Idaho Statesman - Idaho’s 1st medical school rises in Meridian. Can its physicians fix our doc shortage?

The students who fill the 150 slots in the inaugural class of the Idaho College of Osteopathic Medicine will get to simulate medical procedures on mannequins so lifelike they breathe and blink.

They will get to study in a sunny outdoor plaza equipped with high speed Wi-Fi. They will share ideas with fellow students and professors in a common area with a view of treetops and the Owyhee Mountains in the distance. When they’re stressed or want to pray, they will be able to retreat to a spirituality room.

Idaho’s first medical school is going up in a 94,000-square-foot building on East Central Drive in Meridian, just off Locust Grove Road, next to Idaho State University’s Meridian Health Science Center. The schools are affiliated, and students will be able to use facilities at ISU during their training.

The medical school is still a construction site. But construction is about three weeks ahead of schedule, said Robert Hasty, the school’s founding dean.

Hasty loves showing visitors around. An osteopathic physician himself, he knows the three-story building’s layout down to its finest detail, from the clinical spaces to its lecture halls and the anatomical mural that will hang in the multistory atrium.

Running a medical school will be new for him. Hasty comes to Idaho from the Campbell University Jerry M. Wallace School of Osteopathic Medicine in North Carolina, where he was associate dean for postgraduate affairs.

He promises to be ready when the first students arrive on campus in August 2018.

Come December, the college — already becoming known by its abbreviation, ICOM — will start recruiting. But interest among prospective students is already “off the charts,” Hasty said. Based on inquiries he has received so far, he expects 4,000 to 5,000 applicants to vie for those 150 spots.

The Burrell Group, the medical school’s major investor, in recent years also opened an osteopathic school in New Mexico. In 2016, the Associated Press reported it had 160 students and another 300 on its waiting list.

Idahoans and applicants from the region (Montana, North Dakota, South Dakota and Wyoming) will be given priority consideration for admission to ICOM.

The college will mean more jobs for the community, too, opening with 75 full-time employees. More than half will be faculty members specializing in surgery, internal medicine, radiology and other fields. The school will also employ information technology staffers and administrative support workers, including librarians for its 124-seat library. Hasty expects the staff will grow to 104 by the time the first class graduates in 2022.

“Idaho has incredible needs,” Hasty said. It ranks 50th per capita in the U.S. for the number of primary care physicians per capita, and until now has been the most populous state without its own medical school.

“This is the most important thing we’ve done,” Hasty said. “We want to change health care for everyone.”

Ideal ratios, ideal spaces

Osteopathic medicine is a branch of medicine that emphasizes a holistic approach when treating patients. The design of the building, with its emphasis on light and communal spaces, reflects that philosophy. Its exterior will be clad in tan limestone with copper accents. A notable detail is a large section with a sloping roof and windows that look south toward the Owyhees.

The budget for building the new school is $34 million — $25 million for construction, $7 million for equipment, $2 million for professional fees. The project is within its budget, Hasty said.

Many classrooms in the building are designed for small classes with an 8-to-1 student-to-instructor ratio. Hasty cites a number of studies, including one from the Association for Medical Education in Europe, concluding that is the ideal ratio for adult learning.

The school has large lecture halls as well. They are designed with seating in tiers to make interaction between students easier and the physical space more flexible. Students will be able to turn around, pair up or organize themselves in small groups.

ICOM will also offer a “mother’s room” for patients who need to breastfeed and a room for prayer or spirituality as a student defines that.

The spirituality room, Hasty quipped, is next to the room where students will take their exams. Decor for the room has not been decided, but “It will be a quiet room where persons of all faiths will be welcome to go,” Hasty said.

While faculty members will have offices, the building will not have a faculty lounge. Teachers will be encouraged to interact with students in community spaces instead. It’s part of the school’s focus on creating an environment that will train more empathetic physicians, Hasty said. This is in response to studies that found the empathy scores of people entering medical school are higher than when they graduate.

“That’s the exact opposite of what it should be,” Hasty said. He blames the culture of some medical schools, and the academic rigor. The school, said Hasty, is doing innovative things to combat the trend.

“A lot of folks want to make med school 24/7,” Hasty said. But ICOM will be closed between 11 p.m. and 7 a.m. to encourage students to go home and rest. The school will also provide health care for students.

Almost like real life

Students will train in a state-of-the-art simulation lab where they can learn to perform medical procedures on lifelike mannequins programmed for medical scenarios, including giving birth, having heart attacks or seizures, and more. The mannequins are so lifelike that they will simulate bleeding wounds and physical reactions when doctors-in-training treat them.

Live actors, whom Hasty calls “standardized patients,” will be involved, too. As a student tends to a mannequin in crisis, an actor playing the part of a panicky or fainting relative might be called in to complicate the mix. Cameras will capture everything. Instructors in control rooms with one-way windows will see everything. Students and their professors will debrief later to see how well students reacted to medical crises and how they handled stresses and personal interactions.

The school will have 10 mannequins for simulating medical procedures. A suite of exam rooms will offer space for traditional exams with human patients as students complete their training.

Residencies still a work in progress

Medical students have one more training step after graduation: Before they can become full-fledged doctors, they must work under one in a medical residency program.

Currently, Idaho has just 42 medical residencies that open to new grads each year.

Residencies are primarily funded through Medicare, and a 1997 law put a cap on Medicare dollars that can pay for new residencies. Medical students focusing on certain specialties must seek out residency programs offering those specialties.

In Idaho, residencies can cost around $180,000 per graduate per year, said Suzanne Allen, vice dean for academic, rural and regional affairs at the University of Washington School of Medicine. Hasty disagreed with that figure; regardless, he said, Medicare pays $137,000 on average for a residency.

Three factors determine where a doctor is likely to practice medicine, Hasty said: where they grew up, where they attended medical school and where they did their residencies.

Early critics of ICOM questioned whether it will find enough local residency spots to avoid pushing graduates outside of Idaho, possibly not to return. The school has budgeted more than $5 million over the its first 10 years toward helping health care systems start residency programs, Hasty said. That money is to help hospitals develop residency programs but will not pay for the residencies themselves, he said.

ICOM, Hasty said, has been in contact with several regional health care companies that are in the process of creating residency programs. In Idaho, those include Eastern Idaho Regional Medical Center and St. Luke’s in Nampa. ISU plans to collaborate with the University of Utah on a psychiatry residency as well.

Hasty has said he believes 50 percent of ICOM graduates will practice medicine in Idaho.

Cost and location

ICOM is a private, for-profit medical school — a type rarely seen in the United States until a few years ago. The Burrell Group, a New Mexico company, is its largest investor.

Tuition will be in the high-$40,000 range, Hasty said. According to the American Association of Colleges of Osteopathic Medicine, the average annual tuition for private osteopathic colleges in the 2016-17 school year was $47,500. The average for a public college was $29,000.

The school received pre-accreditation status in May from the American Osteopathic Association’s Commission on Osteopathic College Accreditation. Before opening, it must receive full accreditation.

Negotiations to create the school happened very swiftly. The Burrell Group had plans to build a similar medical school in Bozeman, Mont., in an agreement with Montana State University. That agreement ended after pushback from Montana physicians who were wary of the project.

The Burrell Group then shifted its focus to Idaho. In the space of about two months, ICOM reached an agreement with ISU and secured a nearly $4 million tax incentive, the Associated Press reported last year. Idaho officials reviewed a heavily redacted feasibility study done for the Montana project but apparently did not commission their own before announcing the project, according to the AP.

The Idaho State Board of Education and the Idaho Hospital Association both approved the proposed school. The $4 million in tax reimbursements will go back into student scholarships, Hasty said.

Location is one of ICOM’s advantages, Hasty said. Meridian has affordable housing options for students, including a new apartment complex near Locust Grove Road and Pine Street that is less than a mile from campus, and another complex near 10 Mile Road and Pine Street.

ICOM will announce a capital campaign soon that will include naming opportunities throughout the campus.