Bills help address shortage of medical manpower, especially on neighboring islands

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Governor David Ige signed two bills to help address the state’s growing doctor shortage and support the University of Hawaii’s mission at Mānoa John A. Burns School of Medicine to retain more of its graduated to practice medicine in Hawaiʻi.

Ige signed Senate Bill 2657 and Senate Bill 2597 on July 7 at JABSOM.

The Hawaii Physician Workforce Assessment Project report says Hawaii needs at least 750 physicians, with the largest statewide shortage being in primary care specialties. The proportional need is greatest on neighboring islands, with Maui and Hawaii County experiencing a 40% doctor shortage.

In addition to bills introduced by the legislature, Ige identified the doctor shortage as a priority at the start of the 2022 legislative session by including funding to expand JABSOM’s residency program in his budget proposal.

“My administration is committed to supporting the development and expansion of high quality education and training sites, especially on neighboring islands where we face the greatest challenge,” Governor Ige said. “Mahalo to our legislators for also making this a priority and to JABSOM and our local medical partners for their dedication to ensuring our local residents can access the healthcare they need now and in the future.”

Senate Bill 2657 funds JABSOM’s expansion of medical residency and medical student training opportunities on neighboring islands, and with U.S. Veterans Affairs (VA) Pacific Islands Health System sites across the state, especially in areas where health care is most needed. The VA is a valued partner in JABSOM’s academic programs. Residents or fellows in internal medicine, family medicine, psychiatry, geriatrics, and addiction medicine have a portion of their curriculum based at VA sites.

Currently, some medical students are doing preclinical rotations for up to three months on Hawaii’s neighboring islands, Lanaʻi, and starting this academic year, Kauaʻi. Third-year students participate in a longitudinal externship program where groups of students train at the same location for a five-month rotation in rural communities. Third-year students currently train at multiple locations on the island of Hawaii, Maui, and Kauaʻi.

“Data shows that more than 80% of doctors who graduate from both JABSOM and its residency programs tend to stay in Hawaiʻi to practice, which is one of the highest retention rates in the country,” said said JABSOM Dean Jerris Hedges. “We know that doctors who train in the rural areas of our neighboring islands are also more likely to put down roots and nurture the communities in which they find themselves. We look forward to extending our medical training opportunities to these areas. underserved and stay true to JABSOM’s ALOHA vision: Achieve sustainable optimal health for all.

To alleviate the physician shortage in the state, more than 225 physicians are participating in JABSOM’s Accreditation Council for Higher Medical Education (ACGME)-accredited residency and fellowship programs. Kaiser Permanente Hawaiʻi also has a primary care internal medicine residency program, and Hilo Medical Center is the sponsor of the island of Hawaii’s family medicine residency program. With the exception of the Hilo-based program, the rest of these civilian residency programs are on Oʻahu, with some having clinical rotations on nearby islands. Neighboring island rotations—through VA clinics or in partnership with other neighboring island physicians and health systems—give residents and fellows the opportunity to train and potentially practice in rural areas.

“Hawaiʻi Residency Programs, as the employer of JABSOM residents and most fellows, is committed to our rural and at-risk communities by training our future medical workforce,” said Natalie Talamoa, Executive Director of Hawaiʻi Residency Programs. . “We are thrilled that the State of Hawaii shares our goal and we look forward to working together on this initiative to invest in the communities on our neighboring islands that have been hardest hit by the doctor shortage. This funding will increase access to training opportunities for our residents and fellows, and provide them with exposure and understanding of our most vulnerable populations so they will want to return to serve these communities.

“The VA’s ability to expand higher medical education can help reduce the effects of an anticipated shortage of physicians here in the Pacific Islands, particularly in Hawaiʻi, through the partnership we have with the John A. Burns School of Medicine,” said Adam Robinson, Jr., director of the Pacific Islands Veterans Health Care System. “We pride ourselves on providing the largest healthcare professional education and training company in the nation, but we cannot do this without the relationships we share with our valued Affiliate University Residence Sponsors.”

Senate Bill 2597 allows for more loans under the Hawaii State Loan Repayment Program, which helps graduates of JABSOM and other healthcare professions reduce their student debt. studies in exchange for their stay in Hawaii to practice. Loan repayment programs are a critical component in addressing the shortage of health professionals, and Hawaii’s program has proven to be very effective.

According to Kelley Withy, director of JABSOM’s Hawaii and Pacific Rim Health Education Center, “83% of loan repayers remained in Hawai’i to practice, and 70% remained at the site where they performed their service. Currently, there are 25 active providers in the program and seven more awaiting funding. We are very grateful to the Legislature for matching funds so that we can provide more opportunities for those who wish to care for communities where there is a severe shortage of health care providers.

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Health professionals who have benefited from the loan repayment program serve on all the islands and in the communities of Waimea, Kihei, Waiʻanae, Hilo and Wailuku; at Federal Qualified Health Centers in Kalihi-Palama and Kokua Kalihi Valley; and in public facilities at the Honolulu Federal Detention Center, Halawa Correctional Facility, and Maui County Correctional Center. Healthcare professionals who are eligible to participate in the program include physicians, nurse practitioners, psychologists, social workers and many others.

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Among those present at the bill signing ceremony were state lawmakers Rep. Gregg Takayama, Rep. Ryan Yamane, Sen. Donna Mercado Kim and Sen. Jarrett Keohokalole, UH President David Lassner , JABSOM Dean Jerris Hedges, JABSOM Associate Dean for Academic Affairs Lee Buenconsejo-Lum, JABSOM Associate Dean for Administration and Finance Nancy Foster, as well as leaders from affiliated hospitals, Hawaiʻi Residency Programs , Inc., the VA Pacific Islands Health Care System and leaders from several JABSOM clinical departments and the Office of Medical Education which oversees the MD program curriculum.

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