Students and state gain from the experience of off-campus clerkships.

In Africa they say it takes a village to raise a child. In Iowa, you might say it takes a state to train a doctor. Iowa's Statewide Medical Education System, established in 1974, provides community-based clinical education for UI medical, pharmacy and physician assistant students, as well as specialty training for resident physicians. The system links six Regional Medical Education Centers-in Cedar Rapids, Davenport, Des Moines, Mason City, Sioux City and Waterloo-with the UI Carver College of Medicine and UI Hospitals and Clinics.

The Office of Statewide Clinical Education Programs (OSCEP) oversees the College's affiliation with the six regional centers, facilitating communication, coordinating programs and advising UI and state leaders on physician education and workforce issues.

Every UI medical student receives some aspect of her or his training off-campus, beginning with clinical shadowing experiences during the M1 year. The community-based primary care clerkship required of every third-year student takes place at a hospital or clinic affiliated with one of the six regional centers-in fact, the centers are primarily responsible for organizing and administering the clerkship. And the regional centers host students in a variety of other required and elective clerkships. The relationship between the College and the regional centers is mutually beneficial.

For the College, off-campus clinical clerkships give students a taste of medical practice as most will know it during their professional careers, exposing them to rural and inner-city patient populations they may not encounter in the UI's academic medical center. Also, this volunteer teaching effort has tremendous value to the College, said Roger Tracy, director of OSCEP. "The value of their contributions is incalculable," he said. "Many of them are with students and residents on a continuous basis."

For the regional centers, their UI affiliation gives volunteer faculty physicians the opportunity to teach and interact with medical students. "To teach is to learn twice," said Steven Craig ('76 BS, '79 MD), executive director of the Des Moines Area Medical Education Consortium. "We all enjoy the stimulation of working with bright students and seeing them grow and evolve."

The College provides training and resources to support community physicians in their teaching. "I appreciate how much effort they put into teaching us to be better teachers," said Dean Bunting ('84 MD), a family medicine physician and faculty employed by the UI-affiliated Davenport Medical Education Foundation. Bunting participated in the innovative Community Teaching Scholars Program organized by the College's Office of Consultation and Research in Medical Education.

Having medical students come for clinical rotations also helps the regional centers recruit resident physicians for their specialty training programs. In the past two years, 18 UI medical graduates have taken residencies at the regional centers.

Another benefit for the community physicians is their access to faculty and educational resources at the UI. Iowa City-based faculty regularly visit the regional centers to conduct continuing medical education programs and share the latest practices with their community-based colleagues.

"They offer us a level of expertise that we don't have at our institutions," said Douglas Workman ('86 BS, '89 MD), a family medicine teacher at Broadlawns Medical Center in Des Moines. "We appreciate their taking their time to do that." Community-based faculty also have access to the resources of the Hardin Library for the Health Sciences, including its online search engines and journals.

Iowa's Statewide Medical Education System could be a national model-if it were better known. According to Tracy, former Association of American Medical Colleges President Jordan Cohen called it one of the "best-kept secrets" among the nation's medical schools. With the continuing efforts of the state's medical education community, more and more people will be in on that secret.