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There is a nationwide shortage of physicians. According to the Association of American Medical Colleges, the U.S. could see a shortage of 100,000 or more physicians by 2033. The severity of the problem varies from specialty to specialty. According to an article by Time Magazine, “Neurology and psychiatry, as well as pulmonary and critical care medicine are headed for larger shortfalls due to the complex, chronic conditions America’s aging population must manage.”
This is a concerning situation that could lead to poorer health outcomes for many patients. Rural communities tend to suffer more, as high educational debt tends to lead new graduates to seek higher paying positions in larger metropolitan areas.
One physician at IU Health Arnett has made it his mission to change the outcomes for Greater Lafayette and nearby communities by teaching the physicians of tomorrow—Akram Al-Makki, MD, FACP, FASN.
Al-Makki joined the IU Health Arnett nephrology department in 2004. Stephen Ash, MD, FACP and his life-long pursuit to make hemodialysis technology simpler and safer was a big factor in Al-Makki’s decision to move to the area. Ash was a physician he admired and wanted to learn from. Al-Makki also knew he wanted to become more involved in academics.
“When you take the oath, part of the mission should be sharing your knowledge with both students and patients,” shares Al-Makki.
The road to becoming a physician
It takes 10 – 14 years to become a physician. Physicians must complete a four-year undergraduate program, an additional four years of medical school, then three to seven years in a residency program to study the specialty they choose to pursue.
Since 1971, the Indiana University School of Medicine has offered medical education on the Purdue University campus in West Lafayette, Ind. Originally, medical students would spend the first two years of classes in West Lafayette then transfer to finish their third and fourth years of medical school in Indianapolis.
Shadowing opportunities in Greater Lafayette were sparse, but that needed to change, according to Al-Makki. The Graduate Medical Education (GME) program for medical students was established at Arnett Hospital in 2009 and Al-Makki volunteered to serve as the Internal Medicine and Nephrology Education Site Clerkship Director. In 2012, he was appointed Director of the program—an appointment that was based on his advocacy for research, having a passion for education and believing in the importance of constantly learning.
“I formulated vision and mission statements that I used as a guide and inspiration to strongly encourage my fellow physicians to volunteer to teach medical students,” shares Al-Makki. “Policies, procedures and orientations were developed. I helped advance the program and expand the number of physicians involved in medical education and students rotating at IU Health Arnett.”
Growing physician involvement
Within two years, the number of physicians involved increased from around 40 to more than 120. Today, more than 140 IU Health Arnett physicians are involved with medical student education.
In line with Al-Makki’s vision, the IU School of Medicine added a third year of medical education to their West Lafayette regional campus at Purdue in 2012 and a fourth year in 2013. Led by medical education and research experts, the IU School of Medicine in West Lafayette follows the school’s statewide core MD curriculum. Like all IU School of Medicine statewide locations, the West Lafayette campus offers community participation opportunities and exceptional clinical education through student groups, medical service-learning programs and other extracurricular activities, and a strong partnership with local clinical providers to ensure students get authentic experience in applying basic science concepts to real patient cases.
Keeping medical students in our community
Now students at the IU School of Medicine in West Lafayette can complete all four years of their medical education in Greater Lafayette. Two graduates from the first class to remain in Greater Lafayette all four years joined local medical practices in our community after finishing their post-graduation residency training. Many others who have graduated since 2014 have also returned to serve our community after finishing their residency training.
“Teaching is my passion,” shares Al-Makki. “The best way to learn is to teach. The students enrich my experience and that of the patient. They add a lot to what we do every day, help us stay up to date on technology and they ask questions—which stimulates the brain.”
Jake Whiteside is one of the medical students from the IU School of Medicine-West Lafayette campus completing his four years of medical education in the Greater Lafayette area. West Lafayette was a draw because his best friend lives locally. Being a husband and father of three young children, he also did not want to move his family for clinical rotations in his third and fourth years of medical school.
“Being here, I knew I would have a lot more one-on-one education,” shares Whiteside. “I appreciate being involved with the patients and being able to ask questions. I also ask my mentors to challenge me.”
How do the patients react to the medical students?
“The patients receive more attention,” adds Al-Makki. “The addition of the medical students provides a good discussion of the issue and possible solutions which helps the patients. I also ask the students to review the patient history with me and the patient.”
Whiteside shares that learning at Arnett and in the Lafayette area has been a good fit for him and his family.
“My physician mentors and the team at IU Health Arnett have been friendly, approachable and flexible—always willing to work around anything I need in my professional and personal life,” shares Whiteside. “I really feel that we are all in this together.”
Whiteside has found his passion in general surgery—his past experiences in general and bariatric surgery research contributed to his excitement to learn more about general surgery and its subspecialties, including hand surgery, bariatric surgery and robotic surgery, among others. Whiteside has matched into an active-duty surgical residency program at Wright Patterson Air Force Base/Wright State University and will begin his surgical training there in summer 2023.
Will he return to Indiana? He hopes so.
“It is a great place to live and work,” adds Whiteside. “The Midwest offers a lot of flexibility.”
Al-Makki expanded locally a statewide summer educational program called Hospital Medicine Education (HME) and secured funding to provide a grant to a female and a male student moving from their first year into second year. The eight-week program allows the students to rotate through various departments at Arnett, in hopes that the students will be interested in remaining in our community. The HME program has become very popular with the medical students.
Al-Makki is continuously working to improve health care at Arnett by advancing the quality of medical students and physicians' education through collaboration with the IU School of Medicine and its curriculum priorities. His work in raising the engagement of medical education has resulted in a higher level of professional satisfaction of physicians through mentoring and teaching students.
“I take pride in what we have accomplished,” shares Al-Makki.