Strategies for increasing the physician workforce: the Oregon model for expansion.

The physician workforce shortage and inequity of physician distribution throughout Oregon require the Oregon Health & Science University (OHSU) School of Medicine to graduate more physicians and increase the number committed to practice in nonurban areas. The most cost-effective and expedient method to accomplish these goals has been to develop community partnerships and regional campuses. However, expansion must be strategically developed to maintain educational quality and to minimize the impact on available resources. Leveraging partnerships with existing health care delivery systems and major state universities makes expansion more expedient and economical. In 2001, the OHSU School of Medicine began implementing a four-phase plan to increase medical student enrollment. Phase 1 (2001-2006) used only capital budget resources to increase enrollment incrementally at the school of medicine's Portland site; Phase 2 (2006-2007) creates community partnerships to develop regional sites using the physical facilities of partners, again avoiding the need for capital investment; Phase 3 (2007-2010) builds on the prototype developed in Phase 2 to create additional regional educational sites; and Phase 4 (2010-2015) involves a feasibility study and subsequent capital campaign for a facility on Portland's south waterfront. Establishing regional campuses and matriculating the student population best suited for the physician workforce of the future are key elements of the OHSU model of expansion, particularly in addressing the state's physician distribution inequities.