Alaskans’ participation a medical school program is threatened by an impasse over how to pay for it.
While lawmakers’ disagree over the program, students like Jesse Klejka, born and raised in Bethel, are worried that they’ll see large tuition increases.
He’s one of 20 Alaskans accepted each year into WWAMI, a medical doctorate program that allows Alaska to help host and train medical students without operating an in-state medical school.
Students graduate from the University of Washington School of Medicine but can receive training across the West The program is named for the first letters of the names of the five states that participate: Washington, Wyoming, Alaska, Montana and Idaho.
Klejka is in his second year of the WWAMI program. He’s been interested in it since he was nine.
“I was excited to hear about a program that puts special emphasis on training and retaining docs for Alaska, with assistance for those students who are interested in going down the path of rural medicine,” Klejka said.
He said the WWAMI program acts as a pipeline for doctors to serve in Bethel.
“Our hospital works to recruit talented individuals, but for many who aren’t from Alaska, it’s hard to call it home,” he said. “I’ve seen the same challenge exists across the state, with hospitals having to spend money on recruitment and travel docs to help fill shifts.”
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Klejka is working in a clinical rotation in Ketchikan. Students in the program attend the University of Alaska Anchorage for a year and a half, then get clinical training at locations around Alaska and the other states. It’s the only medical program that allows you to train in Alaska while becoming a physician.
But on Friday, Klejka was told that barring a resolution to the Legislature’s budget dispute, he and his classmates must have to pay out-of-state tuition this year.
While he doesn’t know what that difference will be, last year the average difference was $30,000. In addition, recruitment for Alaska students for next year’s class has stopped. First-year students — who start class on Aug. 17 — will still pay in-state tuition this year.
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For many years, the Legislature has voted to fund the WWAMI program from an account separate from the rest of the state budget: the Alaska Higher Education Investment Fund.
But this year, because of political gridlock over the state budget and the permanent fund dividend, that vote failed. Without a legislative solution, students are now on the hook to pay tens of thousands of dollars more for tuition.
Students and others involved in health care in Alaska are asking lawmakers to agree to fund the program in the upcoming special session. They spoke last week at a meeting of the working group of legislators weighing changes to the state budget for the long term.
Dr. Kristin Mitchell, a WWAMI faculty member who lives in Kenai and works in Soldotna, told lawmakers the state receives an impressive return on its investment because WWAMI students tend to stay in the state. She moved to Alaska in 1998 to attend the program.
“Alaska has a primary care shortage, and I know you’re aware,” she said. “We urgently need to train excellent Alaskan physicians to provide medical care to Alaskans.”
It’s not just primary care that’s a challenge for Alaska. Mitchell said most psychiatrists in the state are older than 60, as are nearly half of orthopedic and heart doctors.
She said the budget dispute is causing anxiety for students over how to pay for their education. And, she said, a similar budget dispute two years ago caused Alaska to lose future doctors.
“I fielded untold calls from students and families who wondered if they should accept offers of admission from other schools than the University of Alaska and from WWAMI,” she said. “And we lost the opportunity to train some outstanding students over that funding uncertainty.”
Kathryn Mitchell (no relation) grew up in North Pole and chose WWAMI so she could stay in Alaska. Mitchell said she’s concerned that the funding problem will mean the end of the program.
“I ask you to think about your own experiences in health care and ask yourself what it could mean if you could have a doctor who is from your community, knows your environment and the needs of your region,” she said.
Not everyone who testified in from of the legislators supported the WWAMI program.
Some who support higher Permanent Fund dividends, said they consider WWAMI a special interest.
Kerri Mullis of Delta Junction said the Legislature’s first priority should be putting the PFD in the state constitution and paying Alaskans the dividend amounts they would have received the last five years if the state followed the formula in a 1982 law. Including this year’s dividend, that adds up to more than $10,000.
“The WWAMI people shouldn’t be calling in tonight,” she said. “This is about people and their PFD. The WWAMI people shouldn’t even be allowed to talk tonight. And I just want you guys to do the right thing, which is to do the constitutional PFD and give us back our money.”
Some Republican House members who voted against restocking the fund that would pay for the WWAMI program have said they still support it. But they want the funding to be paid along with the rest of the budget, not from a separate fund. Opponents of that proposal say it would require drawing more than planned from the Permanent Fund’s earnings reserve, and that this would open the door to spending down the Permanent Fund in the future.
Gov. Mike Dunleavy hasn’t put funding for WWAMI or similar programs on the agenda for the special session, which means lawmakers won’t be able to consider it. But he could add them to the agenda at any time before the session ends. The session is scheduled to start on Aug. 16 and can last up to 30 days.
Andrew Kitchenman is the state government and politics reporter for Alaska Public Media and KTOO in Juneau. Reach him at akitchenman@alaskapublic.org.