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New program begins to support rural and Hmong students looking to become physicians

Published: Jan. 29, 2021 at 8:15 PM CST
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WAUSAU, Wis. (WSAW) - Friday marks the end of the first full week of a new program working not only to help build a physician workforce in rural central Wisconsin but a more diverse one, as the state continues to see a shortage of physicians.

The U.S., Wisconsin, and particularly rural areas have been seeing a steady increase in the shortage of physicians over the last few years. The Association of American Medical Colleges issued a report in June estimating a shortage of 54,100-139,000 physicians in the U.S. by 2033, and that is without factoring in systemic barriers; then the estimation jumps to needing 74,100-145,500. It cites population growth overall, as well as growth in the aging population, are the primary drivers for increasing the demand for physicians. On top of that, roughly two out of five physicians are at the traditional retirement age.

A 2018 statewide report from the Wisconsin Council on Medical Education & Workforce estimated the demand for physicians would increase by 20.9%, though noted it could be more. It added rural areas would experience the biggest shortages. Though it may only take a few physicians in rural areas to sustain the demand, there are fewer resources to recruit and retain physicians.

The Medical College of Wisconsin, Central Wisconsin Campus is looking to address not only the need for more physicians locally but the need for diverse physicians, particularly Hmong physicians. Wisconsin has the third-largest population of Hmong Americans in the U.S. followed by Minnesota and California. Wausau, specifically, has a 12% Hmong population.

Amy Prunuske, PhD, an associate professor with the college noticed the makeup of the students did not reflect the Hmong population in Wausau. She created the Advocates in Medicine Pathway (AMP) to ensure rural and Hmong students interested in becoming a physician had the support and resources needed.

“In order to adequately address the healthcare needs of Central Wisconsin rural and Hmong populations, it is important that we develop a pathway for students from underrepresented backgrounds to successfully matriculate into MCW-CW,” said Dr. Prunuske. “The AMP will allow us to train more doctors that are equipped to address these needs and more likely to practice in the region.”

Not having a diverse workforce creates barriers. Sheng Khang, the education and outreach coordinator for the North Central Health Education Center is guiding students through the AMP program. She said she has seen those barriers in her personal experience. Language is the biggest barrier.

“I’ve heard from Hmong patients, that through interpreters information got lost or the expressions or delivery of their concerns are lost,” she said.

Not all Hmong people are literate in the written Hmong language, and not all are literate in English written and/or spoken. So, like in Khang’s personal experience, she often has to take her family members who do not speak English to their doctor’s appointments. Somethings get lost in translation. It also creates additional barriers for Khang, herself in a different way.

“When I have to take care of myself or one of my family members to the doctor because they don’t know English, it takes time away from me building my career and it also takes time from my employer,” she explained. “So if there are physicians out there that can understand the Hmong population and culture for those types of barriers and things like that, that would allow me to be performing at my fullest potential for my employer and for myself.”

The AMP program supports 10 students who have completed their undergraduate degree. Maysee Lao, a recent UW-Oshkosh grad and D.C. Everest High grad was among 30 applicants chosen to be part of the program.

“I really love helping people and the medical field is where I can see myself,” Lao said.

She explained the process to become a physician has been stressful and overwhelming, but worth it. She added Khang has been guiding her and answering any questions she has. The process to get into the AMP program itself, Khang explained, was an introduction to prepare them for other parts of becoming a physician.

“[We] ust wanted to get them prepared with the process because medical school involves going through the application stage and an interview, which can also make or break a candidate that wants to go into the medical field,” Khang stated. “So with the program, we wanted to try that to see where the students are with their interview skills and then work with them during the spring semester to build their confidence with interviews so that their true identity and their passion show.”

The program gets students introduced to the Medical College of Wisconsin, Central Wisconsin Campus professors, and students. It also lets them interact with local health systems ultimately doing an internship during the summer. The local community and the health issues it faces are big parts of the program too.

“That course will expose them to the social determinates of health, the opioid addiction that’s going on right now,” Khang said.

She said they also plan to incorporate panel discussions with community members, including bringing in a Hmong shaman, as spirituality is part of the Hmong culture specifically in how health is handled.

Creating an understanding, and diverse health network in central Wisconsin is something Lao said is crucial to her, especially during a pandemic where information and science is constantly evolving and impacting everyone’s lives completely.

“It’s important that patients are getting resources, the correct, right information about viruses like this [COVID-19], whether that be having a physician who speaks the same language as them or maybe just understands them a little bit more,” she urged. “Communication is a big part and I think there needs to be physicians who are able to meet the needs of all kinds of people.”

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