West Virginia Higher Education Report Card Health Sciences and Rural Health Education Partnerships, 2002

Transcription

1 West Virginia Higher Education Report Card Health Sciences and Rural Health Education Partnerships, 00

2 WEST VIRGINIA HIGHER EDUCATION POLICY COMMISSION Health Sciences and Rural Health Education Partnerships J. Michael Mullen, Chancellor Policy Commission J. Thomas Jones, Chair Mary Clare Eros, Esq., Vice Chair Elliot G. Hicks, Esq., Secretary Kay H. Goodwin R. Ken Hall John R. Hoblitzell, Esq. Terry R. Sammons, Esq. Dr. David L. Stewart Shawn R. Williams

3 West Virginia Higher Education Policy Commission Health Sciences Alicia Tyler Program Coordinator Marilyn Bowe Secretary Rural Health Education Partnerships West Virginia University Office of Rural Health Hilda R. Heady Executive Director 08 Kanawha Boulevard, East Suite 700 Charleston, West Virginia 530 Telephone: (304) FAX: (304)

4 Table of Contents Health Sciences Medical School Enrollment West Virginia University Health Sciences Center... Marshall University School Of Medicine... West Virginia School of Osteopathic Medicine... 3 Performance on Medical Licensure Exams... 4 Primary Care Trends... 5 Retention WV Medical School Graduates: 6-Year Cohorts... 6 WV Medical Graduates, 99-97, all Specialties... 7 WV Medical Graduates, 99-97, in Primary Care... 8 WV Medical Graduates, 99-97, in Non-Urban Areas... 9 WV Medical Graduates Completing Primary Care Residencies...0 Health Sciences Graduates, Medical School Indebtedness... Scholarships and Loans...3 Rural Health Education Partnerships Rural Health Education Partnerships Consortia...4 Winding Roads Health Consortium...5 Training Consortia Infrastructure...6-7

5 Student Evaluation Overall Quality of Rotation...8 Educational Value of Community Service Project...8 Effect of Rotation on Interest in Rural Health...9 Retention in West Virginia...9 Preferences on Size of City/Town...0 Community Service Contacts... Student Rotations Rotations by County... Rotations by School/Discipline...3 Rotations by Year/Discipline...4 Program Overview: Rotations and Weeks of Training...5 Community Service Contacts...5 Field Faculty...6 Training Sites...6 Work-in-Progress...7

6 Medical School Enrollment Average scores for the Medical College Admission test (MCAT) are reported as 'means' for the multiple-choice sections and 'medians' for the Writing Sample. Test scores on the multiplechoices sections are on a scale of -5 and, on the Writing Sample, from J-T. The national averages for students entering allopathic medical schools in 00-0 were: Biological Science 0. Physical Science 0.0 Verbal Reasoning 9.5 Writing Sample P Applicants In-State Total,8, Acceptances Issued In-State Total First Year New Enrollment In-State Total Total Medical Students Entering Class Data West Virginia University Health Sciences Center The national mean GPA was Source: Association of American Medical Colleges. Mean GPA Mean MCAT Scores Biology/Biological Science Physics/Physical Science Reading/Verbal Reasoning Median Writing Sample O O P O O

7 Medical School Enrollment Average scores for the Medical College Admission test (MCAT) are reported as 'means' for the multiple-choice sections and 'medians' for the Writing Sample. Test scores on the multiplechoices sections are on a scale of -5 and, on the Writing Sample, from J-T. The national averages for students entering allopathic medical schools in 00-0 were: Biological Science 0. Physical Science 0.0 Verbal Reasoning 9.5 Writing Sample P Applicants In-State Total,047, Acceptances Issued In-State Total First Year New Enrollment In-State Total Total Medical Students Entering Class Data Marshall University School of Medicine The national mean GPA was Source: Association of American Medical Colleges. Mean GPA Mean MCAT Scores Biology/Biological Science Physics/Physical Science Reading/Verbal Reasoning Median Writing Sample O O O P P

8 Medical School Enrollment Average scores for the Medical College Admission test (MCAT) are reported as 'means' for the multiple-choice sections and 'medians' for the Writing Sample. Test scores on the multiplechoices sections are on a scale of -5 and, on the Writing Sample, from J-T. The national averages for students entering osteopathic medical schools in 00-0 were: Biological Science 8.54 Physical Science 8.08 Verbal Reasoning 8.0 Writing Sample O The national mean GPA was Applicants In-State Total,9,630,493,553,37 Acceptances Issued In-State Total First Year New Enrollment In-State Total Total Medical Students Entering Class Data West Virginia School of Osteopathic Medicine Mean GPA Source: The American Association of Colleges of Osteopathic Medicine. Mean MCAT Scores Biology/Biological Science Physics/Physical Science Reading/Verbal Reasoning Median Writing Sample NA NA NA NA NA 3

9 Performance on Medical Licensure Exams Number or Examinees/Number Passing West Virginia University 73/73 76/76 74/74 76/76 83/8 65/65 Marshall University 45/43 43/40 44/4 5/50 43/40 50/47 WV School of Osteopathic Medicine 64/56 60/48 58/54 70/6 59/54 56/55 Data for MD students are based on the USMLE Step 3, and data for DO students are based on the Comlex-Level 3. Data are for first-time test takers. 00% 90% 80% 00% 93% 88% 00% 98% 80% 98% 93% 93% 00% 98% 87% 98% 93% 9% 00% 94% 98% Data for MD students become available two years after graduation, e.g., results for 999 graduates are shown in % 60% 50% 40% 30% 0% 0% 0% WVU MU WVSOM 4

10 Primary Care Trends In 00, 3 (44%) of WVU medical graduates and 34 (7%) of MU medical graduates choose primary care residencies, compared to a national average of 53% for all allopathic (MD) graduates. *Primary care is defined as family medicine, internal medicine, pediatrics, and ovstetrics/gynecology. **Osteopathic students enter a one-year general internship following graduation; they choose a residency the following year. In 00, 39 (64%) of WVSOM 00 graduates chose primary care residencies. The national average for osteopathic (DO) graduates is not available. Medical School Graduates Choosing Primary Care Residencies* WVU Medical MU Medical WVSOM NA** TOTAL NA 00% 80% 60% 40% 0% 0% 7% 77% 76% Percentage of Medical School Graduates Choosing Primary Care Residencies, % 63% 5% 57% 5% 69% 63% 74% 7% 58% 67% 64% WVU MU WVSOM 44% 7% 5

11 Retention West Virginia Medical School Graduates 40% 36% 40% 39% 38% 38% 39% Retention of graduates is tracked annually for a 6- year cohort of medical school graduates who have completed residency training. Baseline is the cohort of graduates from % 0% % % 3% 4% 5% 9% 0% 0% 0% 0% % % Practicing in WV All Specialties Practicing in WV Primary Care Practicing in WV Non-Urban Areas 6

12 Retention To track the retention of medical school graduates, one must factor in the additional 3 to 5 years of residency training that physicians complete in their specialty before beginning practice. Consequently, the following charts and maps present data on graduates from ; 93% of these graduates have completed their training and begun practice. Data for WVSOM exclude SREB contract students who have a contractual obligation to return to their home states following graduation. WV Medical Graduates, 99-97, in All Specialties Number Practicing in Each County In 998, 3% of the active patient care allopathic (MD) physicians in the United States graduated from home state medical schools. (Source: State Health Workforce Profile, U.S. Department of Health and Human Services, December 000.) 60% 50% 40% 30% 0% 0% 0% 44% 99 33% 3% Percentage of Graduates Practicing in West Virginia 48% 45% 47% 40% % 39% 35% 38% 3% % % 45% 30% 997 6% 3% WVU MU WVSOM 7

13 Retention WV Medical Graduates, 99-97, in Primary Care Primary care is defined as family medicine, internal medicine, pediatrics, and obstetrics/gynecology Number Practicing in Primary Care by County % 40% 30% 0% 0% 0% 4% 4% % Percentage of Graduates Practicing in West Virginia in Primary Care 6% 6% 30% 6% 3% 33% 3% % 9% % 0% 36% 0% 39% 9% WVU MU WVSOM 8

14 Retention WV Medical Graduates, 99-97, in Non-Urban Areas 3 3 The chart and map show graduates in "non-urban" areas, which, by definition, exclude graduates practicing in Beckley, Charleston (including South Charleston, Dunbar, Nitro, Institute, etc.), Clarksburg, Fairmont, Huntington (including Barboursville), Martinsburg, Morgantown, (including Star City and Westover), Parkersburg (including Vienna), Weirton, and Wheeling Number Practicing in Non-Urban Areas 50% 40% 30% 0% 0% 0% 7% % 5% Percentage of Graduates Practicing in Non-Urban Areas of West Virginia 4% % 6% 5% 6% % 4% 3% % 6% 8% 3% 3% 5% 6% WVU MU WVSOM 9

15 Retention Today's medical school graduates begin practice after completing 3 to 5 years of residency training in a given specialty. Two factors are important in tracking the retention of these graduates: () specialty choice, because primary care fields are most needed in rural areas of the state; and () location of the residency, because graduates who complete residencies in West Virginia are more likely to practice in the state. West Virginia is developing graduate medical and nursing education in four regions of the state with a $.57 million federal grant through the Area Health Education Center program. This initiative builds on the existing RHEP consortia % 80% 70% 60% 50% 40% 30% 0% 0% 0% WV Medical Graduates Completing Primary Care Residencies Completing WV Residencies Out-of-State Residencies Percentage Practicing in West Virginia 8% 73% 68% 6% 57% 9% 4% 4% % 8% Completing WV Residencies Out-of-State Residencies 0

16 Retention Health Sciences Graduates, West Virginia University Dental Pharmacy Nurse Practitioner Marshall University Nurse Practitioner Percentage Practicing in West Virginia 00% 90% 80% 70% 60% 50% 40% 30% 0% 0% 0% 36% 80% 57% 79% 39% 67% 66% 53% 3% 76% 6% 88% 43% 76% 87% 8% 73% 76% 93% 73% 59% 68% 9% 8% WVU Dental WVU Pharmacy WVU Nurse Practitioner MU Nurse Practitioner

17 Medical Student Indebtedness $73,70 $68,693 $03, $96,870 $87,4 $7,548 The chart shows the average indebtedness of final year medical students $05,34 $88,460 $7,838 $0,64 $98,88 $85, $77,746 $07,95 $46,83 $0 $40,000 $80,000 $0,000 $60,000 WVU MU WVSOM

18 Scholarships and Loans Health Sciences Scholarship Awards Accepted The Health Sciences Scholarship Program was established in 995 to provide an incentive for students to practice in underserved areas of West Virginia. Students who receive a $0,000 scholarship make a twoyear commitment to practice primary care in an underserved area. In 00, the Legislature increased the award amount to $0,000 for medical students and added a new category of eligibility - nurse educators Medicine Nurse Practitioner Physician Assistant The Health Education Student Loan Program was established in 99 to assist state medical students. Awards are made from the Medical Student Loan Program component of the program, which is funded by a portion of the medical education fee paid by medical students. Borrowers may earn loan forgiveness for practicing in an underserved area or in a medical shortage field. Health Education Student Loan Program Loans Awarded Loan Forgiveness

19 Rural Health Education Partnerships In 00, the Rural Health Education Partnerships (RHEP) partners celebrated ten years of introducing students to the rewards and challenges of rural practice through training in rural communities. To date, West Virginia is the only state in which the public higher education system holds completion of training in rural underserved areas as a degree requirement for some ten different health care disciplines. Beginning in 00, RHEP tracks service-learning activities, health prevention, and wellness services provided by students according to the West Virginia Healthy People 00 objectives. This effort will help gauge the impact of rural training on services in these communities, as recommended by the Future Visions Workgroup in 000. West Virginia Rural Health Education Partnerships Cabell 0 Wood Mason Putnam Wayne Lincoln Logan Mingo Boone 5 Gilmer Calhoun 3 Jackson Roane Kanawha McDowell Tyler Pleasants Wirt Wyoming Ritchie 7 Fayette Raleigh Clay Brooke 9 Doddridge Mercer Hancock Ohio Marshall Wetzel 6 Braxton Harrison Monongalia Marion 3 Summers Monroe Barbour Upshur Lewis Randolph Nicholas Taylor Webster Cabin Creek Health Center Consortium Cabwaylingo Health Education Consortium 3 Country Roads Consortium 4 Eastern WV Rural Health Education Consortium 5 Little Kanawha Area Consortium 6 Mountain Health Partners Consortium Preston Greenbrier Pocahontas 8 Tucker 4 Grant Pendleton Mineral Hampshire Hardy Morgan Berkeley 7 Rivers and Bridges Consortium 8 Rural Mountain Consortium 9 Rural Ohio Valley Education Resources 0 Southern Counties Consortium Webster-Nicholas Education Consortium Western Counties Consortium 3 Winding Roads Consortium Area shared between Cabwaylingo and Western Counties Consortia Area shared between Country Roads and Rural Mountain Consortia Jefferson 4

20 Winding Roads Health Consortium The Appalachian Adventure was developed by Winding Roads Health Consortium nine years ago. It is an opportunity for students, faculty, and community members to learn more about the culture, history, and people of West Virginia. The curriculum helps health care professionals better understand their roles and relationship to the community's needs. As an interdisciplinary team session (IDS), it allows students to leave the boundaries of the Learning Resource Center or clinic setting and take a different approach to the learning process. Students can interact on a more personal level, gain a perspective of other disciplines, understand limitations of care within their own disciplines, and begin to build a team concept of health care. Ripley Spencer JACKSON ROANE Training Sites Roane County Family Health Care, Lead Agency Roane General Hospital Brannon Dental Associates Staats Pharmacy Roane General Medical Clinic Roane County Schools (Nursing) Jackson County Jackson General Hospital Dr. James Gaal (Internal Medicine) Dr. Al-Mahayri (Surgery) Dental Care Associates Wal-Mart Pharmacy Fruth Pharmacy Family Health Care, the Lead Agency of the consortium, was one of the three original Kellogg Community Partnerships that began in 99. The consortium has been hosting students for almost years and, with the creation of RHEP in 996, added Jackson County to its service base. Former Students Recruited Town 4 Physicians Lead Agency 4 Physician Assistants Training Sites Dentist Learning Resource Center 4 Pharmacists Family Nurse Practitioners Dental Hygienist 5

21 Training Consortia Infrastructure Consortium Lead Agency and Sub sites Counties Training Sites* Number of Field Faculty The RHEP infrastructure covers the most underserved area of 47 counties and includes the following: Thirteen training consortia, with local boards of directors, linking 38 training sites; Nearly 600 rural health care professionals serving as field faculty; and Learning resource centers at 7 locations, 9 of which are connected to statewide educational programs through MDTV. Cabin Creek Health Consortium Cabin Creek Health Center Cabwaylingo Health Education Consortium Ft. Gay Family Health Center Country Roads Consortium Monroe Health Center Eastern WV Rural Health Education Consortium Grant Memorial Hospital City Hospital Underserved areas of Kanawha 9 Cabell, Wayne, and Lincoln Berkeley, Jefferson, and Morgan 0 Monroe, Greenbrier, and Summers Grant, Hardy, Hampshire, Mineral, Pendleton, and Tucker Medicine 3 Pharmacy Dental 9 Nursing 9 Medicine 3 Pharmacy Dental 4 Nursing 6 Medicine 5 Pharmacy Dental Nursing Social Work Physical Therapy Physician Assistant 7 Medicine 8 Pharmacy Dental 8 Nursing Physician Assistant Midwifery Occupational Therapy 4 Physical Therapy Psychology Social Work 37 Medicine 5 Nursing Dental 3 Physical Therapy Occupational Therapy 0 Pharmacy Training sites include rural hospitals; health centers; Little Kanawha Area Consortium private physicians, dentists, and pharmacies; public health departments; human Mountain Health Partners Consortium service agencies, mental St. Joseph's Hospital health centers; schools; other health care organizations (e.g., home health); and community Braxton County Memorial Hospital agencies. Calhoun, Ritchie, Gilmer, Pleasants, Tyler, and Wirt Barbour, Lewis, Randolph, and Upshur Braxton and Clay Medicine 5 Pharmacy Dental 6 Nursing 4 Physician Assistant 6 Medicine 7 Nursing 3 Dental 9 Physical Therapy Med. Tech Occupational Therapy 9 Pharmacy 9 Medicine 6 Nursing Dental Physical Therapy 3 Physician Assistant Pharmacy Grafton City Hospital Taylor, Harrison, Preston, and Marion 59 7 Medicine 6 Nursing 5 Dental Social worker Physician Assistant 7 Physical Therapy 8 Pharmacy Medical Technology Occupational Therapy 6

22 Training Consortia Infrastructure Consortium Lead Agency and Subsites Counties Number of Training Sites* Number of Field Faculty RHEP field faculty are rural practitioners who also teach students. In 00, the theme of the annual Faculty Development Conference was "Building a Foundation for Effective Clinical Education." The Faculty Development Committee is continually looking at ways to make education more accessible to busy rural preceptors. The committee is exploring the idea of regionalized programs that could be offered several times a year. Rivers and Bridges Consortium New River Health Association, Inc. Rural Mountain Consortium Rainelle Medical Center, Inc. Rural Ohio Valley Education Resources (ROVER) Consortium Cameron Community Health Center Southern Counties Consortium Webster-Nicholas Education Consortium Camden-on-Gauley Medical Center Fayette and Raleigh Greenbrier and Pocahontas Marshall and Ohio Boone, Logan, McDowell, Mingo, and Wyoming Webster and Nicholas Lincoln, Mason, Putnam, Wayne, and rural portions of Cabell Western Counties Consortium Pleasant Valley Hospital 35 Winding Roads Health Consortium Roane County Family Health Care Roane and Jackson Medicine 5 Pharmacy Dental 5 Nursing 4 Physician Assistant Midwifery 5 Medicine Pharmacy Dental Nursing 3 4 Physical Therapy 8 Medicine 3 Nursing Pharmacy Physical Therapy 5 Medicine 4 Pharmacy Physical Therapy 3 Nursing Dental 7 Physician Assistant Medicine 3 Pharmacy Dental Nursing 0 Physician Assistant Physical Therapy 9 3 Medicine Nursing Dental 6 Physical Therapy Pharmacy 7 Medicine Nursing 3 Dental Physical Therapy 7 Pharmacy 97 Medicine 77 Pharmacy Totals 8 Dental 99 Nursing 7 Physician Assistant 5 Physical Therapy 3 Medical Technology 4 Occupational Therapy 3 Social Work 3 Midwifery 38 Psychology Field Faculty 594 7

23 Student Evaluation How would you rate the overall educational quality of the rotation? "... one of the two or three best rotations that I've had. My experiences were more than memorable, some actually changed the way I practice medicine." Physician in residency training 50% 40% 30% 0% 0% 0% 4% 37% 36% 36% 8% 5% 6% 8% % % Excellent Very Good Good Fair Poor Medicine N=397 All RHEP N=787 "The best experience was my interaction with the patients... They taught me the most about rural practice; I learned how important it is to give back to the community." Dentistry Student 50% 40% 30% 0% 0% 0% How would you rate the educational value of the community service project? 3% 30% 8% 5% 8% 8% 6% 5% 8% 5% 3% 4% Excellent Very Good Good Fair Poor Does not apply Medicine N=400 All RHEP N=79 8

24 Student Evaluation Did your rural rotation increase, decrease or leave unchanged your interest in rural health? "Home visits taught me the unique conditions of a rural setting. Due to the relative isolation of patients... home visits are often necessary, not to mention unbelievably rewarding. The patients' appreciation makes an extra hour of work something to look forward to..." Medical Student 80% 60% 40% 0% 0% 6% 57% 39% 3% 7% 5% Increased Left Unchanged Decreased Medicine N=398 All RHEP N=79 How likely are you to live and work in West Virginia after training? "My ER experience taught me the most about rural practice. Not only was I able to perform various skills... but the staff was very helpful. In a larger hospital setting, students do not normally get much attention or assistance. Nursing Student 50% 40% 30% 0% 3% % 0% 4% 0% % 35% 7% 0% 0% Very Likely Moderate Likelihood Modest Likelihood Very Unlikely Medicine N=398 All RHEP N=790 9

25 Student Evaluation 35% In what size city/town do you think you will practice after training? The Health Sciences and Technology Academy (HSTA) is working in partnership with RHEP to create an educational pipeline for health sciences students. HSTA reaches out to minority and disadvantaged students in 3 counties and helps them prepare for higher education and health care careers. Students progress through four years of training with local teachers and campusbased faculty and if successful qualify for full tuition and fee waivers at state-supported schools. 30% 5% 0% 5% 0% 9% 6% 6% 3% 8% 7% % 4% 3% 6% In 00, 06 seniors completed the HSTA program. Currently, there are 674 students and 6 teachers in HSTA. The college going rate for HSTA graduates is 96%. 5% 0% Greater than 00,000 50,000-00,000 0,000-50,000 0,000-0,000,500-0,000 % 4% Less than,500 Medicine N=394 All RHEP N=764 0

26 Community Service Contacts June, 00 - May 3, 00 Consortium Cabin Creek Health Consortium RHEP provides an infrastructure for promoting health lifestyles and Cabwaylingo Health Education Consortium providing health services in rural communities. Community service County Roads Consortium activities are targeted throughout the state to all age groups of Eastern WV Rural Health Education Consortium West Virginians. Grant Memorial Hospital RHEP students, faculty, and staff averaged more than 3,000 City Hospital, Martinsburg community service contacts each Little Kanawha Area Consortium month - totaling more than 56,750 for the entire year. Mountain Health Consortium Prevention and Education for General Public 8, ,87 99, Prevention and Education for Adults 7,49 80,90,603, Prevention and Education for Children 8,45,374 5,300 6,966,87 Total 4, ,535 7,894,0 3,47 RHEP dental and dental hygiene students performed 9,96 clinical procedures for about 4,500 patients. Also, students and faculty participated in 350 outreach activities serving 4,500 West Virginians. RHEP dental sites provided $98,000 in uncompensated care. The CARDIAC (Coronary Artery Detection in Appalachian Communities) program expanded to include 7 counties and screened 3,853 fifth graders from 83 schools. St. Joseph's Hospital Braxton County Memorial Hospital Grafton City Hospital Rivers and Bridges Consortium Rural Mountain Consortium Rural Ohio Valley Education Resources (ROVER) Consortium Southern Counties Consortium,58 3,66,779,376 0,770,005 3,303, ,899 4,89 587,40,477,89,663 3,868 4,778,60 6,0 5,359 5,8 6,938 5,059 7,97 5,49 Webster-Nicholas Education Consortium Western Counties Consortium Winding Roads Health Consortium 700 0,96 8, ,984,38,86,60,0 3,96,754 Totals 83,94 3,389 49,44 56,754

27 Student Rotations Students in state-supported health sciences schools must complete mandatory threemonth rotations in rural communities. Dental students, because of unique curricular requirements, complete two-month rotations. This year, students from ten disciplines completed,365 rotations in RHEP sites and in other rural settings. The ten disciplines include: clinical psychology, dentistry, dental hygiene, medical technology, medicine, nursing, pharmacy, physician assistant, social work, and physical therapy. Rotations by County: June, 00-May 3, 00 RHEP Other Rural Sites RHEP Other Rural Sites County Student Rotation Student Weeks Student Rotation Student Weeks County Student Rotation Student Weeks Student Rotation Student Weeks Barbour 4 4 Mingo 5 7 Berkeley Monroe 6 4 Boone Monongalia Braxton Morgan Brooke 5 Nicholas Cabell Ohio 6 34 Calhoun 0 5 Pendleton 7 Clay Pleasants 8 Doddridge Pocahontas Fayette Preston 5 37 Gilmer Putnam Grant Raleigh Greenbrier Randolph Hampshire 0 53 Ritchie 9 69 Hancock Roane 95 7 Hardy 9 Summers Harrison 8 Taylor Jackson Tucker Jefferson Tyler Kanawha Upshur 47 4 Lewis Wayne Lincoln 9 36 Webster 8 Logan Wetzel Marion Wirt 7 Marshall Wood Mason Wyoming 7 70 McDowell 0 0 Mercer Out of State 6 Mineral Totals,8 6,

28 Student Rotations Rotations by School/Discipline: June, 00 - May 3, 00 RHEP Other Rural Sites School/Discipline: Student Rotations Student Weeks Student Rotations Student Weeks Alderson-Broaddus Nursing Physician Assistant Mountain State University RHEP continues to use the Physician Assistant service-learning concept Occupational Therapy Assistant 6 and model in the rural Nursing 4 community-based curriculum. This approach Marshall University Medicine Nursing allows students to learn Other 4 30 ways to engage in social West Liberty responsibility as they Dental Hygiene 3 become educated leaders WV School of Osteopathic Medicine 66, and health professionals. West Virginia University Community members Nursing Nursing-Charleston continue to engage with the Physical Therapy students in ways that Dentistry convey rural community Dental Hygiene 7 0 values and spark the Medicine students' interest in rural Medicine-Charleston Medical Resident practice. Medical Terminology 6 Pharmacy Social Work 38 Psychology 0 40 West Virginia University Institute of Technology Nursing 8 5 Dental Hygiene 9 9 Other: Out of State Schools Total,8 6,

29 Student Rotations RHEP Rotations by Year/Discipline The RHEP Recruitment and Retention Committee coordinates state recruitment and retention efforts, including financial incentives, as a complementary strategy to rural training. Last year, students, including 8 medical students, received $0,000 scholarships through the Health Science Scholarship Program in exchange for a twoyear commitment to practice in an underserved area. In 00, the Legislature increased the award amount to $0,000 for medical students and added a new category of eligibility - nurse educators. RHEP provides support such as reimbursement of preceptors, housing, and travel stipends for physicians in rural residency training. Last year, physicians who completed 49 rural rotations totaling 0 weeks received some RHEP support ,000 3,500 3,000,500,000,500, Medicine Nursing Pharmacy Dentistry Allied Health RHEP Student Weeks by Year/Discipline,75,554,75, , ,68,77,534,96 Medicine Nursing Pharmacy Dentistry Allied Health

30 Program Overview RHEP Student Rotations RHEP provides a wide variety of community services, such as: Health Fairs Screening (blood pressure, glucose, etc.) Diabetic Cookbook Classes Energy Express Flood Relief Clinics Tobacco Awareness High-risk Pregnancy Programs Recycled Medical Equipment Habitat for Humanity Osteoporosis Clinic Playground Safety Diabetic Foot Screening Sports Physicals Oral Hygiene in Childcare Facilities Be Smart, Eat Smart 7,000 6,000 5,000 4,000 3,000,000, ,000 00,000 50,000 00,000 50, ,3 6,639 5,8 5,508 5,836 6,359,3,558,3,59,65, Rotations Weeks of Training Community Service Contacts 6,7 85,74 56,68 56,754 00,564 59,

31 Program Overview RHEP Student Rotations RHEP provides a wide variety of community services, such as: Health Fairs Screening (blood pressure, glucose, etc.) Diabetic Cookbook Classes Energy Express Flood Relief Clinics Tobacco Awareness High-risk Pregnancy Programs Recycled Medical Equipment Habitat for Humanity Osteoporosis Clinic Playground Safety Diabetic Foot Screening Sports Physicals Oral Hygiene in Childcare Facilities Be Smart, Eat Smart 7,000 6,000 5,000 4,000 3,000,000, ,000 00,000 50,000 00,000 50, ,3 6,639 5,8 5,508 5,836 6,359,3,558,3,59,65, Rotations Weeks of Training Community Service Contacts 6,7 85,74 56,68 56,754 00,564 59,

32 Work-in-Progress In West Virginia, community-based health professions education has reached a promising evolutionary stage. This stage is marked by new federal funds through the Area Health Education Center (AHEC) program, increased accountability, and improvements in program evaluaton. In 00, West Virginia received a $.57 million AHEC grant to develop graduate medical and nursing education in four regions of the state. Existing RHEP funds have been used as cost share to guarantee the drawdown of these federal dollars. Building on the existing RHEP infrastructure, two local nonprofit AHEC organizations and centers have been developed. A total of 8 trainees have completed AHEC rotations in the Eastern Panhandle area, and the second AHEC in the southwestern part of the state is recruiting its first AHEC team. The southeastern and northern AHECs are under development. The State Advisory Panel's Finance Committee continued work on moving to a zero-based budgeting system. This year, the Committee implemented the fiscal policies and recommendations from the previous year's program audit and guided the consortia through a beta test of new guidelines for fixed and variable costs. In addition, funds were set aside from the consortia funding to hire a fiscal officer/accountant to support the Vice Chancellor for Health Sciences and the local consortia. The evaluation system used to measure changes in provider and trainee attitudes toward rural practice has been improved, and the response rate from trainees greatly increased. In 000, the Performance Evaluation and Research Division of the Legislature recommended that RHEP add to TRACKER the reporting of health professionals recruited to rural areas. Additional funds will be needed to implement this recommendation; however, recruitment information is gathered and verified through a system of manual counts. 7

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