The Future

[Mith242]

I guess I can see arguments against UAMS up here. But I still welcome it being here. Nothing against Little Rock, but I like having more things based here than having so much down around Little Rock. Just my opinion.

[KJW]

ASU-Bentonville (NWACC) becomes a 4 year school and becomes a great resource for students in the NWA metroplex. It also has some interesting course offerings, such as classes to teach Portuguese, Russian, Hindi, Punjabi, Hunan and Mandarin in response to Wal-Mart's strong presence in the BRIC (Brazil-Russia-India-China) group of nations.

[Architect]

It is as simple as this:

Arkansas only has 2.6M people (or so).

We don't need another medical school.

It's stupid to build another one.

[Mith242]

Well as an Arkansas taxpayer I have no problems with there being another medical school in the state, particularly having something here in NWA.

[astrife]

Well as an Arkansas taxpayer I have no problems with there being another medical school in the state, particularly having something here in NWA.

[Mith242]

Oh, I wonder if UAMS was located in NWA and they wanted to open a second campus in Little Rock if everyone in Little Rock would be complaining about it. I never said it was the best use of money. But I still like the idea of having something here in NWA. If everyone wants to complain about wasted money, I think there's plenty of other areas where money is being wasted. NWA generates a lot of tax revenue for the state. A lot of that gets used elsewhere in the state. That's only fair, because I know in the past other areas of the state were better off that NWA. But I still don't have much of a problem with some of this money being put back into NWA.

[Architect]

Oh, I wonder if UAMS was located in NWA and they wanted to open a second campus in Little Rock if everyone in Little Rock would be complaining about it. I never said it was the best use of money. But I still like the idea of having something here in NWA. If everyone wants to complain about wasted money, I think there's plenty of other areas where money is being wasted. NWA generates a lot of tax revenue for the state. A lot of that gets used elsewhere in the state. That's only fair, because I know in the past other areas of the state were better off that NWA. But I still don't have much of a problem with some of this money being put back into NWA.

[cowbreath]

Why wouldn't someone from NWA want some of the medical school here? I'm not saying it makes logistical sense or financial sense outright for the UAMS program. However, I've known a lot of people who have to relocate to LR because they did their first school work here then had to go there to be a doctor. Once they were set they could come back. I don't understand why UAMS is down there in Little Rock, it's almost as if the UA doesn't have a medical program at all.

I think the real issue is hidden within bias. Both sides represent a bias for a certain area or against a certain area. I think all decisions ultimately will have to have business sense to be successful, and because we aren't the decision makers I don't know if we'll know for sure if they have it until later.

[Mith242]

Oh well, seems we have differing views. I still can't knock it because I think it will be a good asset for NWA. Overall I'm guessing the views will be people in NWA like the idea. While people from Little Rock and central Arkansas don't.

[zman9810]

I know a way to free up some resources so that it wouldn't hurt as much to open what is to be a very limited UAMS campus in NWA. Let's close the Law School campus in Little Rock and move it all to the just expanded facilities in NWA!

(said strictly in jest- I think the Law School campus in LR should stay open)

I do think expanding 2 year schools to include 4 year programs that are already offered in present 4 year schools is a dilution of resources. I still don't understand why Westark Community College was made a 4 year school when the UA is just up the road.

[astrife]

Oh well, seems we have differing views. I still can't knock it because I think it will be a good asset for NWA. Overall I'm guessing the views will be people in NWA like the idea. While people from Little Rock and central Arkansas don't.

[Mith242]

I'm a native of Fayetteville and plan to settle down there, and I am still able to look past my own biases for "progress" in my area of the state.

[astrife]

I meant in general.

[cowbreath]

Of course you did. I didn't take your statement to literally mean that every single person in LR will be against it and every single person in NWA will be for it. I am trying to elucidate the point that even people from NWA can be wise enough to see the waste in this satellite campus.

[Mith242]

While I have never claimed this is the best use of money and resources, I also simply don't see it as a waste either. I still look forward to this happening for NWA. I'm sorry if some people really don't think the idea of it or think it's a waste. But I'm not one of them.

[astrife]

As long as your content with Arkansas having two medicore medical schools at best rather than 1 decent one then I guess this is ok. I don't know about you but I'm sure sick of Arkansas being at the bottom of every damn rankings there is: including educational rankings.

[cocothief]

I think there's a topic on this somewhere else, but...

I think the satellite campus is a good idea and it will lead to an increase overall in enrollment for the medical disciplines, which in turn will lead to more qualified medical personnel in the state.

At a time, I was a pre-pharmacy major at the UofA. One of the factors, aside from an absolute hate of chemistry, which led me to drop that major was the fact that I didn't want to leave Fayetteville and live in LR after 3 years.

It should be insignificant, but college kids make decisions like that from time to time.

More options for students, as well as improved level of medical care in NWA from having a teaching hospital located here, are both good things for NWA, and in my opinion, the state as a whole.

Funding issues could come to bear, but our local business community often steps up in that arena to ensure that we get what we need, even when the state drags its feet.

[Aporkalypse]

While I have never claimed this is the best use of money and resources, I also simply don't see it as a waste either. I still look forward to this happening for NWA. I'm sorry if some people really don't think the idea of it or think it's a waste. But I'm not one of them.

[Architect]

This is a complex issue from my standpoint and that of much of the medical community I think this is generally a bad idea, though not for the same reasons I'm seeing listed.

First, I think you have to realize what the planned satellite campus will actually be. There is no plan to have "UAMS doctors" travel there. It won't bring in new specialists, something that in NWA's future will be determined largely by Washington Regional. The medical students and residents there will be taught by community physicians already there. Now, instead of academic physicians training the residents and students you would have physicians years or decades removed from an academic environment (who chose to go somewhere where they wouldn't be teaching) in a local hospital that doesn't offer as many advanced therapeutic options. In the end, the Fayetteville group with produce inferior students and residents because of poorer training. The hope is that outside of LR these students and residents will be more likely to settle in rural communities, that's the impetus behind all of this. There are a lot of negatives to training in community hospitals instead of university hospitals, which is why the AHEC-Northwest (along with Pine Bluff) just had accreditation issues. The doctors there are more focused on generating revenue and getting their own patients seen than on teaching and certainly there is no research component. Conferences, etc would certainly be several notches below the main campus. In any case, few of the NWA physicians are really excited about this proposal, either.

The scenario UAMS is basing this on at KUMC is actually quite rare amongst U.S. medical schools. Now, KUMC itself is decent but not spectacular, much like a smaller UAMS. However, the KUMC-Wichita campus is really kind of a stepchild campus focusing largely on rural medicine.

To expand the medical school classes by a significant number will require adding additional training sites. To me and a lot of the physicians I've spoken with the best way to deal with this is to allow students to spend a portion of their time at nearby hospitals like St Vincent's and Baptist, many of the physicians in these places were faculty at UAMS a few years prior. They are close enough in proximity that students and residents wouldn't have to move and could attend conferences at the main campus. Furthermore, compared with the current 385 beds at UAMS Baptist has 880 beds and SVI 650, plenty of patients for teaching purposes. Doing things this way the students could still spend 3/4 of their time on the main campus and in specialties like surgery and internal medicine spend a piece of their rotation at St Vincent's or Baptist while not missing out on the opportunity to spend all of their time doing pediatrics at Arkansas Children's or psychiatry at the State Hospital and VA.

It's not any bias against NWA, I just think a clearly inferior second campus will really create a lower class of physicians in Arkansas, most of whom will stay in Arkansas and many will settle in NWA. I think ultimately it could just reinforce a lower quality of care offered up there.

[cowbreath]

I thought satellite campuses are just standard practice anyways. At least it's not web-based surgery. Would this mean a degradation to the quality of students coming out of the UAMS system? I mean, in other words, would a student's whole curriculum be based up here in Fayetteville, and by these non-academic doctors? Would it be any different from a curriculum standpoint? I'm guessing from what you've said, Apork, that it would be a different cohort altogether and a different set of instructors for the full curriculum, which could be limiting.

I have no opinion that would be more important than an informed opinion. Thanks for bringing that to the table, Apork. However, I would personally doubt that we have a very high level of physicians here in this area anyways. I've never really met a doctor who is too useful, and if he/she is then he/she is working too hard. Anyways, I'm just saying I'd never know the difference judging from family medical practice.

[Aporkalypse]

I thought satellite campuses are just standard practice anyways. At least it's not web-based surgery. Would this mean a degradation to the quality of students coming out of the UAMS system? I mean, in other words, would a student's whole curriculum be based up here in Fayetteville, and by these non-academic doctors? Would it be any different from a curriculum standpoint? I'm guessing from what you've said, Apork, that it would be a different cohort altogether and a different set of instructors for the full curriculum, which could be limiting.

I have no opinion that would be more important than an informed opinion. Thanks for bringing that to the table, Apork. However, I would personally doubt that we have a very high level of physicians here in this area anyways. I've never really met a doctor who is too useful, and if he/she is then he/she is working too hard. Anyways, I'm just saying I'd never know the difference judging from family medical practice.

[silent]

To answer one question, the current plan is to expand UAMS from 150 to 180 students and have all students spend the first two years together in LR and then 30 would go to the Fayetteville campus and spend the two years of clinical training there. That small cohort would have a totally different educational experience. I agree with something you may be getting at, which would be let all students (or at least most) spend a little time at the satellite campus and provide them with housing. That way everyone would get the same quality of education.

The AHEC system already has students training in the state's six AHECs that have family practice residencies for their one month family practice rotations.

[astrife]

This is my first post ever so please forgive any mistakes I make.

I have lurked around this topic long enough, so much so that I felt I had to enter the discussion. I am currently a college of medicine student at UAMS approaching the finish/start line (depending upon how you look at school/residency). I feel that Apork has an excellent grasp on the complexity of this issue particularly the points about how a satellite campus would almost certainly produce at least an inferior educational exposure if not inferior graduates.

As I see it, UAMS/ACH treat primarily (but certainly not exclusively) two general classes of patients--those with limited financial resources and those with very rare/complex diseases. Those patients with limited resources are generally from the surrounding area and could be well taken care of by most any competent Internal Medicine/ Family Practice/ General Surgeon physician anywhere in the state (i.e. they need UAMS/ACH for their convenience and for financial reasons, not for the expertise available there). Those suffering on the other hand from the very rare/ complex diseases need UAMS/ACH for the expertise that can really not be found anywhere else in the state (and sometimes outside of our state). And these patients often arrive at UAMS/ACH at great personal expense and inconvenience to themselves. To state it more simply they need the fellowship trained physicians (fellowships are optional, competitive placement training programs beyond a residency--sort of experts among experts, teachers of doctors) found in high numbers at UAMS. For example, a general surgeon needs 5 years of residency training to work on the belly (e.g. taking out gallbladders, appendices) but if he or she wants to operate on adult hearts they need at least three more years of fellowship training (maybe more for kids hearts). In my opinion, UAMS/ACH have assembled quite an impressive cadre of fellowship trained physicians--many from out of state. These doctors draw patients from all over the state and many times from beyond. I honestly cannot see a satellite medical campus that would be oriented in the direction of serving these complicated/ very ill patients because for no other reason it would very, very difficult to recruit fellowship trained physicians to a new program that oh yeah, by the way would have to compete with a very well established, much larger and more well known center--UAMS/ACH in Little Rock. I firmly believe that a satellite campus anywhere in our state would, for the complex patient, be nothing more than a pit stop before being transferred to Little Rock or somewhere outside our state because the proper personnel resources would not exist at that satellite campus. UAMS/ACH right now are not hesitant at all to transfer or refer their patients to other centers around the country. Likewise UAMS receives multiple myeloma patients from around the world because it is the place to be treated for multiple myeloma. I see no such renown in store for any satellite campus.

So why would this absence of complicated patients result in an inferior learning/training atmosphere for students and residents? In most simple terms these are the patients that have the most to offer to students/residents in terms of breadth and depth of learning complexity. These are the patients that really teach you something and there can be no substitute.

The most backwards aspect of medical school in our state is (or at least was 4 years ago) the idea that a minimum number (I think 24/ district) of entering freshman had to by law come from each of the four U.S. congressional districts in Arkansas with the remaining spots filled on an at large basis.

[cowbreath]

Rockefeller's give $12M UAMS gift - I know this isn't supposed to be about UAMS on this thread, but I guess I didn't know where I should put it. It's good news for UAMS, and I think it justifies my feelings that UAMS won't be losing any presense/quality in Little Rock.

[astrife]

Rockefeller's give $12M UAMS gift - I know this isn't supposed to be about UAMS on this thread, but I guess I didn't know where I should put it. It's good news for UAMS, and I think it justifies my feelings that UAMS won't be losing any presense/quality in Little Rock.