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MEDICAL
EDUCATION
UNTHSC and TCOM are partnering with Midland College and that early exposure to primary care plays an important role in sway-
Midland Memorial Hospital on an innovative program designed to ing medical students’ decisions to choose the specialty.
grow and keep its own crop of future doctors in the area. The Pri-
mary Care Pathway identifies interested, high-achieving community “It’s a long road, but certainly these programs help us get further
college students likely to be successful in medical school and guar- down that road in having a positive effect on the physician work-
antees them an accelerated pathway to a doctor of osteopathic med- force and education in our state,” Dr. Silverman said.
icine (DO) degree, focusing earlier and more intensely on primary
care. The targeted program allows students to get their undergrad- Community Effort
uate and medical degrees in seven years versus eight; the first crop The Pathway model seeks to provide additional opportunities for
of eight students enrolled last fall.
students from historically underserved communities to attend and
Community college students have valuable experience that doesn’t succeed in medical school. Selected students enter the pipeline pro-
always make up the typical application sought by medical school gram in their first year at Midland College and benefit from shad-
admissions committees, Dr. Nash says. But local ties, combined with owing and mentoring experiences in primary care in the area. After
early exposure to primary care training, create what she describes as successfully completing an enhanced three-year premed curriculum,
a natural fit. students would have automatic admission to TCOM.
“This is really done in cooperation with the local community and The basic program structure includes:
what their needs are in terms of medical services, and we can pre- • Two years of full-time study at Midland College;
dictably say in pretty much all of rural Texas the most acute need is • One year of full-time study at UNT Denton; and
primary care,” she said. “It’s just a natural extension taking it back • Four years of study at TCOM.
in the pipeline. And if this works, it could be a model replicated • Two summer clinical internships after their first and second years
many places across the state.”
at Midland College give students firsthand training outside the
Thanks in part to several victories the Texas Medical Association classroom.
and Texas medical schools won over the past two legislative sessions
to increase medical education funding, Texas is finding ways to chip TCOM Dean Don N. Peska, DO, says a number of puzzle pieces
away at primary care physician shortages in the nation’s fastest-grow- fell into place to launch the Pathway.
ing state. More than 5 million Texans — 20 percent of the state’s
population — live in designated primary care shortage areas, accord- A Midland County judge who was a member of UNT’s Board of
ing to federal statistics. (See “Texas’ Primary Care Profile.”) Regents caught wind of the new medical education grants and
pushed the idea of partnering with Midland Memorial Hospital on
The Pathway launched in October 2015 with help from a an initiative to get more doctors to the area. Around the same time,
$350,000 primary care innovation grant, one of several grant pro- Dr. Peska noticed a significant number of applicants who did a por-
grams the 2013 and 2015 legislatures approved to expand availabil- tion of their undergraduate education at community colleges around
ity of undergraduate and graduate medical education (GME) across the state. Meanwhile, leadership at Midland Memorial — already a
Texas. In 2015, lawmakers also revived the decades-old Texas teaching hospital — had close connections to Midland College.
Statewide Primary Care Preceptorship Program, a mentorship pro-
gram that, like the Pathway, gives interested medical students early “We saw we had all the components we needed other than putting
exposure to primary care by matching them with internists, family a medical school there, and we felt we had an opportunity to bring
physicians, and pediatricians. (See “Medical Education Wins Big.”) the whole community into this initiative,” Dr. Peska said. “We felt
the more we use the community for this, the more successful we
“Our need is so great that meeting that need is a goal that is still would be.”
out there,” said Stacey Silverman, PhD. She is deputy assistant com-
missioner for academic quality and workforce at the Texas Higher Some hurdles were encountered in developing the curriculum.
Education Coordinating Board, which oversees the state grants. For medical schools to maintain their accreditation, for example,
students need at least 90 credit hours to begin their training. Mid-
The Pathway program, for example, not only shortens the physi- land College offers only 60 credit hours toward an associate degree
cian pipeline and promotes primary care, but it also “does outreach and didn’t have the advanced science courses required for TCOM
to a sector of higher education not really picked up yet. We have so admission.
many students starting out in community college we need to reach,
and this sets a new pathway for community colleges to follow, mak- “But of course, we have an undergraduate school. So we said we
ing it a really innovative model,” Dr. Silverman said. At the same could take candidates coming out of Midland, and UNT [Denton]
time, she adds, the preceptorship program has shown over the years could give them the additional 30 credit hours in coursework we
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