The people who run the state’s only medical school say its national accreditation falls in jeopardy or is lost, if money isn’t raised for a new, $75 million structure at its Kansas City campus.
“If you're not an accredited medical school, your students can't take board examinations. Your graduates cannot get into residency programs that are accredited. And in most jurisdictions if you can't sit for your boards and you don't graduate from an accredited residency program you can't practice (medicine), you can't get a license. So accreditation is a huge deal,” said Dr. Glen Cox, the dean in charge of keeping the school OK with the Liaison Committee on Medical Education, the national group that certifies medical schools.
The current education building on the school’s Kansas City campus was built in 1976 and officials here say if it isn’t obsolete it is nearly so, especially given the changes happening in the ways doctors and other health professionals are trained.
“A building built in the 1970s just can't fit the technology needs of today,” said Dr. Steven Stites, acting executive vice chancellor of the University of Kansas Medical Center, which includes the medical school. “We have a structural problem and we can’t renovate it. It would cost more to fix it up than it would to replace it.”
Lecture halls, even in the first year of study, now are considered less important to learning than small practice rooms that allow for simulations that mimic the conditions students — as doctors — will face when they encounter real patients. Also, with growing emphasis on coordinated care within the health care industry, schooling now focuses increasingly on teamwork, not just among fellow medical students but also drawing in nursing students and other health-care trainees.
The school has some spaces for that sort of teaching by doing in small groups, but not enough, according to the people in charge. The accreditation process is so meticulous, as described by Cox, that it even dictates how much private space and storage must be allowed for each resident.
Cox said he is among the few people at the medical school to remember the accreditation problems it experienced in the 1990s, a years-long ordeal he said he would prefer not to live again. And that was before he was the administrator tasked with keeping those things in order.
Need for more docs
Besides warding off accreditation woes, a new school would allow for training more doctors, KU officials said. Experts across the country for years have warned of doctor shortages that have since arrived and are growing and of the need to expand medical schools to slow or reverse that trend.
KU between 1998 and 2007, according to medical school statistics, graduated an average of about 165 medical students per year and 41 percent (an average of about 67 graduates per year) stayed in the state.
The new building would allow the school to have 25 more students per class year in Kansas City and — after counting graduates from expanded satellite campuses in Wichita and Salina — the state should see 96 new KU-trained doctors a year practicing in the state by 2016, according to projections prepared by KU. That would be a net gain of almost 30 doctors a year.
With a generation of baby-boom doctors retiring or soon to retire, many Kansas towns struggle to recruit new doctors. A disproportionate number of the doctors working in the state’s rural and underserved areas are KU graduates.
There are about 259 doctors per 100,000 U.S. residents. In Kansas, however, there are only about 213 doctors per 100,000 residents. The state also is below the national average when it comes to primary care doctors.
According to KU estimates, the state will need 213 new doctors a year by 2030 just to maintain the state’s current below-average ratio. To match the national average, it would need about 285 new doctors a year by 2030.
The tricky part
It’s been known since Coronado traipsed the Plains that gold doesn’t always turn up in Kansas. And, unfortunately, Dr. Glen Cox did not win the Lottery last week (he said), so KU is struggling to come up with a way to pay for the school building that KU and other higher education officials say it must have and that the state needs.
Faced with the formidable task of recruiting and training enough doctors to replace a retiring generation, Kansas education leaders would like to find more medical students like David Le, who are willing to work in the state’s rural and underserved areas.
Le’s from western Kansas and sees himself going back there some day to practice.
The third-year student at the University of Kansas Medical Center said his thinking on the matter crystallized during a recent rural surgery preceptorship with Dr. Tyler Hughes in McPherson.
“His practice is very alluring,” Le said. "I could see making a career out of serving in a rural community, a community hospital, sort of the same feel as McPherson where everybody knows one another."
"There were a few times (Hughes) said, 'Well, you can. Rural surgeons are highly sought after.' He really was encouraging of it," he said.
"That's something I'd want to do after I've received more of my training in a larger setting."
In that respect, he could follow Hughes’ lead.
After working 15 years at a large hospital in his native Dallas, Hughes picked up his family and moved 400 miles north to a Kansas town where he could be a “real surgeon,” averting the administrative track he was on, he said.
"I wanted to take care of patients and I felt there was a need out in the rural environment," Hughes said.
That was 17 years ago. Since then, he has trained some 80 students, most of them through KU’s program. But he also has let younger area youngsters interested in medicine shadow him on the job, sometimes with pay.
"When I was 17, going on 18, I wanted to be a surgeon. An orthopedic surgeon from my town named Dave Selby heard about it, and he invited me to do it and he paid me a small amount,” Hughes said. “I thought that was incredibly wonderful and I promised myself that I would always teach, even if I had to pay the students myself."
Currently Hughes’ practice in McPherson offers KU’s only rural surgery preceptorship in the state.
Hughes’ drive to extend his formative experiences to others was recognized this month at the National Rural Health Association’s annual conference, where he was named 2012 Rural Health Practitioner of the Year, a national honor.
The distinction comes on the heels of Hughes’ appointment in February to a six-year term as at-large director of the American Board of Surgery.
Le said that Hughes was clearly surprised by the recent accolades.
"He said he's not done anything different the last 30 years, but it kind of seems overnight he's become this huge sensation," Le said. "I think he embraces it fully because he likes the ability to give input to the profession. He likes teaching."