From concept to culture: The WWAMI program at the University of WashingtonSchool of Medicine

Shortages of primary care physicians have historically affected rural areas more severely than urban and Suburban areas. In 1970, the University of Wa shington School of Medicine (UWSOM) administrators and faculty initiated a four-state, community-based program to increase the number of generalist ph ysicians throughout a predominantly rural and underserved region in the U.S . Northwest. The program developed regional medical education for three nei ghboring states that lacked their own medical schools, and encouraged physi cians in training to practice in the region. Now serving five Northwest sta tes (Washington, Wyoming, Alaska, Montana, and Idaho), the WWAMI program ha s solidified and expanded throughout its 30-year history. Factors important to success include widespread participation in and ownership of the progra m by the participating physicians, faculty, institutions, legislatures, and associations; partnership among constituents; educational equivalency amon g training sites; and development of an educational continuum with recruitm ent and/or training at multiple levels, including K-12, undergraduate, grad uate training, residency, and practice. The programs positive influences on the UWSOM have included historically early attention to primary care and c ommunity-based clinical training and development of an ethic of closely mon itored innovation. The use of new information technologies promises to furt her expand the ability to organize and offer medical education in the WWAMI region.