Archive for March 2018

Graduating medical students nationwide learn on Match Day where they will be spending their residencies

Tawana Evans reacted after being matched with the University of Louisville. (Photo by Selena Jabara, University of Kansas Medical Center)

by Greg Peters, University of Kansas Medical Center

The third Friday of March brings its own special version of match madness to medical schools across the county. While there are no buzzer beaters or Cinderella stories to be written, there is plenty of white-knuckle nervousness to go around as graduating medical students from coast to coast hold their breath as they learn on the same day where they will be matched for their residencies and in which specialties.

On Match Day at the University of Kansas School of Medicine in Kansas City, Kansas, the envelopes are torn open amidst a chorus of shouts and cheers from friends and family gathered in Battenfeld Auditorium as the doctors-in-training learn one by one where their next stops will be on the path to becoming practicing physicians.

One hundred and nineteen students from the KU School of Medicine on the Kansas City, Kansas, campus matched, along with 79 from KU School of Medicine—Wichita and another 10 from KU School of Medicine—Salina.

“I’m excited for Match Day to see where everyone is going,” said Tawana Evans, a hometown student from Kansas City, Kansas, who graduated from Wyandotte High School. “I am proud of all my peers who have made it this far. And I am proud to be a Jayhawk.”

Students submit their preferences after interviewing with various residency programs, and the nonprofit National Resident Matching Program uses an algorithm to determine the pairings based on information submitted by both the applicants and the various residency programs. The residencies can last from three to seven years, depending on the specialty.

KU prides itself on being one of the nation’s leaders in producing primary care doctors, and this year was no exception with 45 percent of the students matching in this specialty. And many of the students will be staying nearby for their residencies. Of the 208 total students matched on the three campuses, 61 (Kansas City 27, Salina 2 and Wichita 32) will be staying in Kansas for their residencies.

Evans, who matched in obstetrics and gynecology at the University of Louisville, said she is a Wyandotte Bulldog through and through.

She always knew she wanted to help people but she had never met any black doctors until her sophomore year at Wyandotte High School when she joined the Health Careers Pathways Summer program, which targets inner-city kids who are interested in science, math and engineering. Her first mentor was internist David Dembinski, M.D. Curtrina Strozier, M.D., and Reggie Fears, M.D., also took her under their wings and continue to consult with her to this day.

Evans and her husband, Dwayne Coates, were raising their 1-year-old daughter when she started classes at KU Medical Center. She credits her husband – the man who lifts her spirits when she’s discouraged – and her mother, Janice Evans, for being her support system as she earned both her Master’s in Public Health and Doctor of Medicine.

On Match Day, she was joined by her husband and mother along with her daughter, Kamaria Coates, who is now 6.

“I live one day at a time so Match Day is surreal,” Evans said. “It has taken a lot of hard work, discipline and prayer to get to this point.”

Allison Beito, who grew up in Bellevue, Washington, and graduated from the U.S. Coast Guard Academy, comes from a long line of doctors. Her father is a general surgeon and his father was an internist.

After receiving her undergraduate degree, Beito served for five years in the Coast Guard as a shipboard engineer and project manager, while finishing up her prerequisite coursework for medical school and preparing for the MCAT. She remembers many times while at sea that she had to wait until the middle of the night or over the weekend to make a dodgy internet connection so she could turn in her online assignments.

For Beito, medical school at KU was just another chapter in a life filled with many memorable experiences on her way to an internship in psychiatry at the Mayo Clinic.

“I will never forget the joy of delivering my first baby,” she said. “I’ll never forget sitting with a patient while he died. I’ll never forget the first time a patient hugged me. And I’ll never forget the Sunday on surgery when a patient came in with a terrible gunshot wound, and while we were in surgery I looked down at the beating heart and lungs gently rising and falling and thinking to myself ‘how beautiful – what an incredible thing the human body is.'”

When David De La Cruz stepped onto the stage to learn his fate, his wife, Viki, and their children Elijah, Arya and Dominic were with him to celebrate learning he had matched in emergency medicine at the University of Wisconsin-Madison.

“Med school has really made me grateful for the tremendous opportunity I’ve been given,” said the Peoria, Illinois, native who has wanted to become a doctor since he was 11 years old and his older brother was in medical school. “As I look back, I’ve come to realize how much I owe pieces of my success to other people: my wife, my parents, my teachers and classmates, and countless patients.”

In Wichita, Nikki and Ross Miller were supported by a host of family members when they found out they had been matched to The University of Kansas Health System. Nikki matched in internal medicine and Ross in emergency medicine.

The couple met in a biology class at KU in 2010, and their goals of becoming physicians were cemented on a medical mission trip to Costa Rica and Panama where they spent every day setting up clinics to treat underserved individuals, many of whom had never seen a doctor.

They also share an interest in medicine through family ties. Nikki, who excelled in science and math and loved caring for people, would tag along with her mother while she was taking care of her great-grandmother.

Ross became interested in medicine by observing the rheumatologists who treated his grandfather, who suffered from rheumatoid arthritis throughout his life.

“We’ve been building up to this for four years, so it’s a feeling of excitement and relief,” Nikki said. “We are proud of the programs we’ve matched with and are excited for the adventure to come.”

Yet another married couple in the School of Medicine matched together, this time on the Salina campus. Catie and Vince Adams, who met at a house party during their undergraduate years and married seven years later, will be heading to Marshall University. Catie matched in internal medicine and Vince in general surgery.

“It felt amazing finding out where we matched,” Catie said. “It’s taken a lot of hard work and sacrifice to get to this point. It will be nice to plan the next phase of our lives and training.”

The Adamses have each overcome their own share of adversity to make it to Match Day. Vince, whose father is a dermatologist, failed one of his modules during his second year when he was both sick and injured, but he says it was an enlightening experience.

Catie’s father became deathly ill during her third year, and she spent a lot of time commuting to Texas to be at his bedside before he died. It was difficult making up for missed time on her rotation while still grieving the sudden loss of her father.

“I believe that medical school changes you in many ways,” Catie said. “You absolutely have to mature and get your priorities in line.”

Vince added, “I’m certainly more mature and responsible than I was when I started medical school. At this point I much more closely resemble the person I would want to be my own physician than I did when I started.”

For at least one candidate, Match Day was a little less intense. Taylor Batson, from Girard, Kansas, found out in December that she matched in pediatrics at the Naval Medical Center in San Diego, and will continue to serve in the Navy after her residency.

“KU has given me so many opportunities to work in a variety of settings outside of my comfort zone,” she said. “I have practiced in rural and inner-city hospitals, small pop-up clinics in Panama, and a district hospital in South Africa all thanks to KU. An incredible and diverse group of doctors has mentored me, inspired me and has given me a solid foundation from which to start.”

Greg Peters is the senior communications coordinator for the University of Kansas Medical Center.


Consultant suggests Kansas schools could need $450 million to $2 billion more

by Celia Llopis-Jepsen, Kansas News Service

Getting most Kansas schoolchildren on track for college and up to speed math and reading could cost an extra $2 billion a year — or roughly half what the state already spends on aid to local schools.

The figure comes from a report released Friday that lawmakers commissioned to help them judge the costs of getting better classroom results and to comply with a Kansas Supreme Court order.

Dozens of school districts that have been suing the state for seven years wanted at least $600 million to meet demands in the state’s constitution. They accuse the state of underfunding schools and reneging on court-approved plan in the mid-2000s that called for higher funding.

A spokesman for Kansas City, Kansas, schools said the report — which lays out funding increase scenarios ranging from $450 million to $2 billion — validates the plaintiffs’ legal argument that money matters.

“It says if we’re going to get substantially higher outcomes,” David Smith said, “then we need to spend more money.”

The analysis — by external consultants — matters because Republican legislative leaders had hoped it could form the basis of their rationale to the Kansas Supreme Court for whatever amount they ultimately spend on schools this spring.

The legislature hired the consultants following a court order to fix school funding. At least one legislative leader had sticker shock after seeing the report. Senate President Susan Wagle said following the study’s recommendations would mean massive cuts to other state services, and corresponding tax hikes.

“There will be major losers at the end of this,” Wagle said, “and that will be either the Kansas taxpayers or other state services whose funding stream will be cut.”

In a statement, she said the money could only come from a major tax increase and cuts to “health care, social services, transportation, and higher education all in the favor of schools.”

Democrats appeared happy with the report. Yet they had initially called into question one of the author’s credentials, apparently concerned the study might give legislators political and legal cover to spend less than $600 million.

People who had long advocated for more robust state spending on local schools took vindication from the consultants’ report.

“It proves what we’ve been saying in the legislature and in the courts,” House Democratic Leader Jim Ward said. “We’ve underfunded schools significantly over a long period of time. … It’s going to be expensive to fix it.”

The Kansas Supreme Court has charged lawmakers with coming up with a school funding formula aimed at closing achievement gaps.

Like past studies, Friday’s report suggests more money is needed to get results for students.

Republican Sen. Molly Baumgardner, who heads the Senate education committee, was more uncertain of what the 160-page report means. Lawmakers received it at 1 p.m. Friday and scrambled to digest it.

“OK, we don’t know exactly what it says,” she said. “We’re going to read and we’ll go from there.”

Republicans and Democrats alike want to know whether the report contains errors or other problems, such as how student enrollment was calculated. The report’s authors will come to Topeka Monday to answer questions.

The report lays out three spending scenarios. The cheapest, which aims for a 95 percent graduation rate by 2022, would cost an estimated $450 million.

But it would cost $1.7 billion to get 90 percent of students on grade level in math and reading by that same year, and $2 billion to get 60 percent of them at the levels in those subjects that they’ll need for college.

Those calculations don’t specify where that money should come from. Schools are funded with a combination of state, local and federal dollars.

Curtis Tideman, a lawyer for the House, told lawmakers the report “expands probably the number of different choices that the legislature has.”

“There’s a possibility of using pieces” of the report’s analysis, he said. “There are a number of different ways this report might be used.”

The Kansas Supreme Court was highly critical last year when the Legislature voted for a $300 million increase to schools and the state then argued to the court that a quick four-page statistical analysis of school spending validated the amount.

It’s the first comprehensive look at the cost of education in Kansas in more than a decade.

That prompted legislative leaders to commission a detailed study for $245,000 from Texas A&M University economist Lori Taylor and the nonprofit consulting and research firm WestEd.

It’s the first comprehensive look at the cost of education in Kansas in more than a decade.
Previous studies commissioned by the Legislature concluded public education was underfunded, and school districts suing the state say following the guidelines in those studies — adjusted for inflation — would mean adding around $1.7 billion to schools.

A plan to increase K-12 funding in the mid-2000s was derailed by economic recession. After Sam Brownback became governor in 2011, the plaintiffs in the current lawsuit argue, he cut income taxes instead of getting the school finance plan back on track.

When lawmakers agreed last spring to hike school spending by $300 million annually, phased in over two years, the plaintiffs argued inflation would eat up half of that increase. They also said too little would be left to make a dent in the problem Kansas is trying to fix — the fact that a quarter of its students are struggling with basic math and reading.

In October, the Kansas Supreme Court agreed with the plaintiffs. It wants Kansas schools to have enough resources to help kids acquire seven key skill sets before they graduate.

In addition to problems with overall funding, the justices identified four ways in which Kansas’ school funding system was unfair to poorer school districts, including a tailored injection of money that benefited two Johnson County school districts alone.

Celia Llopis-Jepsen is a reporter for the Kansas News Service, a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio covering health, education and politics. You can reach her on Twitter @Celia_LJ. Kansas News Service stories and photos may be republished at no cost with proper attribution and a link back to the original post.

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Wyandotte County health officials persist in their efforts to improve county’s health ranking

by Mary Rupert

Being 99th out of 103 counties in the state on health outcomes, after working several years to improve the county’s health ranking, is an uninspiring picture for Wyandotte County. However, local health officials are not giving up.

Instead, the county points to how it has moved out of the very last position at No. 103, up four positions in the past few years on the County Health Rankings from the Robert Wood Johnson Foundation.

Terry Brecheisen, director of the Unified Government Health Department, said the county has made progress in addressing health issues during the past few years, and it is currently in the process of developing a community health improvement plan.

A comparison with other counties doesn’t necessarily show improvements that have been made here. If all the other counties on the health ranking list are making the same amount of improvement, everyone else would stay at the same rankings, he said.

“You have to compare yourself with yourself, and are you doing things to make things better, and I think the answer is yes,” Brecheisen said.

He is not one to give up just because the rankings don’t show dramatic improvement in a few years.

“This is my hometown, I like living here,” Brecheisen said. He would like to live in the best lifestyle possible in a safe, clean and healthy place, he added. “I’m excited about living in Wyandotte County in the future.”

The county health rankings include some areas that are not traditionally thought of as health, such as income and education. Brecheisen said they’re addressing those nontraditional health areas, such as income, education, affordable housing and access to care, in the new community health improvement plan.

Factors such as education and income were shown to be two of the greatest predictors of health, he added.

While one might think that the community has little control over the income and education of its residents, Brecheisen said efforts such as bringing the new Amazon facility to Kansas City, Kansas, with thousands of jobs, and efforts to keep students in school can have a positive effect on health.

Better jobs equal better pay, with probably better insurance, allowing residents to go to the doctor more than if they did not have a job, he said. Jobs absolutely make a difference in people’s health, he said.

Those students who stay in school and graduate can get better jobs and make better decisions, he added.

In the current health rankings, the number of children in poverty was listed at 24 percent in Wyandotte County, compared to 14 percent in Kansas.

Brecheisen said some of these factors listed on the health rankings will not change overnight. If there are generational factors, such as families where there have never been high school graduates, he said, it’s tougher to change. The Wyandotte County high school graduation rate was listed at 73 percent, with the Kansas average at 86 percent.

Two other tough areas to change are smoking and obesity.

“You don’t get people to stop smoking overnight, and adult obesity takes time,” he said.

Still, he expects to see a change one day because of an ordinance change in the community increasing the age to buy tobacco products to 21.

Studies have shown that if people do not start smoking by age 21, a high percentage of them will not smoke at all, he said. That’s why younger people were targeted, and the age to buy tobacco products was raised, he said, because each year they get older, the chance of smoking is less.

The county health rankings, however, are behind a year or two, he said, so that any changes from the recent ordinance will not be visible yet.

On the current health rankings, adult smoking was listed at 23 percent in Wyandotte County, compared to 17 percent in Kansas. Adult obesity was listed at 37 percent here, compared to 32 percent in Kansas.

Besides the ordinance change, a number of other programs have been listed by the local government to improve health in the past year, according to officials.

On the positive side, the health rankings report showed Wyandotte County improved in life span, he said.

Another improvement is the teen pregnancy rate here is lower than the previous report, he said. He said the Wyandotte County Health Department is actively involved in health education for teens, along with the Kansas City, Kansas, Public Schools. They emphasize responsible decision-making in their educational programs, he said.

There was a big push at the Health Department and at other agencies in Wyandotte County to get uninsured people signed up for health insurance under the Affordable Care Act, he said.

“That was successful,” Brecheisen said. “There are more people now with insurance than there used to be in the county, and that’s terrific.”

That might not yet be reflected on the health rankings because they are a couple years behind, he added. The uninsured here were listed at 17 percent on the health rankings, compared to 10 percent statewide.

Violent crime also is listed on the health rankings, with 603 cases reported in Wyandotte County as compared to the Kansas average of 348.

While violent crime is something the Health Department doesn’t specifically deal with, the community health plan will address interventions, he said. It will discuss whether more recreation centers and more after-school programs are needed to prevent crime. He added the current health ranking data on violent crime is from 2012 to 2014.

While the topic of lack of physicians in rural areas is frequently discussed at the state level, urban areas such as Wyandotte County are well below average in the number of primary care physicians per resident.

According to the health rankings report, Wyandotte County had 2,550 residents per primary care physician, with physicians well below the state average of 1,320 to one.

For dentists, Wyandotte County had 2,370 residents per dentist, as compared to the Kansas average of 1,760 to one.

And for mental health providers, Wyandotte County had 720 residents per mental health provider, as compared to the state average of 560 residents per one, according to the county health rankings study.

The study also found health disparities among black and Hispanic residents of Wyandotte County in areas such as infant mortality, child poverty and household income.

Brecheisen said the Health Department led a community health assessment last year to evaluate health needs here.

He said the assessment will be followed by a community health improvement plan, led by the Health Department, that will come out later this year with a three-to-five-year plan for strategies and action steps. The four areas to be focused on by the improvement plan will be safe and affordable housing, access to medical, dental, and mental health care, violence prevention, and education and jobs.

The improvement plan is part of the Health Department’s strategy to become accredited, he said. Once the plan is completed and approved, Brecheisen said he looks forward to implementing the strategies in it.

To see the county health rankings, visit