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Preserving Primary Care in Michigan

In July 2005, Michigan State Medical Society released the results of its study on physician supply. The findings painted a grim picture for Michigan if current trends continued into the future, showing that Michigan would face a shortage of nearly 6,000 physicians by 2020. Over 57 percent of practicing physicians indicated that they planned to retire by 2020, significantly decreasing the number of available physicians across the state—especially in rural areas.

Two subsequent studies conducted in 2005 by the Michigan Department of Community Health and by four Michigan medical schools confirmed that the state would face a severe shortage of physicians if steps were not taken soon.
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To address the expected shortage, Michigan State University College of Osteopathic Medicine (MSUCOM) announced plans in 2007 to increase its entering class size to 300 students and to expand its Statewide Campus System in Southeast Michigan, adding new training facilities at Macomb Community College’s University Center and at Detroit Medical Center (DMC).

MSUCOM’s Statewide Campus System is a collection of affiliated hospitals across Michigan, preparing students and residents for careers in osteopathic medicine. With the addition of new training facilities in Southeast Michigan, MSUCOM could accommodate 100 total new students each year in Detroit and Clinton Township.

“Michigan State University has had a long-standing relationship with teaching hospitals in Michigan,” said Kari Hortos, associate dean of MSUCOM at Macomb University Center. “In our Statewide Campus System, we have over 27 hospitals across the state that participate in programs with Michigan State University College of Osteopathic Medicine, and a majority of them are in Southeast Michigan.”

Synchronous Teaching

After years of planning and preparation, MSUCOM students began attending classes on June 30 at Macomb Community College’s University Center and at Detroit Medical Center. Students enrolled at the Macomb campus are taking anatomy at the DMC this summer, and will occupy leased facilities at the University Center this fall. A new building, dedicated to MSUCOM at Macomb Community College, is expected to open in early 2010.

“Macomb County is the heartland of community-based medicine because you have seven major training hospitals within 20 miles of our Macomb campus,” according to Hortos. “Our DMC location was chosen for its urban setting and educational milieu. With this program, we are providing students with the two years of preclinical courses they will take before starting two years of clinical rotations in SCS hospitals.”

To educate students at the two Southeast Michigan campuses and the main campus in East Lansing, MSUCOM is using innovative, synchronous teaching methods and telepresence technology. All three campuses are attached by fiber-optic connections to Merit Network’s backbone and use high-definition videoconferencing over the network to educate students. Lectures primarily originate from Fee Hall, 102 Conrad, and the Life Sciences Building in East Lansing and are available at Macomb Community College and DMC through telepresence. Professors also routinely perform their lectures at Macomb College or DMC and then transmit the lectures back to the other locations. For each discipline, faculty are present in the classrooms in addition to the televised lecturers.

“The majority of the curriculum is being simultaneously broadcast to all three sites. The quantity of the broadcasts is probably the greatest in North America. We are doing 12 to 15 hours a week per class right now, and next year, we’ll be up to 30 hours a week total,” Hortos said.

The telepresence program has been very successful with the high-definition videoconferencing system performing well for the most part.

“We’re still developing this system since it’s all brand new,” Hortos said. “The technology has assisted with curriculum development and enabled us to try new things. We make discoveries every time we try something, but for the overwhelmingly majority, it’s worked very well.”

Simulated Patients, Better Patient Care

In addition to class lectures, MSUCOM is using the videoconferencing technology for training simulated patients, community members who volunteer to act sick during simulated medical appointments. Students gain valuable first-hand experience by interacting with simulated patients, learning how to diagnose medical conditions.

“We had an inservice with the community members at the three sites and were able to train all of the people at one time using the technology,” Hortos said.

A doctor and two experienced simulated patients in East Lansing instructed six volunteers at the DMC and 12 volunteers at Macomb Community College by videoconference, demonstrating how to behave as simulated patients. The session lasted nearly two hours and allowed the volunteers in Detroit and Clinton Township to ask questions and interact with the training physician in East Lansing. Without the videoconferencing technology, the physician would have had to drive more than four hours roundtrip to Detroit and Clinton Township to train each group.

“The technology saved time, resources, and travel time. In a short period of time, we were able to train two groups of simulated patients,” Hortos said.

Helping Rural Michigan

Michigan State University’s commitment to health care in Michigan isn’t limited to training future physicians. MSU’s health care units have dedicated their time and talent to serving the needs of rural areas in the state.

Through the Michigan Center for Rural Health, MSU doctors and professors are providing outreach and education to rural areas. MSU professionals routinely present continuing education courses by teleconference and telepresence as part of the Grand Rounds program. Delivered to rural health care providers in Michigan, the initiative provides courses related to arthritis, geriatric health, psychiatry, social work, pharmacy, emergency medical services, nursing, and special topics. The program allows rural health professionals to learn new techniques and earn continuing education credits. During 2008, over 2,000 people attended the Grand Rounds programs around the state.

In rural areas where very few psychiatric care providers are available, doctors from the Colleges of Osteopathic Medicine and Human Medicine have been tackling a number of cases, meeting with patients across the state via videoconference. From Cadillac to Marquette, psychiatrists have met with patients through a secure video connection, treating ailments such as attention deficit disorders and depression. The program has been especially important for helping children since there are very few child psychiatrists north of Mount Pleasant and only one in the Upper Peninsula.

The goal of osteopathic medicine is to restore the integrity and health of the body. By educating future physicians and serving the needs of rural patients and providers, Michigan State University College of Osteopathic Medicine is preserving the current well-being and future health of Michigan’s residents.


Established in 1969, Michigan State University College of Osteopathic Medicine consistently ranks in the top five percent of all medical schools for its primary care education, recently being ranked seventh in the country by U.S. News and World Report. Two-thirds of its 3,933 living alumni practice in Michigan, and more than 90 percent of the students in the entering classes are Michigan residents.

Michigan State University has been a Governing Member of Merit Network since 1966. MSU’s main campus is connected by a 10G connection, and the University Center location in Clinton Township now has a direct fiber connection back to MSU’s main campus.