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With the increasingly high cost of medical education and sky-rocketing student debt, coupled with the disproportionate number of osteopathic medical schools that depend on tuition dollars from students to cover basic operating expenses, the entire osteopathic medical community should come together to answer the simple question, "Can we do better?"
How long can the profession sustain a system of medical education that over-produces graduates relative to training slots, limits graduates' opportunities for competing for ACGME-approved training slots by not embracing a combined residency match, and continues to fund the building of "branch campuses" of osteopathic medical schools on the backs of D.O. students by annual incremental tuition hikes? The tuition at Pikeville, as cited in the story, is $28K. Most of these graduates will pursue careers in primary care after 3-4 years of residency and compounding interest in student loans.
Trouble is coming. This is the first sign and a major "black eye." This makes the profession look bad in front of the AAMC and other leading medical education groups. Let's hope that good leadership, solid professional stewardship, and conscientious, vision-driven planning prevails over simple greed and sprawl.
I'm all for growing the profession. But the profession should grow by parterning with established and well-endowed academic institutions who can commit to funding the development of COMs through the expensive "growing pains" stages, by partnering with public universities and establishing medical schools to meet the health care needs of the communities they serve, and by partnering with hospitals and health care networks who understand medical education and are dedicated to developing quality graduate level medical programs and residencies.
At Appalachian med school, would-be doctors apply for welfare
ROGER ALFORD
Associated Press
PIKEVILLE, Ky. - For Cindy Herford, the wife of a medical student, walking into the local welfare office and signing up for food stamps wasn't easy.
"That was an ego blow," says Herford, whose husband is entering his second year at the Pikeville College School of Osteopathic Medicine. "I was embarrassed."
But she took comfort in knowing that others were in the same situation at the unique medical school, which draws many of its students from chronically poor central Appalachia and strives to send its graduates back to the same region.
"We have a high percentage of students who are poor," said the school's dean, Dr. John Strosnider. "We try to offer them every opportunity that is legal and available to help ease the financial strain of medical school."
Because of the private nature of welfare programs, no one at the medical school knows how many students are on welfare. Estimates based on anecdotal evidence range from as little as 10 percent by the administration to more than 50 percent by an auxiliary group. That group also estimates that 80 percent to 90 percent of the nontraditional students at the school are on food stamps, and it even distributed informational packets to reassure incoming students they should not be ashamed.
"Most of the med students are on food stamps," the literature reads. "It's just for a short time and it really helps out. So go for it."
Still, the Association of American Medical Colleges says the widespread welfare at Pikeville is rare.
Robert F. Sabalis, the organization's associate vice president for student affairs, said the vast majority of medical students across the country pay their way "through a combination of federal and private educational loans, scholarships and grants, spousal employment, family support, and a frugal lifestyle."
Strosnider said the medical school's mission is to increase the number of primary care physicians in central Appalachia. That means students who are residents of impoverished central Appalachia are recruited heavily. Often, Strosnider said, they're the sons and daughters of coal miners and may be the first person in their families to attend college.
"These kids are not driving Cadillacs," he said.
Citing privacy issues, the medical school declined to identify students who enrolled in government welfare programs. But Strosnider acknowledged that some Pikeville medical students, especially nontraditional students with children, receive benefits such as food stamps or government-subsidized housing.
Pikeville medical student Mike Garrett said many of his classmates are on tight budgets, living on loans to cover living expenses and the $28,000 a year in tuition. He said those who qualify shouldn't be begrudged government benefits.
"The public might think that all medical school students are rich, but that's not necessarily true," said Debby Murphy, adviser to the student auxiliary that distributed the informational packet. "Some are struggling to make ends meet."
The informational packet sent to students contains addresses of local schools, daycare centers and banks. It also gives the address and phone numbers for the local housing authority to apply for housing assistance and the local welfare office to apply for food stamps and Medicaid for children.
The Pikeville medical school was established in 1996 with $10 million from private corporate and government donors. Its goal from the start was to address medically underserved central Appalachia, which despite a push to recruit doctors still has just one primary care physician for every 1,200 people. That falls far short of the standard in urban areas of one for every 900 people.
The ratio is even lower in the region's most economically distressed counties. For example, Owsley County, with 4,800 residents, has only two doctors.
The first group of 40 homegrown physicians produced by the school opened offices throughout the mountain region last year. An additional 50 will finish residency programs next month and begin new practices.
There are currently 270 at the Pikeville school, with 180 more now going through three-year residency programs in osteopathic medicine, which places a special emphasis on the interrelationship of organs and body systems. Osteopaths undergo similar training to medical doctors, and like MDs can prescribe drugs and perform surgeries.
Garrett said medical students spend their weekdays in the classroom and have to spend their evenings and weekends studying. That, he said, leaves no time for jobs to support themselves and their families.
Baron Herford, a Texas native, is the son of a mechanic and was the first in his family to graduate from college. He worked 15 years as a respiratory therapist in Atlanta before enrolling in medical school. He and his wife have two sons, ages 7 and 3.
They receive loans to cover the cost of tuition and rent on their small apartment in the central Appalachian town that's home to the medical school. Those loans, Cindy Herford said, are not enough to cover food for a family of four.
"It has been a financial struggle," she said.
Even so, the decision to apply for the food stamp program was a difficult one. She said one of the staffers in the welfare office eased her trepidation by telling her that everyone needs a helping hand sometime.
"We have gotten over the 'Oh, I'm so embarrassed,'" she said. "We are doing something here to make a better life not just for ourselves and our children but for the community we serve after medical school."
How long can the profession sustain a system of medical education that over-produces graduates relative to training slots, limits graduates' opportunities for competing for ACGME-approved training slots by not embracing a combined residency match, and continues to fund the building of "branch campuses" of osteopathic medical schools on the backs of D.O. students by annual incremental tuition hikes? The tuition at Pikeville, as cited in the story, is $28K. Most of these graduates will pursue careers in primary care after 3-4 years of residency and compounding interest in student loans.
Trouble is coming. This is the first sign and a major "black eye." This makes the profession look bad in front of the AAMC and other leading medical education groups. Let's hope that good leadership, solid professional stewardship, and conscientious, vision-driven planning prevails over simple greed and sprawl.
I'm all for growing the profession. But the profession should grow by parterning with established and well-endowed academic institutions who can commit to funding the development of COMs through the expensive "growing pains" stages, by partnering with public universities and establishing medical schools to meet the health care needs of the communities they serve, and by partnering with hospitals and health care networks who understand medical education and are dedicated to developing quality graduate level medical programs and residencies.
At Appalachian med school, would-be doctors apply for welfare
ROGER ALFORD
Associated Press
PIKEVILLE, Ky. - For Cindy Herford, the wife of a medical student, walking into the local welfare office and signing up for food stamps wasn't easy.
"That was an ego blow," says Herford, whose husband is entering his second year at the Pikeville College School of Osteopathic Medicine. "I was embarrassed."
But she took comfort in knowing that others were in the same situation at the unique medical school, which draws many of its students from chronically poor central Appalachia and strives to send its graduates back to the same region.
"We have a high percentage of students who are poor," said the school's dean, Dr. John Strosnider. "We try to offer them every opportunity that is legal and available to help ease the financial strain of medical school."
Because of the private nature of welfare programs, no one at the medical school knows how many students are on welfare. Estimates based on anecdotal evidence range from as little as 10 percent by the administration to more than 50 percent by an auxiliary group. That group also estimates that 80 percent to 90 percent of the nontraditional students at the school are on food stamps, and it even distributed informational packets to reassure incoming students they should not be ashamed.
"Most of the med students are on food stamps," the literature reads. "It's just for a short time and it really helps out. So go for it."
Still, the Association of American Medical Colleges says the widespread welfare at Pikeville is rare.
Robert F. Sabalis, the organization's associate vice president for student affairs, said the vast majority of medical students across the country pay their way "through a combination of federal and private educational loans, scholarships and grants, spousal employment, family support, and a frugal lifestyle."
Strosnider said the medical school's mission is to increase the number of primary care physicians in central Appalachia. That means students who are residents of impoverished central Appalachia are recruited heavily. Often, Strosnider said, they're the sons and daughters of coal miners and may be the first person in their families to attend college.
"These kids are not driving Cadillacs," he said.
Citing privacy issues, the medical school declined to identify students who enrolled in government welfare programs. But Strosnider acknowledged that some Pikeville medical students, especially nontraditional students with children, receive benefits such as food stamps or government-subsidized housing.
Pikeville medical student Mike Garrett said many of his classmates are on tight budgets, living on loans to cover living expenses and the $28,000 a year in tuition. He said those who qualify shouldn't be begrudged government benefits.
"The public might think that all medical school students are rich, but that's not necessarily true," said Debby Murphy, adviser to the student auxiliary that distributed the informational packet. "Some are struggling to make ends meet."
The informational packet sent to students contains addresses of local schools, daycare centers and banks. It also gives the address and phone numbers for the local housing authority to apply for housing assistance and the local welfare office to apply for food stamps and Medicaid for children.
The Pikeville medical school was established in 1996 with $10 million from private corporate and government donors. Its goal from the start was to address medically underserved central Appalachia, which despite a push to recruit doctors still has just one primary care physician for every 1,200 people. That falls far short of the standard in urban areas of one for every 900 people.
The ratio is even lower in the region's most economically distressed counties. For example, Owsley County, with 4,800 residents, has only two doctors.
The first group of 40 homegrown physicians produced by the school opened offices throughout the mountain region last year. An additional 50 will finish residency programs next month and begin new practices.
There are currently 270 at the Pikeville school, with 180 more now going through three-year residency programs in osteopathic medicine, which places a special emphasis on the interrelationship of organs and body systems. Osteopaths undergo similar training to medical doctors, and like MDs can prescribe drugs and perform surgeries.
Garrett said medical students spend their weekdays in the classroom and have to spend their evenings and weekends studying. That, he said, leaves no time for jobs to support themselves and their families.
Baron Herford, a Texas native, is the son of a mechanic and was the first in his family to graduate from college. He worked 15 years as a respiratory therapist in Atlanta before enrolling in medical school. He and his wife have two sons, ages 7 and 3.
They receive loans to cover the cost of tuition and rent on their small apartment in the central Appalachian town that's home to the medical school. Those loans, Cindy Herford said, are not enough to cover food for a family of four.
"It has been a financial struggle," she said.
Even so, the decision to apply for the food stamp program was a difficult one. She said one of the staffers in the welfare office eased her trepidation by telling her that everyone needs a helping hand sometime.
"We have gotten over the 'Oh, I'm so embarrassed,'" she said. "We are doing something here to make a better life not just for ourselves and our children but for the community we serve after medical school."
This is a story about medical students in Appalachia, many of whom are extremely poor to begin with it has nothing to do with osteopathic or the state of the profession. Tuition is high at med schools across the country not just DO schools.
