Shelbie Harris
News Editor
When he received his official investiture on Friday, Sept. 14, 2007, Idaho State University President, Arthur Vailas, was already an accomplished academic administer and biomedical researcher.
Under his leadership, ISU has been on a trajectory for financial stability and growth in statewide, strategic areas such as community engagement, graduation and retention rates and becoming a leader in health sciences.
At ISU, the past 10 years have been anything but dull and monotonous, with many people quick to become critical of the headmaster and his controversial decisions.
As the dust settles following Gov. Butch Otter’s announcement of a private for-profit medical school that will be affiliated with ISU and located in Meridian, Vailas critics are again working their way out of the woodwork while ISU’s 12th president stands firm on his decisions.
One individual critical of Vailas, the administration and the quick decision to collaborate with the Burrell Group on the creation of the Idaho College of Osteopathic Medicine (ICOM), is longtime Pocatello physician, Bill Brydon.
“I think the medical school in Meridian will be a disaster for ISU,” said Brydon, who graduated from ISU in 1952 and donated over $1.5 million to the construction of the Stephens Performing Arts Center. “ISU is in big-league trouble as it is. The number of medical students who are required to have clerkships in places to get some of their training is going to wreak havoc on the division of health sciences.”
The proposed medical school involves two years of instruction focused principally on human biology, while the latter two involve apprenticeships requiring a great deal of time and attention from supervising physicians.
After four years, medical students graduate with their degrees. However, they are in no way ready to practice medicine in any state without completing post-graduate training, a so-called residency.
In Idaho, five residency locations open only 41 positions annually. According to Andrew Wilper, a third-generation Idahoan, practicing internist and chief of medicine at the Boise VA hospital, where he supervised medical students and residents for nearly eight years, the ratio of medical student applicants for these training slots is roughly 75:1 in the Boise area.
Vailas believes the partnership involving ISU, ICOM and private investors will create opportunities for synergy, workforce improvement and economic development outside of the state institution in terms of healthcare.
“I don’t think collaboration is a bad thing,” Vailas said. “Look at how the partnership will help the potential in workforce and related areas for our hospitals and clinics, or maybe new clinics. When you look at healthcare, you can’t just focus on a doctor. You have to focus on everything from business to technicians and all the fields. A doctor is one small piece to the healthcare system.”
In 2009, the State Board made expanding residency training programs its top priority in order to increase the number of practicing physicians in the state. With ICOM planning to train 600 students annually, 300 of those students will need to secure placement in hospitals and doctor’s offices.
Additionally, ICOM will serve a five-state region including Idaho, Wyoming, North Dakota and South Dakota. This means a majority of students attending ICOM will be imported, and then exported for residencies in other states, which according to Brydon, does nothing to address the shortage of physicians in rural, lightly populated towns across Idaho.
“Graduates will be able to attend residency programs throughout the U.S.,” said Robert Hasty, founding dean and chief academic officer of the proposed school. “ICOM will be investing time and resources in developing additional residency programs throughout the five-state region in advance of the first anticipated graduating class in 2022 to help advance the mission.”
Transparency is another pivotal issue ISU and the Vailas administration has battled over the years, with the spotlight now shifting from the almost forgotten president’s residence facility to the announcement of the medical school partnership.
According to articles in the Idaho Statesman and Idaho State Journal, though ICOM had extensive discussions with its accrediting body, the Idaho Osteopathic Physicians Association (IOPA), the Idaho Medical Association (IMA) was left uninformed regarding discussions and decisions between ICOM, ISU and state officials.
“IOPA, who does have members who are also members of IMA, supports ICOM,” Hasty said, adding that IMA as well as additional stakeholder organizations will be part of the discussions surrounding how the groups can work together as a team to bring Idaho’s first medical school into reality moving forward.
Despite the positive and negative reactions to the medical school announcement, stating that ICOM will be Idaho’s first medical school is debatable when considering WWAMI Regional Medical Education (Washington, Wyoming, Alaska, Montana and Idaho) has been providing medical education to Idaho students since the early ‘70s.
A 2011 ISU pharmacy graduate and current University of Washington WWAMI student pursuing his Doctor of Medicine degree, Bobby Endo, recently wrote an email to Brydon expressing his concern with the recent announcement.
Without speaking on behalf of WWAMI or his classmates, he wrote, “I am a firm believer that becoming a physician is a privilege and an honor that should be reserved to the most dedicated and accomplished individuals. I even doubt my own abilities and credentials often and suffer from the ‘imposter phenomenon.’ I hate to allow the opening of a subpar medical program in our state when we have what I truly believe is THE BEST medical program in the country with UW.”
Endo is correct when it comes to UW and WWAMI being the best in the country, as U.S. News & World Report has identified the program as the nation’s top primary care, family medicine and rural medicine training school for the past 23 years.
WWAMI utilizes in-state universities at the University of Idaho and UW Medical School in Seattle to instruct medical students from Idaho. Recently, the Idaho legislature approved five additional student positions in each of the last two legislative sessions to make 35 first-year students at the University of Idaho in Moscow.
“I think the lack of involvement for our most important stakeholders is frustrating to us all, and I really am not in the know as to any of the hurdles to follow for ICOM. I imagine they have a long road ahead of them and I do feel bad for the layperson who believes this to be a step in the right direction.”
Brydon noted each student costs the state $42,000, adding that an extraordinary 51 percent returned to practice in Idaho. Endo and members of his class have written Gov. Otter and the letter reflects much of what he wrote in the email to Brydon.
“The voices of prominent figures in the state’s medical community were not heard and as such must be heard now,” Endo wrote. “None of us are opposed to medical education, but many of us find it quite sacred. A for- profit group jumping from state to state looking for a home is a big turn off to me.”
Opinion aside, ICOM will provide degrees for osteopaths to practice medicine but those students score, on average, 12.5 percent lower on the MCAT test than students who enroll for traditional medical schools. A holder of the D.O. degree may become licensed as an osteopathic physician, with equivalent rights, privileges and responsibilities as a physician with a doctoral degree in medicine (M.D.).
However, a blatant difference is the cost of attendance.
According to its website, the Burrell College of Osteopathic Medicine (BCOM) will charge $46,650 for the 2016-2017 academic year. In contrast, the UW Medical School charged $33,759 for in-state tuition for the 2015-2016 academic year.
The U.S. News & World Report compiled statistics of the top 10 private and public medical schools to attend in the country. For public schools, students could get away with paying less than $20,000 a year. Students at private schools with the lowest national tuition pay between $30,000 and $50,000 per year.
“What if the medical school will be affordable?” Vailas asked. “Will there be any pushback then? People are concerned about quality, but truthfully, you can’t have a poor quality medical school. It wouldn’t become accredited if so,” he said.
The reality is that any private, for-profit institution rarely sets competitive prices and with many of Idaho’s locations being rural, slower economic areas, graduated doctors can expect to make less money than if they were to move out of state.
Regardless of the public backlash or the avid supporters, president Vailas remained true to his belief of improving ISU’s financial situation and said he took over the helm of a university that was on the verge of extinction.
Vailas said he doesn’t care about the critics, or those who believe the decision for a medical school was rash or hasty, and argues this decision has been planned and methodical. As a president, Vailas cares about outcomes and if he can foster long-lasting positive relationships along the way, great. If not, it’s business as usual.
“Do you think doctors will be different in the future?” Vailas asked. “They’ll come here but the main thing is the economic benefit of a medical school. The story isn’t really about the doctors. It’s about the spin-offs and relationships that benefit the people of Idaho including access, clinics, technology, biotech, translational research and new ways to treat people. This puts Idaho on the map through ISU, and that’s the golden crown.”
