Birth of a med school

SPOKANE - Like the season unfolding on its campus, it is early spring in the lifetime of Washington State University's Elson S. Floyd College of Medicine.

John Tomkowiak, who was hired as the fledgling school's first dean last year, paused between meetings on a recent day to share his vision.

The college will focus on training physicians willing to practice in rural and underserved areas, Tomkowiak said, and also on "figuring out how can we transform health care in those areas."

More doctors

From a fifth-story conference room in the Academic Center building that anchors Washington State University Spokane, Tomkowiak looks out on the campus that in the next couple of years will be home to WSU's first class of medical students.

From this vantage point, he can see the campus' newest building, the nearly completed Spokane Teaching Health Clinic, where medical school graduates will have the opportunity to participate in a new psychiatry residency program. Tomkowiak, who was dean of the Chicago Medical School before coming to WSU, is himself a psychiatrist.

The clinic is set to serve Spokane-area patients starting this summer and will add 25 residency positions to the 90 or so currently offered in Spokane.

Physicians are more likely to practice medicine near where they complete their residency, the hands-on experience medical school graduates need before they get their medical license, WSU College of Medicine spokesman Doug Nadvornick said.

Rural medicine, 21st-century style

Tomkowiak envisions doctors trained to use technology worn by patients to monitor their health, like the wireless FitBit devices people use to track their activity. Worn in an ear, on an ankle or attached to glasses, such instruments could transmit a rural patient's health data to a doctor located in a city far away.

"That's just the beginning," Tomkowiak said. He estimates about 35 percent of doctor visits in 2018 will be conducted using that kind of device.

Training doctors to lead the way in incorporating that technology and managing and interpreting the data produced is a challenge Tomkowiak sees as a niche for WSU.

"That's a different kind of skill than we've taught doctors before," he said.

While he argues remote monitoring will be integral, he acknowledges it won't solve every problem related to accessing medical care.

"Technology is definitely part of the solution," he said. "But not the best for every situation."

Floyd's legacy

He didn't know the college's namesake, the late WSU President Elson Floyd, but Tomkowiak said Floyd's legacy feels personal.

"I almost feel like I do, because everyone I meet and talk to was touched by him and has a story," he said.

Floyd, who made it his project to see the medical school created, was clear about how it should develop, Tomkowiak said.

"He wanted it to be bold, audacious and visionary."

Known for thinking and acting quickly and expecting others to do so as well, Floyd inspired the concept of "Elson Time," a phrase that has persisted at WSU since his death of colon cancer last year.

"I frequently invoke Elson Time around here," Tomkowiak said, smiling.

'We will be ... ready'

In 2015, the Washington Legislature gave WSU the green light to start a medical school, but the first steps already had been taken.

The Spokane campus, in development for more than 25 years, was officially designated WSU's health sciences campus by the university's board of regents in 2010.

Also known as Riverpoint, the campus is nestled just east of downtown, along the Spokane River. It is comprised of eight WSU-owned buildings and two in which the university leases space. Students from WSU, Eastern Washington University and the University of Washington study nursing, pharmacy, dentistry, speech and hearing, and nutrition and exercise in the classrooms, labs and clinics.

An accreditation team is expected to visit the campus early this summer. Preliminary accreditation, tentatively slated to be determined in October, would give the school the green light for recruiting its first class, probably 40 to 60 students, to begin in fall 2017.

But that scenario, Tomkowiak said, is optimistic. A fall 2018 start, he said, might be more realistic.

"It wouldn't surprise anybody if that's what they (accreditation team) said. That would be the standard scenario," he acknowledged. "We're sort of on an accelerated pace here."

No matter when the school sees its first class, one thing is certain, Tomkowiak said.

"When we have students come, we will be absolutely ready."

Building a budget

The annual costs as the medical school comes together hinge on a long list of factors, Vice Dean of Administration, Accreditation and Finance James Zimmerman said.

"Those numbers could vary widely, in actuality," Zimmerman said.

The college is scheduled to spend about $16 million this fiscal year and is budgeting for about $23 million next year, as additional positions required for accreditation are filled. Around 50 new faculty and staff members are expected to be hired over the next 18 months.

Much of the budget goes toward the school's research enterprise, which was established even before the formal accreditation process began.

"Research is part and parcel of an allopathic medical school," Zimmerman said.

Allopathic refers to the version of medicine taught at the college, a traditional approach to medicine resulting in physicians with the title doctor of medicine, or M.D. The UW's medical school also is allopathic. Washington's other medical school, Pacific Northwest University of Health Sciences in Yakima, is an osteopathic school, producing doctors of osteopathy, individually known as a D.O.

WWAMI no more

Until last year, the University of Washington was the state's only public medical school, serving students from an additional four states that lack medical schools of their own. Through the WWAMI program - for Washington, Wyoming, Alaska, Montana and Idaho - UW accepted 254 students for the 2015-16 school year from 1,316 applicants, according to UW medical school spokeswoman Kim Blakeley. Another 6,724 students from other states applied, 36 of whom were accepted.

Whether WSU's medical school will have seats only for Washington students or will accommodate some from other states has not been determined.

Students in the WWAMI program have typically completed their first year of medical school on their local campuses, including Pullman and Spokane, then finished medical school at UW in Seattle. With the creation of the Elson S. Floyd College of Medicine, UW chose to discontinue its partnership with WSU. Instead, Spokane's WWAMI students will attend classes at Gonzaga University next school year. Those students will likely still have some presence at WSU Spokane next year, though, as they are expected to return to the campus to use the anatomy lab.

The next step

As they anticipate accreditation, administrators are focused on securing more involvement from the clinical community, a component Tomkowiak describes as essential.

The college, which has clinical campuses in Vancouver, Everett and the Tri-Cities, continues to seek out medical professionals across the state to provide future students a broad range of options as they zero in on their specialty during their four years of medical school.

"We've made lots of great partners in Spokane and across the state," Tomkowiak said. "But we can never have enough."

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Stone may be contacted at mstone@lmtribune.com or at (208) 848-2244. Follow her on Twitter @MarysSchoolNews.