Two microphones suspended from the ceiling allowed them to talk to their instructor, Mike Wacker, and to a larger group of students 55 miles away in Kansas City at UMKC’s School of Medicine on the Health Sciences Campus. A big video screen showed Wacker and both groups of students, giving the feeling they were all together.

Remote learning is nothing new, of course, especially since the pandemic hit a year ago. But this class occurred at a brand-new campus, the UMKC School of Medicine-St. Joseph, which went from drawing board to reality in just two years — and from Higher Learning Commission approval to students in classrooms in just two months.

The campus, housed inside Mosaic Life Care’s medical center in St. Joseph, also has a special mission: to train students in rural medicine and increase the number of physicians serving outstate Missouri.

“Students training in rural programs are three times as likely to remain in practice in those areas,” said Mary Anne Jackson, M.D. ’78, dean of the School of Medicine. “Our goals are to recruit students from rural communities or who are committed to rural health care and prepare them with the same innovative curriculum students receive on the Kansas City campus as they live and learn in St. Joseph.”

‘Already working well together’

In January, the St. Joseph site welcomed its first class of 20 students, doubling the size of the school’s latest four-year M.D. class. These students will see patients with Mosaic physicians and experience rural medicine firsthand. The plan is to add another class of 20 each year till the campus is home to 80 students.

“We have been a pretty tight group from the very first,” said Sameer Khan, who grew up in Plainfield, Illinois, population 43,000. “I think we’re all excited to not just learn but to apply that knowledge to treating patients.”

Many in the inaugural class come from Missouri and earned their undergraduate degrees in the state, but universities in Kansas, Illinois, Arkansas, Minnesota and Georgia also are represented. Several have experience as teaching assistants or medical scribes, and most can trace their interest in medicine to experiences they have had with physicians.

Khan shared that his 88-year-old grandmother has had cancer and a stroke. “Just seeing all of the care she has received, and the kind manner and calming demeanor the doctors have had, attracted me to medicine,” he said.

For Abigail Bowser, whose hometown is Smithville, Missouri, health care has always been part of life.

“My mom is a nurse,” she said. “And I’ve had a series of health challenges, including asthma. I also was born with three kidneys – and it was a resident who figured that out. Some test results came back and he said, ‘I’ve seen this before. We need a full internal scan.’

He was right, so I’m eager to see what I can learn and discover.”

Response to a big need

The American Association of Medical Colleges projects a shortage of nearly 122,000 physicians by 2032 in the United States, with primary care physicians making up almost half of that number.

In rural areas, the shortage is already acute. Nearly every rural county in Missouri — 99 of 101 — already rates as having too few primary care health professionals for its population.

When Jackson took the helm at the School of Medicine in 2018, she was asked how UMKC could build on the school’s success. “Service to our state” topped her list of areas for improvement.

“It was clear to me as a graduate of this school that we had experienced some mission drift from our initial plan when we opened our doors in 1971,” she said. “That mission was to serve the people of Missouri.”

Jackson and vice deans Steven Waldman, M.D. ’77, and Paul Cuddy, Pharm.D., identified northwest Missouri as one of the best areas for growth to expand the school’s rural reach.

“It seemed that the surest way to make an impact was to establish another campus,” said Waldman, now the dean for the new campus. “We looked around the state for clinical partnerships, and Mosaic and St. Joseph were clearly our best option.”

Several qualities made Mosaic a perfect partner. It has a large rural primary-care network, including facilities in the Missouri towns of Albany and Maryville. It is known for excellent patient care and an emphasis on quality and patient safety. It has won a Malcolm Baldrige National Quality Award, the gold standard for performance excellence. And it is a member of the Mayo Clinic Care Network, allowing it to consult and collaborate with some of the top physicians in the country. 

Mosaic’s chief medical officer, Davin Turner, D.O., also said the partnership with UMKC was right for the hospital, allowing Mosaic to show medical students what the health system and rural medicine had to offer.

“This is an opportunity to grow our own physicians, and it’s great for St. Joseph,” Turner said. “A hundred years ago, there were three medical schools in St. Joseph. Now, with almost a quarter-million residents in northwest Missouri, St. Joseph should have a medical school again.”

The road to approval

By early 2019, UMKC and Mosaic decided to pursue the partnership and new campus. The task involved winning approval from multiple governing bodies, with the goal of being up and running in 2021.

Key support for the new campus came from Missouri’s senior U.S. senator, Roy Blunt, who worked to secure funding and resources targeted toward improving access to rural health care, and the area’s state representative, Brenda Shields. Also on board were UMKC’s chancellor and provost. By the end of 2019, a proposal was sent to the Liaison Committee on Medical Education, which gave the go-ahead to pursue the expansion.

When the pandemic hit, communication and collaboration needed to keep the project moving forward became more difficult. But Jackson and her team drove even harder toward their goal. Requests to the University of Missouri Board of Curators, the Missouri Department of Higher Education and Workforce Development, and the Missouri Higher Learning Commission followed and were met with approval at each stop on the way.

At the same time, efforts moved forward to pursue grant money to finance the venture. In June 2020, HRSA — the U.S. Health Resources and Services Administration — granted $7 million for the new campus from a $75 million pool Congress had appropriated across 2019 and 2020 to bolster rural medicine.

Making it happen

Though all the final approvals and signed contracts weren’t in place till mid-November 2020, Waldman, Turner and others had pushed ahead with their planning so the campus could be ready on time. Much of that logistical work fell to another key member of the team, Kristen Kleffner, Ph.D., the new campus’ assistant dean.

Just as Waldman brought other skills and credentials to the task, including a law degree and an MBA in health care administration, so did Kleffner. She has worked for the School of Medicine for several years in various student service roles and recently earned her doctorate in higher education administration.

“My first job was in Columbia, which included placing medical students in rotations in northwest Missouri,” she said. “So I’ve come full circle.”

Mosaic staff and St. Joseph institutions such as the Chamber of Commerce also were helpful, Kleffner said, whether she was arranging housing for students, buying furniture and other supplies, or making sure everything from computers to restrooms was working in the UMKC campus space.

“Students are my passion,” Kleffner said, “and I’m always willing to do whatever I can to help them succeed.”

The campus also was able to fill out its staff with key hires who brought just the right experience with them. In addition to Luke, who continues to spend time in classrooms helping students until he starts his neurology residency back in Kansas City this summer, the staff includes James Shackelford, who has a master’s in public administration from the UMKC Bloch School of Management. Shackelford, a former executive assistant in the Health Sciences Campus dean’s office, has a dual mission in recruiting and special initiatives, including gaining future funding.

Bright future

As the campus’ first semester unfolded, students were getting used to the heavy workload of medical school and looking forward to working with Mosaic physicians, starting in April.

“I’ve been interested in science and medicine at least since high school,” said Jess Halla, whose college experience in Kansas included being a teaching assistant for physics and anatomy, and shadowing a surgeon in Winfield, Kansas. “Having contact with patients and our docent here will be a good next step.”

The administration also is looking ahead. Turner is working on expanding the school’s space for adding classes over the next three years.

“We would like to establish some residencies here, too,” Turner said, “to show what we have to offer and attract more physicians to the region.”

Waldman also had good news to announce after the semester started. In February, the campus was notified that an additional $5 million in HRSA grant money had been approved. And in March, word came that $160,000 in rural health scholarships had been awarded to members of the first class.

“These funds will help our current students and help the school with our goals going forward,” Waldman said.

“There’s no shortage of high-quality students who want to study rural medicine with us, and we’re working to enhance our recruiting of Native American students and other underserved populations.”

In short, Waldman said, “We are off to a great start, and the future looks even brighter.”