Tufts teaming with Maine hospital to train doctors

A Boston medical school is partnering with a Maine hospital to meet a growing need for primary care doctors that is particularly pronounced in rural Maine, the institutions announced today.

Tufts University School of Medicine is creating a program at Maine Medical Center through which medical students will spend their first two years at Tufts in Boston but then move to the 600-bed Portland hospital for all of their third-year clerkships and part of their fourth-year of rotations through different medical specialties. They will graduate with a joint diploma from Tufts and Maine Medical Center.

“This is really intended to address what is not only a New England and state of Maine but really a national shortage, both actual and projected, of physicians that’s particularly acute in rural areas,” Vincent S. Conti, president and CEO of Maine Medical Center said in an interview. “The overall objective is that graduates would be attracted to come back to Maine for residency and having done that would more likely want to stay in a rural setting.”

The Tufts Maine Track curriculum will focus on issues important in rural and small-town practices, where physicians have fewer resources to turn to for diagnosis, follow-up, or specialty referrals compared with urban centers. A team approach relying on nurse practitioners, physician assistants, pharmacists, and physical therapists will be emphasized, Conti said.

The program will set aside 20 of its 36 openings for residents of Maine and for students attending college in Maine or adjacent states or in states similar to Maine. Students will apply for admission to Tufts medical school and complete a separate application to join the Maine Track. Interviews will begin this fall for the first class of students, who will enroll in Boston in the fall of 2009 and in Maine in 2011.

Tufts has major affiliations with six hospitals: Tufts-New England Medical Center, Caritas St. Elizabeth’s Medical Center, and Faulkner Hospital in Boston, Lahey Clinic in Burlington, Newton-Wellesley Hospital, and Baystate Medical Center in Springfield. Eastern Maine Medical Center in Bangor is a clinical teaching affiliate. But the Portland program will be different, Tufts dean Dr. Michael Rosenblatt said.

“Each place has its own flavor but they don’t have a program that is geographically set up the way we will have in Maine,” Rosenblatt said.

It allows Tufts to increase the size of its medical school student body and means Maine Medical Center can offer medical education without the cost of building a new medical school, he said.

The shortage of primary care physicians is being felt nationwide. It includes not only primary care physicians but also doctors who practice family medicine, pediatrics and obstetrics/gynecology. The Maine Hospital Association lists about 200 primary-care vacancies across the state.

“Primary care is in a crisis, practically in freefall in the United States in the last five years,” Rosenblatt said. “The goal is to produce more doctors for the state of Maine.”

Maine does have a school of osteopathic medicine, at the University of New England in Portland. Its students will continue to train at Maine Medical Center.

The hospital also held discussions about developing a Maine Track with Dartmouth Medical School and the University of Vermont College of Medicine, which currently has a training program for medical students at the hospital. The UVM program, in place since 1980, will end when the Tufts program begins. Tufts had been affiliated with Maine Medial Center from the 1930s until UVM’s arrival.

Edward Salsberg, director of the Center for Health Workforce Studies at the Association of American Medical Colleges, said the Tufts program in Maine will address one aspect of the primary care physician shortage. He also cited problems in how healthcare is delivered and financed.

A workforce report released last year by his center showed Maine ranked eighth in the nation -- Massachusetts came in first -- in the number of physicians per 100,000 people, but the report did not break down rural versus urban settings.

“Exposing medical students and residents early to care opportunities in underserved rural areas can be positive,” he said. “This sounds like a very encouraging project.”