With major medical organizations predicting a national shortage of physicians in coming years, a number of institutional models are being considered to increase the numbers of medical students. At a time when the cost of building new medical schools is extremely expensive, many medical schools are considering alternative methods for expansion. One method is regional expansion. The University of Washington School of Medicine (UWSOM) has used regional expansion to extend medical education across five states without the need to build new medical schools or campuses. The WWAMI program (the acronym for Washington, Wyoming, Alaska, Montana, Idaho), which was developed in the early 1970s, uses existing state universities in five states for first-year education, the Seattle campus for second-year education, and clinical sites across all five states for clinical education. Advantages of regional expansion include increasing enrollment in a cost-effective fashion, increasing clinical training opportunities, responding to health care needs of surrounding regions and underserved populations, and providing new opportunities for community-based physicians to enhance their practice satisfaction. Challenges include finding basic-science faculty at regional sites with backgrounds appropriate to medical students, achieving educational equivalence across sites, and initiating new research programs. UWSOM’s successful long-term regional development, recent expansion to Wyoming in 1997, and current consideration of adding a first-year site in Spokane, Washington, indicate that regional expansion is a viable option for expanding medical education.
Dr. Norris is professor of family medicine and vice dean for academic affairs, University of Washington School of Medicine, Seattle, Washington.
Dr. Coombs is professor of family medicine; associate vice president for medical affairs, clinical systems, and community relations; and vice dean for regional affairs, rural health, and graduate medical education, University of Washington School of Medicine, Seattle, Washington.
Mr. House is director of regional and rural education, research, and support, University of Washington School of Medicine, Seattle, Washington.
Dr. Moore is affiliate professor of medicine and assistant dean and coordinator for the WWAMI program in Laramie, Wyoming, University of Washington School of Medicine, Seattle, Washington.
Ms. Wenrich is affiliate instructor of medical education and biomedical informatics and director, UW Medicine special research and communications projects, University of Washington School of Medicine, Seattle, Washington.
Dr. Ramsey is professor of medicine, vice president for medical affairs, and dean of the School of Medicine, University of Washington School of Medicine, Seattle, Washington.
Correspondence should be addressed to Dr. Norris, Box 356340, University of Washington School of Medicine, Seattle, WA 98195-6340; telephone: (206) 685-3466; fax: (206) 543-9051; e-mail: (email@example.com).