F E A T U R E

More Than a Medical School

By Renée Gearhart Levy

Graduating its fifth class of osteopathic physicians, NYITCOM-Arkansas is delivering on its mission to increase the number of physicians and reduce healthcare inequity in the Delta region.

As an internist in the outpatient clinic at NEA Baptist Memorial Hospital in Jonesboro, Ark., Paige Parnell (D.O. ’20) is acutely aware of the physician shortage in her native state. “We see such a big population of people in the Delta,” she says. “I’ve got patients who come from southeast Missouri, from south Arkansas, and from little towns all over.”

But she also recognizes the impact being made by the New York Institute of Technology College of Osteopathic Medicine at Arkansas State University (NYITCOM-Arkansas), which opened in 2016 specifically to address the state’s physician shortage. Parnell was a member of the first class. After completing residency training in internal medicine last year at NEA Baptist—a program started by one of NYITCOM’s key clinical partners as part of a collective effort to increase the number of residency programs in the state—she joined the staff.

Previously, only two physicians were working in the outpatient clinic. Parnell is one of four residency program graduates who stayed on at NEA Baptist after completing their training. “Patients used to struggle to see any sort of primary care physician, just because there weren’t that many,” she says. “But the addition of the medical school and increase in residency programs is really helping alleviate this shortage of physicians and medical care.”

That’s just the point. Arkansas and the Mississippi Delta region have a long history of being medically underserved. In the early 2010s, Arkansas State University began exploring the possibility of opening a medical school on its Jonesboro campus and visited with potential partners across the country. NYITCOM, located in Old Westbury, N.Y., may seem like an unlikely choice.

But the private osteopathic medical school had a history of public service within its own Long Island community and a strong track record of producing primary care physicians who stay and practice in the areas they train. NYITCOM was all in on the concept of opening a second location in a place with significant healthcare needs. Arkansas, which ranks near the bottom for health outcomes nationally, was just that.

Administrators from both institutions worked together to gain accreditation and launch the school, initially under the leadership of Barbara Ross-Lee, D.O., then vice president for health sciences and medical affairs at New York Tech, who relocated to Jonesboro to serve as founding dean.

Paige Parnell examines a patient at the NEA Baptist Clinic in Jonesboro, Ark. Upon graduation from NYITCOM-Arkansas, Parnell attended residency at NEA Baptist Health System and is now an attending physician at the same institution. PHOTO: NICOLE FRAKES, NEA BAPTIST

When NYITCOM-Arkansas welcomed its first class in 2016, it became the second medical school (in addition to the University of Arkansas for Medical Sciences) and the first osteopathic school in the state. In June, the school graduated its fifth class of physicians. Most students from the first two classes have now completed residency training.

Thus far, 67 percent of graduates have pursued the primary care fields of internal medicine, family medicine, or pediatrics. An additional 18 percent have gone into psychiatry and obstetrics/gynecology, also considered under the umbrella of “primary care.” Importantly, more than half of graduates have matched for residency in Arkansas or another Delta state.

“We see our graduates pursuing primary care, staying in the region, and going into needed areas where there is a shortage of physicians as a clear success of our mission,” says Shane Speights, D.O., site dean of NYITCOM-Arkansas since 2017.

Shane Speights teaches students in a medical simulation lab. PHOTO: PHILIP THOMAS

That’s not luck. Speights says the school is targeted in the students it recruits, specifically seeking students with an interest in primary care who come from the Delta region.

“The data shows that if we recruit a student from a small town in rural Arkansas, he or she is more likely to go on to practice in a small town in rural Arkansas,” says Speights.

“We feel that part of our charge is to help address the social determinants of health of our region and help produce better health outcomes. We want to be leaders in that area, not just graduate physicians.” –Shane Speights, D.O.

Community Impact

From the outset of their studies, NYITCOM-Arkansas students are charged with making a positive impact on the communities they serve, learning to give screening exams and vaccinations and doing outreach in public schools.

“From day one, there was an expectation that as medical students, we were integrating the community into what we were learning,” says Carter Lee (D.O. ’20), a member of the inaugural class who completed his residency at St. Bernards Healthcare, a key clinical partner, and now practices internal medicine at a St. Bernards clinic in Jonesboro. “But we wanted to do that. It was a big part of why we were there.”

As a student, Carter Lee worked in NYITCOM-Arkansas’ Delta Care-a-Van. He is now an attending physician at Clopton Clinic in Jonesboro.

An integral part of the NYITCOM-Arkansas curriculum not found at every medical school is its emphasis on population health. In addition to their D.O. (Doctor of Osteopathic Medicine) curriculum, all students are required to complete a certificate in Population Health. “We feel that part of our charge is to help address the social determinants of health of our region and help produce better health outcomes,” says Speights. “We want to be leaders in that area, not just graduate physicians.”

Through funding from the U.S. Department of Agriculture, the school developed a mobile clinic called the Delta Care-a-van that includes two exam rooms and state-of-the-art telemedicine technology. Under the guidance of NYITCOM-Arkansas faculty and trained medical experts, students travel to rural communities to conduct screenings and wellness examinations to monitor blood pressure, blood glucose, and signs of mental health conditions. Patients requiring additional treatment are connected to local providers or receive telemedicine consultation while on board the mobile clinic.

“We recognize that underserved populations often have difficulty making it to the healthcare provider, and we are working on creating sustainable solutions to address that issue. However, with the Delta Care-a-van we can bring those resources and education to them now,” says Speights. “At the same time, our students gain valuable clinical training.”

The school is also working to increase the pipeline of students who pursue an education in a health-related field, both in number and diversity. In its inaugural year, NYITCOM-Arkansas students chose the National Outreach for Diversity (NOD) program as their first student-led outreach program.

The NOD program sends medical students to local schools to conduct health programs, provide public health information, and expose youngsters to possible health careers. The NYITCOM-Arkansas chapter specifically targeted the most impoverished school in the region, which includes both elementary and middle school grades.

Another program, Project H.E.A.R.T., is a camp that targets students in their junior or senior year of high school, bringing them to campus for four days and three nights to expose them to an array of healthcare career options, including nursing, occupational therapy, physical therapy, speech therapy, radiation technology, ultrasound technology, and medicine. As part of their first day, they present a poster on their own community and speak to the challenges and opportunities that exist. NYITCOM-Arkansas medical students serve as their camp counselors.

In 2020, NYITCOM-Arkansas launched a master’s in biomedical sciences program, designed as a potential gateway to medical school admission for students who need to strengthen their credentials. Jasmine Stewart (M.S. ’21) was in the inaugural class of the program, and today is a fourth-year medical student where she is president of the Student Government Association and a Congressional Fellow, helping advise Arkansas First District Congressman Rick Crawford on health policy.

A nontraditional medical student from Georgia—she spent 13 years working in retail management and earned her bachelor’s degree at 30—Stewart learned about NYITCOM-Arkansas while attending a Student National Medical Association conference. The organization’s mission is to support current and future underrepresented minority medical students, address the needs of underserved communities, and increase the number of clinically excellent, culturally competent, and socially conscious physicians. “Arkansas had not been on my radar, but I was attracted by the opportunity and the school’s mission,” she says.

Pictured left and right: Jasmine Stewart performs osteopathic manipulation on a classmate. Stewart was a member of the first master’s in biomedical sciences program. She is now a fourth-year student. PHOTO: PHILIP THOMAS

Pictured top and bottom: Jasmine Stewart performs osteopathic manipulation on a classmate. Stewart was a member of the first master’s in biomedical sciences program. She is now a fourth-year student. PHOTO: PHILIP THOMAS

In May, NYITCOM signed an agreement with Henderson State University in Arkadelphia, launching a new Pre-Med Pathway program that prepares students for admission to medical school through a combination of classroom preparation and mentorship opportunities. Students accepted into the program complete a bachelor’s degree in natural sciences (pre-med track) at Henderson State—and provided they meet academic and program requirements—then transition to medical school at NYITCOM-Arkansas, without the time and pressure of having to take the MCAT.

“One of the things we’re finding is that the MCAT doesn’t necessarily correlate with student success in the way we expected,” says Speights. “This program identifies students who are in the top tier of their high school graduating class and have at least an 1100 SAT or 26 ACT. This pathway offers them a program of specific coursework and support through their four years of undergraduate school, with the goal that students are ready to hit the ground running in medical school.”

Leading by Example

Many young people, particularly those from rural areas or small towns, may never conceive that becoming a doctor is a viable career choice. That was the case for Amanda Deel, D.O., assistant professor and associate dean for academics and graduate medical education.

Deel grew up in southern Arkansas, graduating in a high school class of 85 students and the only one of her siblings to go to college. As an undergraduate at Arkansas State, a teacher she respected suggested that she should pursue medical school, a career path she had never considered. “Nobody in my family was a physician, and I didn’t even know any physicians that were female,” she says.

She went on to earn her osteopathic medical degree and was working as a faculty member in the family medicine residency program at the University of Arkansas for Medical Sciences when she was approached about joining a new medical school at Arkansas State.

She was particularly drawn to the school’s mission to increase the number of physicians in the state while focusing on rural and underserved communities and populations. “I’m where I am today because somebody saw something in me that I didn’t see in myself,” she says. “That was part of what NYITCOM-Arkansas was going to strive to do, and I wanted to help do that for others.”

Pictured left and right: Amanda Deel, teaches medical students in one of the simulation labs. PHOTO: PHILIP THOMAS

Pictured top and bottom: Amanda Deel, teaches medical students in one of the simulation labs. PHOTO: PHILIP THOMAS

Deel initially taught in the medical school and helped Speights, then associate dean of clinical education, set up third-year clinical rotations. They established partnerships with physicians and hospitals in communities of all sizes across Arkansas and into Missouri, Tennessee, Mississippi, and Louisiana. “Students know how medicine is practiced in Jonesboro. We want them to experience how medicine is practiced in other areas,” she says.

Students apply for clinical rotations and are selected through a lottery system. Those assigned outside Jonesboro move to those towns for their third and fourth years. The goal is that they become ingrained in their community and choose to return when they go on to practice. “Studies show that if you put students and residents in these rural, smaller communities, the likelihood is significantly higher that they’ll choose to practice in those areas,” says Speights.

Deel later turned her focus to increasing the number of residency programs across the state so that NYITCOM graduates have places to train after completing their medical education.

Ten years ago, Arkansas had only seven residency programs in the entire state, including only one in internal medicine, one in emergency medicine, and one in psychiatry. Today, there are 22 residency programs across the state, an increase due in large part to the efforts of NYITCOM-Arkansas leadership.

“It’s a great start, but we still have a long way to go. Arkansas still only has one general surgery residency, one obstetrics/gynecology residency, and one pediatrics residency,” she says.

Although it’s an obvious fix to the physician shortage, starting a residency program is an expensive undertaking, particularly for a rural community. Deel was recently appointed by Arkansas Gov. Sarah Huckabee Sanders to the Graduate Medical Education Residency Expansion Board, an initiative responsible for reviewing requests for state funds to expand residency programs and create new ones in Arkansas. “We need to do something as a state to attract more physicians, and we know that if we can train them in residency here, we have a higher chance of retaining them as practicing physicians in our state,” she says.

In that role, Deel models NYITCOM-Arkansas’ emphasis on servant leadership. She’s not unique. In addition to being site dean of the medical school, Speights serves as medical director for the city of Jonesboro, county health officer, and medical director for the EMS (emergency medical services) program and local police and fire departments.

“One of our slogans is that we’re more than a medical school,” he says. “Students can go anywhere to get a medical education, but when you come here, we prepare you to be a servant leader who is invested in the community you practice in. It’s more than just treating the patient in front of you. It’s having an impact on the patients throughout your community that you may never see.”