VITAL SIGNS 2011 Community Report
EDUCATE DISCOVER SERVE
Leadership
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Administrative Officers
School of Medicine and Health Sciences Advisory Council
Robert O. Kelley, PhD President of the University of North Dakota Joshua Wynne, MD, MBA, MPH Vice President for Health Affairs and Dean Gwen W. Halaas, MD, MBA Senior Associate Dean for Academic and Faculty Affairs Julie A. Blehm, MD Associate Dean, Southeast Campus Charles E. Christianson, MD, ScM Associate Dean for Clinical Education Randy S. Eken, MPA Associate Dean for Administration and Finance Nicholas H. Neumann, MD, MMM Associate Dean for Student Affairs and Admissions (Interim) and Associate Dean, Southwest Campus
Joshua Wynne, MD, MBA, MPH Grand Forks (Executive Secretary) Thomas F. Arnold, MD Dickinson John R. Baird, MD Fargo Rep. Stacey Dahl, JD Grand Forks Terry Dwelle, MD Bismarck J. Brian Hancock, MD Fargo L. Gary Hart, PhD Grand Forks Sen. Ralph L. Kilzer, MD Bismarck John M. Kutch, MHSA Minot Craig J. Lambrecht, MD Bismarck
2011 Community Report
Sen. Tim Mathern, MPA Fargo Rep. Ralph Metcalf Valley City David Molmen, MPH Grand Forks (Chair) Carol K. Olson Bismarck Shari L. Orser, MD Bismarck Grant H. Shaft, JD Grand Forks Courtney M. Koebele, JD Bismarck (Ex Officio)
Educate, Discover, Serve
More Than Just A Medical School—A School Without Walls Basic Medical Sciences Doctor of Philosophy and Master of Science degrees are available in the following disciplines: • Anatomy and Cell Biology • Biochemistry and Molecular Biology • Microbiology and Immunology • Pharmacology, Physiology, and Therapeutics Medical Doctor (MD) Program All medical students spend their first two years in Grand Forks. They learn through lectures, laboratories, patient simulations, and in patient-centered learning groups, where basic and clinical sciences are taught in the context of patient cases. They then spend two years of clinical training in Bismarck, Fargo, Grand Forks, Minot, or a rural community through the Rural Opportunities in Medical Education (ROME) program. MD/PhD scholars program Outstanding students are prepared for careers in academic medicine and research. Students pursue original research in laboratories or clinical settings with members of the graduate faculty while also completing the medical school curriculum.
Residency Training Beyond the MD degree, the School of Medicine and Health Sciences provides residency training: a period of advanced intensive training for medical school graduates in their chosen medical specialty before independent practice as a physician. Depending on the medical specialty, medical school graduates complete anywhere from three to seven years of residency training after medical school. Residency training is provided in five specialties. • Family Medicine (Bismarck, Minot) • Internal Medicine (Fargo) • Surgery (Fargo, Grand Forks) • Psychiatry (Fargo) • Transitional (Fargo)—a yearlong program designed to introduce graduates to a wide range of medical and surgical specialties. The goal is to build a broad foundation of clinical skills as a base for future training in a medical specialty. (An additional program in Family Medicine is provided through Altru Health System in Grand Forks.)
Master of Public Health In collaboration with North Dakota State University, the School will offer a new Master of Public Health program in 2012. Health Sciences Athletic Training • Four-year Bachelor of Science Medical Laboratory Science • Multiple undergraduate and post graduate training options • Master of Science and Graduate Management Certificate • More than 60 clinical training sites in 10 states; more than half in North Dakota and the surrounding region Cytotechnology Professional Program • Four-year Bachelor of Science professional program or postgraduate certificate Occupational Therapy • Five-year Master of Occupational Therapy Physician Assistant Studies • Two-year Master of Physician Assistant Studies Physical Therapy • Three-year pre-physical therapy and three-year Doctor of Physical Therapy 2011 Community Report
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Educate The primary purpose of the University of North Dakota School of Medicine and Health Sciences is to educate physicians and other health professionals and to enhance the quality of life in North Dakota. Other purposes include the discovery of knowledge that benefits the people of this state and enhances the quality of their lives. —North Dakota Century Code
The University of North Dakota School of Medicine and Health Sciences A National Leader in Rural Health—Serving North Dakota since 1905 Areas of Strength Your School of Medicine and Health Sciences strives to educate health care providers and scientists and to discover new knowledge to serve North Dakotans. The School has a well-deserved reputation for excellence as one of 34 community-based medical schools in the country, which gives our medical and health sciences students the chance to practice in hospitals and clinics across North Dakota. The School is grateful for the more than
The UND School of Medicine and Health Sciences Educates students to focus on patients and communities • The School’s patient-centered learning curriculum is nationally recognized for producing quality medical graduates. • At the forefront of medical education, the School uses the latest in simulation technology for teaching and serves as a valuable resource for health care professionals throughout North Dakota and the region. • An interprofessional health care course makes the School a national leader in providing students with a strong practical understanding of the health care professionals on their team.
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2011 Community Report
900 part-time or volunteer clinical faculty in over 30 communities throughout the state who help to educate medical students and residents. There are four clinical campuses located in Bismarck, Fargo, Grand Forks, and Minot. Health sciences students receive training not only here in North Dakota but also across the country, including an occupational therapy campus in Casper, Wyoming, and a medical laboratory science campus at Mayo Clinic in Rochester, Minnesota.
• Medical students and residents provide direct care to North Dakotans through the Centers for Family Medicine in Bismarck and Minot as well as through clerkships in communities throughout the state. • Health sciences students provide direct care and services through internships in health care facilities across North Dakota.
Discover, Serve
The UND School of Medicine and Health Sciences Discovers new knowledge to transform lives through research Areas of Research Strength • Cancer and the environment • Neurodegenerative disorders • Health disparities in rural and American Indian communities • Eating disorders and obesity • Gerontology • Infectious diseases
The School has facilities for the study of drug addiction and neurodegenerative diseases such as Parkinson’s, Alzheimer’s, multiple sclerosis, epilepsy, and others.
MD/PHD Scholars Program The MD/PhD Scholars Program prepares physician-scientists to take observations from the bedside into the laboratory, make basic discoveries, and translate their discoveries into new methods for prevention, diagnosis, and treatment of disease.
The UND School of Medicine and Health Sciences Serves North Dakota • The School improves the health and health care of North Dakotans through research, community engagement, and prevention programs. • Direct primary care to North Dakotans is provided through its family medicine clinics in Bismarck and Minot.
• The School leads the nation in rural health through the Center for Rural Health, one of the nation’s best. The Center is home to the nation’s only Rural Assistance Center, a worldwide clearinghouse for information on rural health issues, and the Health Workforce Information Center, which provides free access to the most recent resources on the nation’s health workforce in one easy-to-use online location.
• The new Master of Public Health program is a partnership between UND’s School of Medicine and Health Sciences; NDSU's College of Pharmacy, Nursing, and Allied Sciences; and other departments at both universities that will bolster the number of rural public health professionals in the state and better equip existing rural health workers with the tools they need to improve services.
2011 Community Report
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Educate In addition to undergraduate and graduate students enrolled in programs offered by the School of Medicine and Health Sciences, faculty also teach basic science courses to undergraduate students who will become nurses, dietitians, teachers, and forensic scientists. Faculty also teach over 400 online courses.
Student Enrollments by Major Spring 2011 Basic Sciences Anatomy and Cell Biology 9 (Graduate—Master and Doctoral) Biochemistry and Molecular Biology 18 (Graduate—Master and Doctoral, includes Pathology) Microbiology and Immunology (Graduate—Master and Doctoral) 10 Pharmacology, Physiology, and Therapeutics (Graduate—Master and Doctoral) 15 Total 52
Total undergraduate student enrollment for the spring of 2011 was 712.
Medical Doctor Year 1—Class of 2014 Year 2—Class of 2013 Year 3—Class of 2012 Year 4—Class of 2011
67 62 61 55 Total 245
Health Sciences Athletic Training Pre–Athletic Training 36 Bachelor of Science 23 Cytotechnology Pre-Cytotechnology 6 Bachelor of Science— Cytotechnology 1 Medical Laboratory Science Pre–Medical Laboratory Science 50 Certificate 66 Bachelor of Science 147 Master of Science 43 Occupational Therapy Pre–Occupational Therapy 215 Professional Year I 49 (Undergraduate) Professional Year II 45 (Undergraduate) Professional Year III 51 (Graduate—Master) Physician Assistant 57 (Graduate—Master) Physical Therapy Pre–Physical Therapy 203 Doctoral 142 Total 1,134
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2011 Community Report
Educate
2011 Community Report
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Educate Students in the health sciences and medicine meet or exceed the average on most nationally recognized exams measuring academic progress.
School of Medicine and Health Sciences Student Performance on Nationally Recognized Exams Program
UND Pass Rate
National Pass Rate
57% 95% 100% 75% 82% 78% 100%
61% 75% 93% 68% 82% 90% 88%
90%
93%
Step 2 Clinical Knowledge Clinical Skills
98% 100%
97% 97%
Step 3 Independent Clinical Practice
100%
96%
Athletic Training Medical Laboratory Science Cytotechnology Histotechnology Occupational Therapy Physical Therapy Physician Assistant Medical Student Step 1 Basic Science
Sources: Data are from the most recent examination in each respective area.
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2011 Community Report
Educate
UND Graduates Entering a Family Medicine Residency 1981–2011 50 46.7
40
Average 1981–2011 UND SMHS 23.0% NATIONAL 11.3%
35.9 34.2
34 32 30.2
30
30 26.9 26 25.9 22.9 22.6
20 Percentage of Graduates
25.4
24.6
24.1
23
23.5
21.8
18
17.9
19
18.4 16.1
12.8
10
15.2
13.6
12.8 12.9 12.5 12.4 11.8
15.9 16.6 14.6 13.4 12.3
11.8 12 10.7 10.8 10.7 10.3
“Family physicians are the bedrock of primary care, and primary care is the foundation of a health care system that provides high quality, effective, and efficient care to patients. It all begins with the medical schools and their faculty’s commitment to family medicine.”
10.8
15.4
13.5
16.7
16.4
14.8
13.4 12.8
10.9 10.9
10.3
9.3
9.2
8.4
8.5
8.3
8.2
7.5
7.8
8.3
0 '81 '82 '83 '84 '85 '86 '87 '88 '89 '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 YEAR
Roland Goertz, President, American Academy of Family Physicians
Sources: Division of Education Division of Research and Information Services American Academy of Family Medicine Department of Family & Community Medicine University of North Dakota 3/11
2011 Community Report
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Educate
Growing Our Own Innovative Programs to Produce Health Care Providers for North Dakota
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GOOD
ROME
RURALMED
To Grow Our Own Doctors and other health professionals, the 2011 Legislature provided to the School of Medicine and Health Sciences $1.8 million in new funding to expand the medical school class size by eight students, the health sciences class size by 15 students, and the residency size by 9 residents. Slated to begin in the summer of 2012, the class size expansion will be focused on educating more primary care providers to deliver care in North Dakota. Coupled with enhanced efforts addressing retention of our own graduates for practice in North Dakota, this expansion of the class size will help to address the current and especially the anticipated looming shortage of providers.
Rural Opportunities in Medicine (ROME) is a 24–28 week interdisciplinary experience in a rural primary care setting that is open to third-year students at the School of Medicine and Health Sciences. Students live and train in nonmetropolitan communities under the supervision of physician preceptors. ROME students experience health care delivery in rural areas throughout the state of North Dakota, where providing access to health care is sometimes challenging. Students learn about problems commonly encountered in primary care, from routine health maintenance to medical emergencies and rare and unusual diagnoses. Each primary preceptor is board-certified in family medicine, but students also work with board-certified surgeons, internists, pediatricians, and other specialists available in the community.
RuralMed is a tuition waiver program (or scholarship) designed to encourage medical students to select careers in family medicine and increase the number of family medicine providers for rural North Dakota. Students accepted for the RuralMed Program have their entire cost of tuition waived in return for their practicing in North Dakota. Students will not have to borrow money for tuition and accrue interest for medical education.
2011 Community Report
INMED The Indians into Medicine Program (INMED), which was established in 1973, is a comprehensive program designed to assist American Indian students who aspire to be health professionals to meet the needs of our Indian communities and to serve reservation populations. INMED has assisted approximately 20 percent of U.S. American Indian physicians with their education.
Educate
SCRUBS CAMPS
SCRUBS ACADEMY
SEARCH
Rural Collaborative Opportunities for Occupational Learning in Health (R-COOL-Health) Scrubs Camps are one-day learning experiences in which students are able to explore health career options by hearing from local health care professionals and participating in exciting hands-on activities. In the first year, 1,457 students participated and 531 volunteers at 23 different Scrubs sites delivered the interactive activities. Students learn about the day-to-day working environment of a surgical nurse, a flight-for-life operator, or a laboratory technician by practicing with suturing simulators, injecting oranges, taking helicopter rides, dissecting pig hearts, typing blood samples, and participating in mock ambulance scenarios.
Thirty-eight students who just completed sixth, seventh, or eighth grade participated in the first Scrubs Academy on June 19–22, 2011, at the Grand Forks campus. Students dissected a pig heart with SMHS Dean and cardiologist Dr. Joshua Wynne, and the students learned about anatomy, medical laboratory science, emergency medical services, mental health, nursing, occupational therapy, optometry, pharmacy, physical therapy, public health, and radiology. The camp supplied CPR training and certification, and the students were given tours of the School of Medicine and Health Sciences and its Simulation Lab.
Student/Resident Experiences and Rotations in Community Health (SEARCH) is a program that helps to establish links between the School of Medicine and Health Sciences and communities to better prepare students and residents in medicine and students in the physician assistant program for primary care delivery in health professional shortage areas. SEARCH takes a “service-learning” approach to health professional education by combining community service and clinical experiences with explicit learning objectives, preparation, and reflection. SEARCH provides health profession students an opportunity to experience firsthand what it is like to live and practice in rural and underserved areas. They quickly see the quality of services that are available in rural facilities and the relationships that providers establish with their patients. Rural training programs can greatly enhance recruitment and retention by preparing students and residents for the realities of rural practice, increasing their clinical competence, and socializing them to rural communities. 2011 Community Report 11
DISCOVER Areas of research strength • Cancer and the environment • Neurodegenerative disorders • Health disparities in rural and American Indian communities • Eating disorders and obesity • Gerontology • Infectious diseases
Studying issues that matter to North Dakotans Sponsored project awards by sponsor Type FY2010 0.01% 4.8% 5.5% 6.1%
83.59%
Total number of proposals FY2010 ..........208 Total number of awards FY2010 ..................93
Research Events Summer undergraduate Biomedical Research Poster Symposium August 2011
Funding The school received 48% more research funding in FY2010 than FY2009, up from $15.4 million to $22.8 million.
Center of Biomedical Research Excellence (COBRE) Annual Neuroscience Symposium Fall 2011 North Dakota Institutional developMENT Award (IDEA) network of biomedical research excellence(INBRE) Annual Symposium for Undergraduate Research October 2011 Federal State Private (Other) Foundation Private (Industry)
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2011 Community Report
32nd Annual Frank Low Research Day April 2012 Family Medicine Research Colloquium June 2012
DISCOVER
Holly Brown-Borg, PhD, Chester Fritz Distinguished Professor in the Department of Pharmacology, Physiology, and Therapeutics, conducts internationally recognized research on the aging process. Left to right: Lalida Rajanathamannee, a postdoctoral student; Sharlene Rakoczy, a research specialist who has worked in the lab for 12 years; and Dr. Brown-Borg. 2011 Community Report 13
Serve Through funding from the state Legislature, the Center helped communities hold 23 Scrubs Camps and a Scrubs Academy for 1,495 children across North Dakota. Scrubs Camps are one-day learning experiences for kids to learn about health professions; the Scrubs Academy was a three-day experience held at the School of Medicine and Health Sciences for 38 middle-school students.
Center for Rural Health The Center for Rural Health at the School of Medicine and Health Sciences provides services to all 53 counties and 100 communities in North Dakota. The Center provides technical assistance to all 38 rural hospitals, 36 of which are critical access hospitals. The assistance is focused on improving access to care, viability of rural health systems, quality of care, and rural health system development. Direct grants to health organizations in North Dakota awarded and administered through the Center for Rural Health totaled $1,353,161 for FY2010 and $1,812,459 for FY2011. in FY 2010, The CeNTer for Rural Health provided • $570,555 to rural North Dakota hospitals for health services development or expansion (including emergency medical services and other rural partners) • $374,795 to expand rural health information technology (funding source was BlueCross BlueShield of North Dakota) • $407,811 for workforce development (funding sources were a federal Area Health Education Center grant, federal Student/Resident Experiences and Rotations in Community Health Grant, and state appropriations) in FY 2011, The CeNTer for Rural Health provided • $646,903 to rural hospitals for health services development or expansion (including emergency medical services and other rural partners) • $375,000 to expand rural health information technology (funding source was BlueCross BlueShield of North Dakota) • $790,556 for workforce development (funding sources were a federal Area Health Education Center grant and state appropriations)
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2011 Community Report
Serve
Neil Westergaard, assistant professor in the Math and Science Department at Williston State College, helped conduct a Scrubs Camp in Williston on April 14, 2011. Neil was among 531 sta from schools and health facilities across the state who volunteered their time to conduct the camps. 2011 Community Report 15
Serve
MORE THAN 600 PRACTICING PHYSICIANS SERVING NORTH DAKOTA COMMUNITIES RECEIVED THEIR EDUCATION AT UND
Charles Nyhus, MD ’79, confers with his patient and Rachel Ott, MD ’10, during an exam at the Central Dakota Clinic in Harvey. 16
2011 Community Report
Serve
PercentageS of Physicians Practicing in North Dakota Who Are Graduates of the UND School of Medicine and Health Sciences All Specialties Family Medicine Internal Medicine Obstetrics and Gynecology Pediatrics Psychiatry
45% 66% 46% 55% 31% 46%
Source: 2010 North Dakota Medical Services Directory published by the North Dakota Medical Association
Percentages of Health Care Providers Practicing in North Dakota Who Are Graduates of the University of North Dakota School of Medicine and Health Sciences Athletic Trainers Occupational Therapists Medical Laboratory Scientists Physician Assistants Physical Therapists
17% 56% 51% 41% 58%
Data were collected from North Dakota state licensing boards and academic departments.
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Serve Nationwide, employee turnover rates of 20–30 percent are often an expected cost of doing business. Imagine locating your company in a state where employee turnover rates higher than 15 percent are cause for concern and many employers do not track turnover because it's not an issue, much less a line item. —North Dakota Department of Commerce
A Stable Workforce The School of Medicine and Health Sciences faculty turnover rate (faculty who have left their jobs) was 8.3% for FY2010. Since 2004, the average turnover rate for North Dakota University System faculty has been 8.1%. The School of Medicine and Health Sciences staff turnover rate was 7.4% for FY2010. Since 2004, the average turnover rate for North Dakota University System staff has been 9.8%.
Benefited Faculty and Staff for Fiscal Year 2010 Total Benefited* Faculty—157 Full time—142; Part time—15 • Basic Sciences (Anatomy and Cell Biology; Biochemistry and Molecular Biology; Microbiology and Immunology; and Pharmacology, Physiology, and Therapeutics)—41 • Clinical Sciences (Center for Rural Health; Clinical Neuroscience; Family and Community Medicine; Internal Medicine; Obstetrics and Gynecology; Office of Medical Education; Pathology; Pediatrics; Radiology; and Surgery)—68 • Health Sciences (Medical Laboratory Science, Cytotechnology, Histotechnology, Occupational Therapy, Physical Therapy, Physician Assistant, and Sports Medicine)—48 Total Benefited* Staff—242 Full time—210; Part time—32
*Benefited appointment is 20 hours/week or more.
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2011 Community Report
Serve
Leaders of the School promote the satisfaction and health of students, faculty, and staff through novel activities such as “Joggin’ with Josh,” an informal 5K walk, jog, or run along the outskirts of campus. Shown is the event on August 12, 2010. 2011 Community Report 19
Educate, Discover, Serve Biennial budget is $161,768,682 The majority comes from non-state sources such as grants, contracts, patient revenue, and tuition.
UND School of Medicine & Health Sciences Expenditures: 2011–2013 total: $161,768,682
Revenue: 2011–2013 total: $161,768,682 3.1% $5,019,240
14.5% $23,456,459
56% $90,590,462
16.6% $26,901,471
29.6% $47,847,971
29.5% $47,721,761 24.7% $40,000,000 26% $42,000,000
Salaries Operating Fringe Benefits
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2011 Community Report
ND General Fund Local Funds Grants & Contracts Tuition One-Mill Levy
Educate, Discover, Serve
Jon Allen, MD, assistant dean of the northeast campus in Grand Forks, is the director of ND STAR (Simulation, Teaching, and Research) for Health Education, the School’s simulation lab, which provides complete and eective simulator training for North Dakota and the region. 2011 Community Report 21
Educate, Discover, Serve
Philanthropy Sources of Donations Fiscal Year 2010
“Thank you for granting me the Academic Achievement Award. I’ve worked hard in my pursuit of my medical degree, and it is gratifying to know that the hard work has paid off. I will continue to strive to do my best to get the most of my medical education.”
1.4% 2.1%
11.4%
64.8%
86.4% 10.1%
23.8%
Bryn Putbrese, Second-Year Medical Student
Retained Donors Re-engaged Donors New Donors
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2011 Community Report
Alumni Friends Corporations/foundations/matching gifts Other
Educate, Discover, Serve
Philanthropy Uses of Donations Fiscal Year 2010 1.5% 4.3%
43.4% 19.9%
30.9%
Faculty Development Priority Needs Students Facilities Programs
“I would like to personally thank you for the scholarship you provided in honor of Matt and Katrin Hjalmarson. I have made it a personal goal in life to help those in need both through my education and financially when possible. By giving back to the community, I hope to repay some of the generosity that was bestowed upon me by scholarships such as this.”
Nicole Likewise, Occupational Therapy Student
2011 Community Report 23
Educate, Discover, Serve
Keep your finger on the pulse of the latest news and events from the School of Medicine and Health Sciences Read Dean Joshua Wynne’s weekly column in E-News, the School’s digital newsletter delivered to your inbox.
Subscribe to North Dakota Medicine, the School’s quarterly magazine available on the SMHS website: http://www.med.und.edu/ or through a print subscription. To subscribe to E-News or North Dakota Medicine, please contact Kristen Peterson, kristen.peterson@med.und.edu. (701) 777-4305.
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If you would like further details about the information in this Community Report or the programs, departments, or research at the School, please contact Denis MacLeod, assistant director, Office of Alumni and Community Relations, UND School of Medicine and Health Sciences, (701) 777-2733, denis.macleod@med.und.edu
Vital Signs 2011 represents the good-faith effort of the UND School of Medicine and Health Sciences to provide current and accurate information about the School. Numerous sources were used in gathering the information found in this community report. We welcome corrections, which we will incorporate in subsequent issues of Vital Signs.