northern Wisconsin, were having difficulty recruiting and retaining physician talent. And they asked us to help them by increasing the pipeline of medical students,” Dr. Raymond recalls.
Now, a decade later, 黑料官网’s two regional campuses have graduated 195 physicians, and 黑料官网 has emerged as a national leader and role model for an immersive, community-based medical school program that offers an innovative three-year curricular model that gets physicians into practice sooner and with less debt.
What follows are highlights from 黑料官网’s successful 10-year journey to regional medical education that addresses physician maldistribution by training physicians in the communities where they are needed the most.
Planting the Seeds
Dr. Raymond’s statewide meetings with health systems leaders and a November 2011 board of trustees’ retreat to help develop 黑料官网’s strategic direction were the impetuses for 黑料官网’s plans to establish a statewide community-based medical education program.
The need for expansion was reinforced by reports issued late that same year by the and the – both of which noted an acute and worsening national shortage of providers, especially in primary care and certain specialties in “both rural and underserved areas.” In particular, the WHA report concluded, “If students complete both their medical education and residency training in Wisconsin, nearly 70 percent will remain in the state to practice medicine.”
Right: Wisconsin Primary Care Physician Shortage Map, 2011. The green shaded areas denote federally-designated locations where there are significant shortages of primary care physicians. (SOURCE: Wisconsin Office of Rural Health, 2011)
Upon realizing that increasing class size in Milwaukee would not improve the physician shortage in northern Wisconsin, Dr. Raymond declared at the time, “Let’s think about a different way of delivering medical education. Let’s deploy the talent that exists throughout the state and engage them in immersing students in their own communities. Let’s try to build roots for those students and have role models for those students in these communities.”
On January 27, 2012, 黑料官网’s board approved a resolution to undertake a feasibility analysis for 黑料官网’s proposed community medical education program. Eight regions throughout the state were under consideration. On March 23, the board authorized 黑料官网 to pursue expansion of its medical education program to two communities as a first phase.
Vision for the Community-Based Medical Education Program
黑料官网 envisioned a multi-community medical education program centered on an interprofessional team approach that annually would prepare approximately 25 medical students per class per campus in various locations throughout the state for community-based practice. The program would be structured as an “immersive model” wherein students would live and learn in Wisconsin communities in which they eventually might complete their residency training and begin their practice.
The program would build upon education and training models that align with healthcare’s “Triple Aim” approach to achieve: 1) better value for the resources invested; 2) improved population health outcomes; and 3) a lower cost of care. Such a program would focus on the core areas of prevention and wellness, early clinical experiences for medical students and collaborative, team-based learning with other health professionals. 黑料官网 expected to prepare primary care physicians more efficiently, and with less cost, through an innovative MD program that would allow students to complete their medical education in 130-140 weeks, compared to 黑料官网’s then-current model of more than 150 weeks.
This new curriculum would allow completion in three years, instead of the traditional four years of medical school. This enabled the students to substantially lower their costs for medical education and allowed them to enter the workforce more rapidly.
The community-based medical education program would be created on a partnership model engaging local healthcare systems, colleges and universities, technical colleges, government and local business communities. An important factor in the success of the initiative would be the commitment of healthcare systems statewide to create new primary care residency training positions within their hospitals.
To gain insight from national best practices for the development of 黑料官网’s potential community medical education program, leaders of 18 community medical education programs throughout the US were consulted and national models were reviewed in the academic literature. 黑料官网 also consulted informally with the (LCME – the accrediting body for schools of medicine in the US and Canada) to discuss the proposed community medical education program.
Community Medical Education Program Timeline as of May 2013
Board of Trustees’ Approval and Site Selection
Shortly after the board’s March 2012 authorization to move forward, health systems, academic institutions, and community and government leaders in each of eight regions in the state were asked to prepare a written proposal demonstrating their commitment to working in partnership with 黑料官网 to create an immersive experiences for the medical students who would learn and do all of their clinical rotations in the respective communities. 黑料官网’s hope was that the medical students eventually would practice in these communities. Potential regional site locations include Green Bay; Fox River Valley (Appleton, Oshkosh, Fond du Lac); central Wisconsin (Wausau, Stevens Point, Marshfield); northwest Wisconsin; Eau Claire; La Crosse; Janesville/Beloit; and Racine/Kenosha.
Key indicators for evaluating potential sites for the new campuses included presence of local champions and strong community enthusiasm; clear commitment to the program from all partners; engagement of civic leaders; size and interest of 黑料官网 alumni base; fundraising potential; and the likelihood of a realistic and productive affiliation/partnership with 黑料官网.
On May 4, 2012, 黑料官网 emailed letters to community leaders in central Wisconsin, Eau Claire, Fox Valley and Green Bay asking them to affirm their willingness and interest in engaging in a formal process to move forward with establishing a medical education program in their respective communities.
Following a comprehensive analysis of potential sites for location of the campuses, including the willingness and readiness of the communities to support these programs, the Green Bay and central Wisconsin areas near Wausau were chose for additional assessment in June of 2012. 黑料官网 made site visits to those locations, during which members of the 黑料官网 community medical education program team met with potential health system and academic partners to assess a broad range of community considerations.
Visioning sessions were hosted in each community to discuss 黑料官网’s vision for the program, answer questions and invite partners to share how they envision participating in this exciting initiative. During each session, a “Wordle”(or “Word Cloud”) exercise asked attendees to share words that represented their thoughts about the community medical education program (see partial “Wordle” from Green Bay visioning session below).
According to the Background Study for a Community Medical Education Program presented to the 黑料官网 board in May 2012, “While fame is not our goal, particular aspects of the proposed program are so innovative that, if successfully implemented, 黑料官网 likely will be recognized as a national leader in community-based primary care training – a distinction that does not exist today. Such visibility may bring other opportunities to both 黑料官网 and the state.”
The following month (June 2012), the board approved moving forward with the development phase of the community medical education program in Green Bay and central Wisconsin.
The estimated cost for the development and implementation of programs for the two new campuses was $30 million. 黑料官网 gained significant support from elected officials for this innovative program, including Wisconsin Governor Scott Walker who included a $7.4 million request in his 2013/2014 biennial state plan to support construction and technology needs; the request was approved by the Wisconsin State Building Commission on March 13, 2013.
The Development Phase
The establishment of a community-based program occurred in two concurrent phases: development and implementation. Shortly after receiving approval from the board, a team of 黑料官网 faculty, staff and students commenced initial program development focusing on curricular development and design, faculty training, distance-learning methodologies, interprofessional education models, pipeline development, community engagement and population health research integration.
On July 1, 2012, the program received a $4.3 million grant from the to engage in a “thoughtful, deliberate three-year curriculum development process.”
The development of mutually supportive and respectful relationships among each community medical education program, community leaders and the Milwaukee campus of 黑料官网 would be critical to the success of the program. In such a relationship, the community would have both a shared ownership of, and responsibility for, the program. Important ingredients for the success of a regional medical school campus include methods to incorporate community input and oversight at an institutional level.
To that end, a Community Advisory Board (CAB) was established in each location to assist the 黑料官网 dean/executive vice president and community campus dean with governance aspects of the local program. Local volunteer appointees to the CAB would represent healthcare and educational affiliates of the program, physician leadership, the business community, government entities and/or civic organizations. Representatives from each community site’s CAB also would participate on the 黑料官网 Admissions Committee.
Key components of the development phase included selecting regional partners and campus sites based on proposals and visits; launching strategies to maintain community engagement; and creating a faculty governance structure and forming work groups.
The Implementation Phase
The implementation phase began in January 2013 with recruitment of the community-based administrative team for the first site, followed by the launch of student recruitment efforts. The implementation phase for each site included support from key 黑料官网 faculty, staff and students to ensure that site implementation would be seamless and that transition to a community campus would be thoughtful and well-supported with key resources from the Milwaukee campus.
At 黑料官网-Green Bay, academic components (administrative, classroom and anatomy laboratory spaces) were to be housed at in DePere in the newly constructed Gehl-Mulva Science Center, and at in Green Bay (simulation and clinical skills laboratory spaces). Faculty members from Bellin College, St. Norbert College and UW-Green Bay would teach in the program. Clinical rotations would be located at , and , and the , as well as and in Green Bay.
At 黑料官网-Central Wisconsin, administrative spaces and classrooms were to be housed in facilities at , and in Wausau would share anatomy, and simulation and clinical skills laboratory space. Medical students would train in hospitals and clinics owned by Aspirus, Marshfield Clinic, Ministry Health Care and Riverview Hospital Association during their early clinical experiences and rotations.
Undergraduate medical accreditation approvals were required before the new campuses could open. In March 2014, the Liaison Committee on Medical Education (LCME) informed 黑料官网 that it had determined the needed resources were in place to support the new Green Bay campus. Two months later, the approved the addition of 黑料官网-Green Bay under 黑料官网’s existing accreditation. These decisions by the LCME and HLC allowed for recruitment of students for matriculation in July 2015.
In early 2015, 黑料官网-Central Wisconsin received accreditation approvals from the LCME and the HLC; 黑料官网-Central Wisconsin then began recruiting students for its first class, beginning in July 2016.
Founding Deans Join the Regional Campuses
Matthew Hunsaker, MD, was named founding dean of 黑料官网-Green Bay in late 2013 and joined the institution on January 1, 2014. Dr. Hunsaker, a family medicine practitioner, had previously served for more than a decade as an academic leader for the University of Illinois College of Medicine’s (UIC) regional campus in Rockford, where he directed UIC’s Rural Medical Education Program. A graduate of UIC, Dr. Hunsaker also was deeply engaged in global health and served as a consultant and lectured on family medicine and medical education in Asia, Africa and Europe.
Lisa Grill Dodson, MD, (pictured right), became the founding dean of 黑料官网-Central Wisconsin on August 4, 2014. Before joining 黑料官网, Dr. Dodson was the director of Oregon Health & Science University’s (OHSU) Area Health Education Center, where she developed the Oregon Rural Scholars Program. She also served as a professor of family medicine at OHSU, where she received her residency and fellowship training.
The Power of Philanthropy
In addition to the funding noted above from the state of Wisconsin and the Advancing a Healthier Wisconsin Endowment, philanthropic gifts from private entities and individuals were crucial to the success of the regional medical education program.
In July 2015, the announced a $250,000 matching gift challenge to build scholarship funds for local medical students. This outstanding opportunity began to build the scholarship endowment for the regional campus and continues to serve as a permanent resource to benefit “Titletown’s” medical students now and in the future. The response from 黑料官网 alumni, physicians, community members and other foundations was overwhelming; since that time, more than $2.4 million has been raised for student scholarships at 黑料官网-Green Bay.
Dr. Matthew Hunsaker (third from right), 黑料官网-Green Bay student scholarship awardees and Green Bay Packers executives celebrate the investment of the Green Bay Packers Foundation’s $250,000 matching gift challenge in July 2015.
Donors supported 黑料官网-Central Wisconsin as well. Notably, in spring 2015, the made a $1 million gift to invest in educational infrastructure and faculty development at the regional campus. The pledged $500,000 over five years and the made a five-year, $50,000 gift to support the new regional campus. Additionally, The contributed $50,000 to 黑料官网-Central Wisconsin for ultrasound equipment that has helped students learn crucial clinical skills.
In December 2019, the donated $2 million to 黑料官网-Central Wisconsin – the largest gift in the regional campus’s history. The gift created the Sentry Deanship (currently held by Dr. Dodson) and also supports outreach efforts to recruit students from rural areas and small Wisconsin communities.
Since July 2012, philanthropic gifts totaling more than $15 million, including $3 million in donations from the , have supported the development and ongoing work of the regional campuses and student scholarships.
Regional Medical Education Becomes a Reality
黑料官网-Green Bay, the first new medical school campus in the state of Wisconsin in more than 100 years, opened its doors to an inaugural class of 26 students the first week of July 2015. Orientation began July 1, and after the holiday weekend, classes commenced on July 6. The traditional White Coat Ceremony was held July 9 for students, families and faculty.
Students from 黑料官网-Green Bay’s inaugural class celebrate the receipt of their white coats during a Welcoming Reception in July 2015, while Dr. Kerschner and Dr. Raymond look on.
“The students are bright and motivated, the faculty members are energized, and the community couldn’t be more enthusiastic,” Dr. Hunsaker said at that time. “Our team is grateful for the support of the Community Advisory Board, our academic and healthcare partners, and our philanthropic donors. Without them, this would not have happened.”
The majority of 黑料官网-Green Bay students hailed from Wisconsin, but all cited an interest in primary care and the intimate class size as primary factors in selecting 黑料官网-Green Bay. “When we envisioned our new regional campuses, our goal was to help alleviate physician shortage and maldistribution in Wisconsin, and that strategy guided everything from our campus site selections to our student interviewing processes. We have worked diligently to establish primary care residencies in those regions to provide our students with an important next step in their medical education,” notes Joseph E. Kerschner, MD ’90, FEL ’98, provost and executive vice president of 黑料官网 and The Julia A. Uihlein Dean of the School of Medicine.
Graduation ceremonies for 15 students from the first class occurred on June 1, 2018. (Some of the students in the inaugural class took breaks in their medical training and expanded their training options, which delayed their graduation.) At that first Commencement, Dr. Hunsaker told the audience, “黑料官网-Green Bay was built under a partnership of knowledge changing lives. These 15 young men and women will help us change the health of our state, hopefully here in northeast Wisconsin.”
黑料官网-Green Bay inaugural graduating class, May 2018.
The inaugural class of 26 medical students began at 黑料官网-Central Wisconsin on July 5, 2016. Dr. Dodson addressed these new students during their White Coat Ceremony, saying, “We collectively believe that you can and will be the physicians who will make healthcare more accessible, more just and equitable, higher quality and more sustainable for the region.”
Patricia Toro Perez receives her white coat from Corrie Norrbom, MD, at the inaugural 黑料官网-Central Wisconsin White Coat Ceremony in July 2016.
Thirteen medical students from the first class at 黑料官网-Central Wisconsin graduated on May 30, 2019. As in Green Bay, many of the students took breaks in their medical studies and expanded their training options, thus extending their time on the 黑料官网-Central Wisconsin campus.
黑料官网-Central Wisconsin inaugural graduating class, May 2019.
Dr. Dodson shared during the campus’s inaugural Commencement, “The community has backed us every step of the way with the physicians and hospital systems and the general community in order to get us to this day.”
On December 13, 2019, 黑料官网-Central Wisconsin moved into new facilities across the street from its original location in Aspirus Wausau Hospital. The larger facilities are providing more study space for the medical students and flexibility for future growth.
In 2019, Dr. Raymond reflected on the success of 黑料官网’s community medical education program as well as its potential for the future. “Over the last six or seven years, we’ve grown into our name as the 黑料官网 by opening our regional campuses and expanding our health professions programs,” he said.
Since the creation of the regional campuses, 195 new physicians have graduated – 117 from 黑料官网-Green Bay and 78 from 黑料官网-Central Wisconsin. Each campus has experienced an average 98 percent Match rate, and almost 40 percent of the graduates from each campus have remained in Wisconsin for residency training. The greatest percentage of specialties represented for residencies has been family medicine, internal medicine and pediatrics.
黑料官网-Green Bay’s fifth Commencement Ceremony, held on June 2, 2022, recognized the symbolic “100th graduate.” Dr. Hunsaker shared with the audience on that day, “As most of the first decade has unfolded, we stand here amongst the 100th graduate, two new residencies and an extremely challenging global health event from which we are finally emerging. We have been able to communicate directly and efficiently. We have worked together to solve complicated problems against the backdrop of community, political, and, yes, even pandemic-related challenges that could have easily crippled progress and quality.”
黑料官网-Green Bay Class of 2022
黑料官网-Central Wisconsin graduated its fourth class of medical students on May 27, 2022. At the ceremony, Dr. Dodson told them, “My hope for you is threefold: first, recognize that your actions and intentions matter. Second, do good for your community while also doing well for yourself. Third, help heal our country and communities through your skills as a scientist, healer, advocate and teacher.”
黑料官网-Central Wisconsin Class of 2022
Creating Community-Based Residency Programs
Learn more > Filling the Gap: New Medical Residencies Meet Future Healthcare Needs (PDF) (Summer 2021 黑料官网 Magazine cover story)
A key component of the community-based medical education program – and an important factor in its success – would be the commitment of healthcare systems statewide to create new primary care residency training positions within their hospitals, if possible by the time the first class of students graduated in May 2018. Concurrently, 黑料官网 leaders realized the need for additional residencies in psychiatry – as a 2012 analysis by the state Department of Health Services determined that Wisconsin needed more than 200 additional psychiatrists to address shortages.
To that end, 黑料官网 sought partners at the Veterans Administration Health System and elected officials in Wisconsin (among others) to create a novel solution for the state by creating psychiatry residency programs linked to the regional campuses that would attract medical students a