Project Description Narrative:
Health inequities and health outcomes in Milwaukee County are among the worst in the U.S. A critical shortage of physicians trained to care for Wisconsin’s medically underserved urban communities is one root cause of these disparities. Of the 33 City of Milwaukee ZIP codes, 12 are currently designated as Health Professional Shortage Areas (HPSAs), with fewer than one full-time primary care physician per 3,000 to 3,500 people—far below the number required to ensure access to essential primary health care services. Efforts to attract physicians to medically underserved areas in the U.S. like Milwaukee have been disappointing.
For 60 years, the federal government has offered student loan forgiveness to physicians who choose to practice in these areas, but this program has led to no significant changes in physician density or county-level mortality rates. Experts suggest that potential solutions are those that attract graduating medical students and trainees to high-need areas before they establish practices, suggesting an important role for medical schools like the Medical College of Wisconsin (MCW), the only medical school in southeastern Wisconsin.
Research also suggests that recruiting aspiring physicians from underrepresented backgrounds and/or targeted underserved areas, offering community-based learning and curricula focused on health equity, and reducing medical education debt may increase the number of graduates who choose to practice in underserved areas. Still, no single tactic stands out as effective on its own, and to have a sustained impact, medical schools will need to take a multi-pronged approach.
With this in mind, this project team has designed the Health Equity Scholars Program (HESP) as a pilot aimed at increasing the number of school of medicine graduates who choose to practice medicine in Milwaukee and who are expertly trained to care for its underserved residents. As a pilot educational intervention, HESP will introduce evidence-based elements designed to influence not just the educational experiences of its participants but also their subsequent career choices and community impact.
Students selected for HESP will be enrolled in the program throughout all four years of medical school, and the pilot will include three consecutive cohorts of five medical students each. This design will allow the team to gather data longitudinally, assess the program’s impact, identify the most effective components of the program, pursue additional funding sources, and determine whether HESP should be integrated into and supported by the institution at the end of the grant period.
HESP has the following specific aims:
- Develop the next generation of health equity physician leaders for Milwaukee;
- Augment ongoing health equity efforts through integration and partnership with current MCW programs; and
- Enhance MCW student engagement with the Milwaukee community.
Using a multifaceted approach, HESP seeks to pilot a program comprised of several innovative strategies that resonate with the broader goals of health equity and community-driven healthcare. The project team aims to positively impact the health of Wisconsinites by directly addressing the critical shortage of physicians in Milwaukee, training the programmatic leaders of the near future, and through rigorous program evaluation, deriving best practices for sustainable, compassionate health workforce development across our state and country.