Quality health care is a concern no matter the place of residence. While conventional allopathic medicine remains widely available in urban settings across the state, Arkansas has continued to grow the number of physicians available to serve rural areas by training doctors of osteopathic medicine (DOM) in addition to those trained as medical doctors (MD).
Osteopathy is recognized as a specific philosophy integrating a holistic approach to traditional medicine. There may be a difference in philosophy, but osteopathic medical schools operate similarly to how allopathic (traditional) medical schools function. Traditional colleges of medicine include four years of study with clinical rotations and licensure. While medical doctors must pass the United States Medical Licensing Exam, doctors of osteopathic medicine must pass the Comprehensive Osteopathic Medical Licensing Examination, both tests being three parts.
The 2020 U.S. census revealed 3.3 percent growth in population for Arkansas. The University of Arkansas’ Rural Profile in 2019 determined that rural areas of the state show an aging population. Along with aging areas, the UA study also reported a steady increase in infant mortality rates, rising highs in adult obesity as well as health risks that seem to disproportionately affect those residing in rural areas.
ARCOM student Savannah Phillips prepares to deliver a COVID vaccination to a local patent at a community health fair.
The University of Arkansas for Medical Sciences (UAMS) has long been the only teaching hospital in the state, and has graduated physicians since its founding in 1879. While medical school acceptance is traditionally and increasingly competitive, the emergence of osteopathic programs such as the New York Institute of Technology College of Medicine at Arkansas State University (NYITCOM) in Jonesboro and the Arkansas College of Medicine at Arkansas College of Health Education in Fort Smith (ARCOM) is providing greater options for students pursuing medicine, and in return more physicians to graduate in state.
Even with the addition of two new medical schools, UAMS serves as the only allopathic teaching hospital in the state, offering dual enrollment programs.
“My personal opinion is that we want educational opportunities broadly,” Susan Smyth, M.D., Ph.D, dean of the College of Medicine at UAMS said.
Vicki Oladoyin, a second-year medical student at NYIT College of Osteopathic Medicine at Arkansas State, teaches a Nettleton High School student to suture using a skin-like silicone pad.
Shane Speights, D.O., is the dean of NYITCOM in Jonesboro — the second medical school and the first osteopathic college of medicine in Arkansas. He stressed the importance of creating opportunities to place more physicians in Arkansas.
“By design, osteopathic medicine is geared to meet the needs of the rural and underserved areas of our state and country. That’s why you see more colleges of osteopathic medicine being started in states like Arkansas,” he said. “Historically, osteopathic medicine produces more of the frontline physicians needed in the United States — physicians trained in family medicine, pediatrics, general surgery, internal medicine, OB/GYN, emergency medicine, psychiatry — which is what we need here in our own state.”
ARCOM dean Rance McClain, D.O., said the surfacing of osteopathic medicine is impacting Arkansas in important ways. According to McClain, osteopathic medical schools are more likely to be private institutions that aren’t affiliated with a large tertiary-care hospital, meaning that these programs are more likely to partner with multiple community-based hospitals and clinics.
“I believe we are making an enormous impact in these areas,” McClain said. “These facilities are a great opportunity for rural areas to highlight what life could be like for these students should they decide to return and set up a practice in the area.”
Yash Makkapati and Makayla Goggins, both second-year medical students at NYIT in Jonesboro, practice intubation techniques on a medical task trainer.
Exposure to these communities is crucial to improving the access to health care in rural areas, he said.
“The majority of [ARCOM’s first] graduating class pursued training in this state or the surrounding states, which are included in our service area. Following national trends, we know that a student who attends medical school in a region, then stays in that region for GME training, is around 70 to 80 percent more likely to remain in that region for their clinical practice upon finishing their residency training.”
Speights thinks Arkansans can expect to see more physicians practicing in those areas that need them now that two osteopathic medical schools are complementing the graduating classes at UAMS.
“Pulaski County has lots of doctors. So does Craighead County, Washington County and Benton County. We need doctors in Mississippi County, Crittenden County, Clark County, Polk County, Ouachita County, Chicot County, Phillips County, and the list goes on,” he said, adding that in order to improve access to health care in underserved areas, students need to experience these communities while they are still in school.
Both NYITCOM and ARCOM have created environments in which students experience hands-on health care in their communities.
According to McClain, this approach has led to the overwhelming evidence of the promise of more practicing physicians in Arkansas.
“We are giving local students additional options to continue their education in Arkansas, and with the GME programs we are developing in conjunction with community hospitals in the state of Arkansas, they are also receiving more options to pursue residency training in this area,” McClain said, adding that this will improve health care.
Speights has emphasized the importance of NYITCOM being involved in its community. The Project H.E.A.R.T summer camp is hosted annually by NYITCOM in order to educate high schoolers about the opportunities for careers in health care. In addition to this, NYITCOM also plays a significant role in working vaccine clinics in rural areas as well as building relationships with school districts in surrounding areas to help educate and advise for COVID-19.
Vineet Mohanty, a fourth-year medical student at NYIT, performs Osteopathic Medical Manipulation (OMM) on a patient while Dr. Brianne Wehner, assistant professor of OMM, observes and instructs.
“We train our students where the health care is being delivered and where it is needed. In addition, we don’t just send them to a rural or underserved area for a one month rotation; they are assigned to those communities for the entirety of their third and fourth years of medical school. They live, buy groceries, shop and go to church in these communities,” Speights said “The intent is that they consider these areas to live and practice, and we’re already seeing that happen.”
NYITCOM sends students to several small communities for clinical rotations, including Mena, Benton, Camden, Batesville, Monticello, Paragould and Gravette, among others.
Speights believes there is a great opportunity for medical schools to do great things in Arkansas by addressing the needs of the state. For NYITCOM, this means staying focused on its mission and working so it doesn’t become “a mile wide and an inch deep.”
McClain said the key is showing potential students that ARCOM’s mission and vision align with their desire for a career in medicine. ARCOM also is focused on recruiting potential physicians from the area who might be more apt to stay home and practice.
The majority of graduating DOs are going into the areas that meet the immediate needs of the state, according to Speights, including family and internal medicine.
For NYITCOM specifically, Speights said 98 percent of students in the first two graduating classes received residency placements with 80 percent being matched in family and internal medicine.
Similarly, ARCOM has seen the majority of its graduates pursue training in Arkansas and in surrounding areas that are still included in ARCOM’s service area. According to McClain, judging by national trends, students who stay in the area of their medical school for GME training are 70 to 80 percent more likely to stay in the area after their residency.
