The Elson S. Floyd College of Medicine launches its first class of physicians to fulfill the mission of bringing health care to rural and underserved communities.
This inaugural class of WSU physicians has 21.4 percent who grew up in a rural county and 18 percent notably in a Washington rural county + 18 percent are first-generation college graduates + 55.4 percent come from a low socioeconomic background + 18 Washington counties represented: Benton, Chelan, Clallam, Clark, Cowlitz, Franklin, Grant, King, Kittitas, Pacific, Pierce, Snohomish, Spokane, Stevens, Thurston, Whatcom, Whitman, and Yakima.
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Most people studying to be a medical doctor have those moments. Alex Franke experienced it when he helped a baby with botulism.
It’s that “ah-ha” event that reminds future physicians why they are joining the medical profession.
While on a pediatric emergency medicine rotation in Spokane last summer, Franke, a fourth-year medical student at Washington State University’s Elson S. Floyd College of Medicine, diagnosed the rare condition, which affects an average of 77 infants each year in the United States. Franke explained the situation to the parents, and, with treatment, the baby was fine.
It was another milestone for Franke, who grew up in Seattle and first became an EMT in New Orleans. Now he is fulfilling his goal to become an emergency room physician, “very much a natural extension of the work that I was doing before as an EMT,” he says.
The first class of medical doctors graduates in May and marks the next chapter for only the second public medical school in Washington state, which launched in 2017 at the WSU Health Sciences campus in Spokane.
After four years of rigorous study and rotations all over Washington state and the country, Franke and the other students take their white coats, MD degrees, and their dreams to residencies around the United States.
One of his fellow students, Becky Gold, was inspired to pursue obstetrics and gynecology.
“The first time I felt a baby born, I knew I was going into OB-GYN. It just took the one time,” Gold says. “The patients actually asked if they could take a picture of me with the baby, because they wanted to put it in the baby book. They could always tell their baby that this was the first baby that I saw born.”
Another student, Brent Conrad, says he felt chills returning to his hometown of Colfax to work with doctors who had encouraged him to pursue medicine. “I saw what a difference a primary care doc could make in a small community,” he says.
Every one of the students will carry their own memories as they become the first class of WSU medical doctors, driven by a mission to serve those who need it most.
How it all began
While medical training in Eastern Washington had occurred for years in a collaboration with the University of Washington, an increasing need for physicians led WSU to start its own medical college in 2015.
The tireless work of late WSU President Elson S. Floyd and others culminated in state government approval for the new college.
In October 2015, John Tomkowiak became the founding dean of the college. Then, it was a whirlwind of momentous events: receiving preliminary accreditation, finding the first group of students, hiring faculty and staff, and connecting with clinical partners for training opportunities.
“I’m incredibly proud of how fast we have built this college,” Tomkowiak says. “Of course, it was through the great efforts of all of our community partners across the state, our legislature, and of course the support of the University itself.”
It was a watershed moment for Spokane and its WSU campus, but a challenging one.
“If anyone ever tells you it’s easy to start a new medical school, they’re probably trying to sell you a bridge somewhere,” says Radha Nandagopal, a pediatric endocrinologist in Spokane, and an associate professor and clinical skills education director at the college.
Nandagopal grew up in Spokane and returned in 2015 to work with Ken Roberts, who became interim college dean. She was involved from the beginning as they prepared for accreditation and is chair of the committee to admit new medical students.
Ted Chauvin (’03 PhD Genetics & Cell Biol.) also started with Roberts, moving to Spokane in 2009 to run Roberts’s lab and then to help launch the college. Chauvin is one of the faculty members who is not a medical doctor. He teaches biochemistry and molecular biology, is in charge of the evidence-based medicine component, and serves on the admissions committee.
When the accreditors came in 2019, they “were shocked that the molecular biologist was in the room,” Chauvin says, but it was part of the holistic vision of the college.
The small group got right to work to bring in the first class of medical students. They decided to use MCAT and test scores for initial screening, but the revolutionary holistic process focuses on personal attributes and experiences of well-rounded students. That included extensive interviews with applicants.
“As soon as we got that preliminary accreditation in 2017, we only had a couple of months to fill the class. We were doing interviews almost every Monday and Friday,” Chauvin says.
It took time, but it was important that students reflected the state, say Chauvin and Tomkowiak. “We were recruiting a student body who all have ties to the state of Washington. Over 30 percent are first-generation,” Tomkowiak says.
Students like Gold really noticed the difference. “I don’t know how they picked the exact right people for this first class, but they did,” she says. “It was like every time we needed something from a student, there was someone who fit that role perfectly.”
The admissions committee selected 60 students, and then decided to call them personally to offer acceptance rather than just an email or letter.
“I remember we had the entire admissions team gathered in my office for our first phone call to a student to accept them,” Tomkowiak says. “I can tell you every single student that is in our college remembers that phone call because it’s a life-changing event.”
After they arrived in fall 2017, the students took part in the white coat ceremony, a medical school tradition to welcome them to the profession. Tomkowiak felt the weight of the moment. “When I gave my first white coat ceremony speech, I ended with a quote that the great thing about a first is it leads to a thousand other firsts,” he says.
Then the hard work began.
“The first two years is like drinking from a fire hose,” Franke says. “The rate at which you’re learning new information, I was kind of scared that not all of it would stick.”
Conrad also noticed the camaraderie during the early classroom years.
“I thought it was going to be a really competitive kind of cutthroat environment,” Conrad says. “Instead, I walked into a place where all my classmates wanted to help each other and we all wanted to succeed.”
Patients first
One of the distinguishing features of the Elson S. Floyd College of Medicine is its laser focus on a mission to help underserved communities.
“You know we’re committed to serving the rural and underserved,” Nandagopal says. “That might look like someone who’s providing care to individuals experiencing homelessness, or it might look like a specialist who has this wide area where they’re helping people by telemedicine.”
Chauvin agrees. “And it’s not just rural. Underserved is underserved, no matter where you are. And the students are really good at pointing that out to us,” he says. “I don’t care if you have $50 million or $50 to your name, you still deserve the best care you can get.”
It’s not just an abstract concept, and the medical students have already been recognized for their service, such as working with COVID-19 testing and vaccination, and with Range Community Clinic, a health network for communities in need.
Conrad says another memorable example is Blessings Under the Bridge, where they provided meals to homeless people in Spokane.
“We really want our students to understand the communities that they’re serving, so our training is built upon that principle,” Tomkowiak says. “We’re already providing care to people who are underserved, like through our street medicine program.”
It hasn’t always been an easy few years, but Tomkowiak says, despite the curveballs, “whether it’s been the fiscal tightening that we’ve had to do or dealing with the pandemic, one of our strengths is that the mission has been a guiding light, a true north that we have not strayed from.”
A key part of accomplishing the mission, says Nandagopal, is emphasis on listening to patients. “I see my role as really imparting those solid clinical skills,” she says. “So, what does that mean? Communication, physical examination skills, demonstrating empathy, and caring.”
Nandagopal points to the rapid shift in health technology as an example of how doctors need to support patients. “Technology may leave those folks behind, unless we’re really intentional about it,” she says. “I think it’s up to doctors to advocate more, not less, for those patients, so they don’t get left behind.”
That sentiment resonates with students. “You have to remember why you started doing this in the first place,” Gold says. “I’ve had my most positive and meaningful experiences when I can educate and advocate for my patients.”
The medical students also benefit from the college’s emphasis on training in health care teams. The interprofessional training, led by nursing faculty Barbara Richardson, brings together students from nursing, pharmacy, the medical college, and other health sciences, which reflects the real hospital experience.
“There’s definitely a commitment to making sure that our students and faculty really acknowledge and work well with multi-disciplinary teams,” Nandagopal says. “I simply couldn’t do my job as a doctor if I didn’t have the staff in the office, the social worker, the certified diabetes educators, to round out how we help care for the patients.”
“We get to do some integrated simulations and sessions with some of those other programs, nursing, pharmacy, nutrition and exercise physiology,” Gold says. “We know how to work with them and it makes the patient care experience a lot smoother if everyone knows their role.”
In addition to the interprofessional teams, the medical students need a solid understanding of science, says Chauvin. “We require them to do 300-plus hours of scholarly work. In the evidence-based medicine component that I direct, I have 10 facilitators and only one of them is a medical doctor. The rest are scientists. We work with the physicians to make sure we teach at the right level.”
The positive results of the clinical training recently struck Nandagopal.
She was on call this spring for pediatric endocrinology when it really hit her that these students were on the cusp of success. She received a page from a local ER and when she called, she heard, “Hi, Dr. Nandagopal! It’s your student, Morgan Black,” in her fourth year and heading into emergency medicine.
“Morgan presented the patient with such grace, accuracy, and confidence. She hit all the high points, asked the right questions, and I couldn’t help but feel I was talking to a colleague,” says Nandagopal. “I didn’t need to talk to the attending physician—and that’s saying something.”
The doctors’ path
From the inception of the medical college, there’s been an emphasis on community-based education, where students go all over the state for rotations.
“We don’t have our own teaching hospital. We rely on communities and our partners to train our students,” Tomkowiak says.
Franke went to Vancouver for part of his education. “I think the quality of our rotations, being a community hospital, were way better than I ever could have imagined,” he says. “I think it was really advantageous that the focus of the education was very much on you and targeted to your level.”
Nandagopal says the students really get to know the places they work in, which is by design.
“We do a homestay that usually does a really good job of integrating us within the community,” Gold says. She worked in Vancouver and Centralia. “It just makes it so much smoother because they really helped out with that kind of learning curve.
“We have patients who really struggle with housing insecurity and food insecurity right next to these really nice neighborhoods and mansions,” she says. “I’m getting to meet patients from all walks of life and learn how their needs are just really different.”
Conrad even found his way back home for one of the rotations. “I got to go to Colfax and do an internal medicine week,” he says. “It was a really cool experience to be back in the place where I started shadowing, and with a lot of these doctors who got me on this track.”
Tomkowiak emphasizes that doctors also need leadership skills.
“Everyone in health care needs to be better leaders,” he says. “We’re the only medical school in the country that has that intensive focus on leadership built into the medical school curriculum. When students eventually go on to practice, they’re going to have skills to be able to help manage and coordinate teams.”
The students actively embraced the leadership curriculum, even taking part in adjusting their own medical education and seeing the results. “I’ve always really thrived in environments where I get to be part of the leadership and get to help create something and build something new,” Gold says.
Even though he has worked at five medical schools, Tomkowiak says, “I’ve never been in a school where I think there’s been this great relationship between faculty and students. We change what we’re doing based in part on student feedback. And that’s allowed us to really be on the innovative edge of medical education across the country.”
The relationship goes beyond innovation in learning. The faculty and students support each other, even outside the classroom or operating room.
Gold faced a tough time last spring when her father died of COVID-19. The college “really worked with me on what I needed and how I could best be learning as I worked through my grief and everything,” she says.
The students, too, really help each other out and remain close, say Conrad, Franke, and Gold.
“Medicine can be really isolating, even pandemic aside,” Gold says. “A lot of times we see really hard things in the hospital and we come home and there’s not that many people we can talk to about it who really understand.
“I saw my first code with one of my very best friends because she and I have a rotation together,” she continues. “I feel really lucky that we got to have that experience together because how can you explain it to someone?”
The future looks bright not only for the future doctors, but for the Elson S. Floyd College of Medicine.
Five years later, Tomkowiak says, “we’re already one of the most productive community-based research colleges in the country.”
The college has plans for more research, with millions in grant funding already coming in. And, this year it received 1,700 applications for 80 spots in the class of 2025. Nandagopal sees promise in all the future students.
“If they’re the doctor who stops and asks their patient, ‘What else can I do?’ I think we’ve done our jobs. I hope that is the special spark that sets them apart as the WSU physician,” Nandagopal says.
After she finishes her residency, Gold wants to practice in a small town in Washington as an OB-GYN. “I fully intend to be a physician who’s very connected to my community,” Gold says.
Conrad aims to return home as a family physician in Colfax.
Franke hopes to become an emergency room doctor in Seattle. An event this spring as he was on a rotation in the emergency department reinforced that goal.
He and the attending physician had a patient go into cardiac arrest, so they did CPR, pushed medication, and were able to bring the patient’s pulse back.
“It really reminded me of why I was going to do emergency medicine,” Franke says, “to be with people at these inflection points in their lives.”
