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As a rural state, Arkansas has a crushing need for additional healthcare workers, from nurses to physicians and all the technicians and therapists in between.

The solution is simple, just expensive: Build more schools, hire more instructors and get more students educated.

UAMS, however, isn't planning on building a new school, just adding a second campus in growing northwest Arkansas.

The most likely of the four towns to host the campus are Rogers, but Chancellor I. Dodd Wilson, MD, said that Fayetteville and possibly Springdale were also in the mix.

"We know that we're going to need additional educational sites because we are going to need more physicians," Wilson said. "What we need is the clinical sites."

Wilson said that when UAMS was looking at expansion, northwest Arkansas wasn't the only area considered.

"We looked at Fort Smith," Wilson said. "They have three hospitals there, and we looked at Texarkana, but we had a possible problem with that site."

Because of the town's unusual map and tax arrangements, Texarkana's hospitals — CHRISTUS St. Michael and Wadley Regional Medical Center — are on the Texas side of the state line. Jonesboro was another area considered.

The plan is to expand the class with all of the first and second year medical students in Little Rock and split off third and fourth year students with a group going to northwest Arkansas.

"We have 150 [students] now and maybe go up to 200," Wilson said. "We might have 185 that would have to choose. And of that 185, we might plan on having 45 in northwest Arkansas and 140 here."

The entering students would indicate where they would like to finish medical school and would sign an agreement that UAMS would be responsible for placement if necessary.

"If we didn't have 45, we would have a lottery," Wilson said. "And the students would be free to make arrangements. Pharmacy would be pretty much the same way."

Wilson explained that what UAMS is planning isn't a revolutionary concept.

"This is not a brand-new idea," he said. "You probably have 40 of those satellite campuses out of 125 medical schools."



Copying is the Best Compliment

One such example is the University of Kansas, with the main medical school in Kansas City and a satellite campus in Wichita.

What UAMS wants to do is so similar to the Kansas model that Wilson led a team of officials and legislators on a tour of the facility. One of their hosts was Jan Arbuckle, the associate dean for administration in Wichita.

"We have about a $25 million budget," Arbuckle said. "Those are the numbers I prepared when they came to visit."

Wilson figures that the budget for northwest Arkansas would be significantly less, more like $6 million.

Wichita faces certain challenges that Arbuckle thinks northwest Arkansas won't face.

"It's difficult to recruit faculty," she said of Wichita, "because it isn't a resort destination like Kansas City. [Northwest Arkansas] is more like Tulsa; it is a resort destination. They will have an easier time recruiting faculty than we do. We have to use a national recruiter, and it requires a certain type of physician. Those who are into a lot of research would not be interested in Wichita."

The campus in Kansas City is the opposite, with research leading the way.

Ed Phillips, vice chancellor for administration in Kansas City, says the satellite campus system is the way to go.

"Building a new medical school from scratch is a very complex and expensive proposition," Phillips said. "A second medical school is not what people in Arkansas or Kansas or anywhere else should be doing. It's just very expensive to replicate. A satellite campus, that's the way to go. It's just more cost-efficient."

And that cost doesn't entail just building new buildings or hiring faculty.

"It takes 11 to 15 years of education for a physician," Phillips said. "No other profession is so time-consuming or expensive, and that's one of the reasons why the federal government helps underwrite so much of physician education."

Part of the education process is residency training.

"Establishing the different residency programs … will be one of their greatest challenges," Arbuckle said of UAMS' planned expansion. "That's really an essential component in training medical students."

It is a problem that Wilson has been mulling as well.

"You need residency physicians, and the number of residency slots that the federal government supports is capped," he said. "We would need to figure a way around that for northwest Arkansas."



Apples to Apples?

One doesn't have to look hard or far for a region of the country that compares favorably to northwest Arkansas in terms of demographics and population.

Long ago, upper-east Tennessee was known as Franklin and was a state unto itself. Now the Tri-Cities had a MSA population of 337,786 in 2002, that compares closely to northwest Arkansas' population of 341,686.

Both have colleges — the University of Arkansas in Fayetteville and East Tennessee State in Johnson City. Both have VA facilities, but the one marked difference is that Johnson City has the James H. Quillen College of Medicine.

"We train physicians in rural medicine," said Dr. Ronald Franks, dean of the school that was founded in the early 1970s as one of five medical schools established by the federal government in more rural parts of the country. "That's the mission of this school."

Quillen has been wildly successful accomplishing its goals and was recently named by U.S. News & World Report as the third leading college in the country for excellence in rural medicine education.

But even with national recognition, Franks says the school still has its troubles.

"It's very difficult for us to find faculty," he said. "We haven't had much luck with the headhunter firms, so we have to go out and identify people who might be interested working in here."

Franks added that usually means finding upper-east natives who are on the faculty at other medical schools or Quillen graduates now teaching elsewhere.

Even though upper-east Tennessee and northwest Arkansas compare favorably on paper, Wilson disagreed with that notion.

"No area in the country can compare with the economic vitality and the growth," he said, pointing out that Bentonville is the home turf of Wal-Mart and the population of the area in 20 years is projected by some to top 800,000 or nearly triple, while upper-east Tennessee is expected to add around 10,000 folks.

ie.
October 2006

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