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A partnership that CommonSpirit Health and Morehouse School of Medicine launched in 2021 already is making headway in ticking up the nation's count of aspiring clinicians. Many of the students and residents are of diverse backgrounds and are in the pipeline to a medical career through the More in Common Alliance.

According to CommonSpirit, the alliance will increase medical education opportunities for more students from populations underrepresented in medicine, including those who are Black, indigenous and people of color or who are from rural areas. A goal is to help Morehouse medical school double undergraduate enrollment and increase the number of post-graduate residency and fellowship slots. Ultimately the partners want to increase the number of students recruited from communities experiencing a provider shortage.

The partnership is increasing the number of students in each cohort at Morehouse School of Medicine from 125 to 225. The partnership also will establish regional medical campuses at three CommonSpirit facilities and plans to potentially add one more. The partnership has also launched a graduate medical education program at a CommonSpirit hospital and plans to add such programs at six more of the system's hospitals in the future.

Dr. Veronica Mallett, chief administrative officer of the More in Common Alliance, says the partnership holds promise to improve health care delivery over the long term, particularly by increasing the number of physicians who are attuned to the needs of diverse populations. She says this "really aligns with the vision of CommonSpirit Health of providing the healing presence of God in the people we serve — especially those vulnerable populations — through a lens of social justice." She says the partnership also is aligned with Morehouse's vision, "which is about leading the creation and advancement of health equity to achieve health justice. And so, the partnership's strength really comes from the shared affinity of their mission, vision and values for taking care of these historically marginalized populations."

Capacity-building
The More in Common Alliance resulted from a chance meeting in 2019 between then-CommonSpirit CEO Lloyd H. Dean and Dr. Valerie Montgomery Rice, president and CEO of Morehouse medical school. Spurred by their mutual concern about the lack of diverse clinicians in the U.S. and the resulting negative impact on care access, they worked with their respective organizations to create the alliance. That effort officially launched about three years ago. CommonSpirit operates 142 hospitals in 24 states. Morehouse medical school is part of Morehouse College, one of the nation's historically Black colleges and universities.

Together, CommonSpirit and Morehouse have contributed about $115 million toward their More in Common Alliance and are fund-raising for additional dollars.

The alliance is using some of the dollars invested by CommonSpirit to erect new facilities on Morehouse's medical school campus in Atlanta to accommodate the growing cohorts of students and the programming expansion happening as a result of the alliance's work.

Also, the alliance is establishing regional medical campuses at CommonSpirit's CHI Memorial Hospital in Chattanooga, Tennessee, with Morehouse School of Medicine students having started rotations in 2021; at Virginia Mason Franciscan Health in Tacoma, Washington, in 2022; and at CHI Saint Joseph Health in Lexington, Kentucky, in 2022; and plans to establish another at Bakersfield Memorial Hospital in California. These regional medical campuses will begin recruiting students from populations in their vicinity that are underrepresented in medicine, including students from rural areas and from racial and ethnic minority populations. Working with Morehouse, these hospitals bolster the undergraduate programs of colleges and universities in their communities to prepare students for the rigors of medical training. After completing their undergraduate education, selected students will get their medical education at Morehouse and then return to their home communities to complete clinical training at their local CommonSpirit hospital.

Through a separate program, multiple CommonSpirit hospitals are working under Morehouse's sponsorship to establish themselves for the first time as teaching hospitals. Dominican Hospital in Santa Cruz, California, launched its graduate medical education program in the summer. Bakersfield Memorial is preparing to start one next year and Bakersfield Mercy Hospital in 2026. Other sites slated to start graduate medical education programs at a to-be-determined date are St. John's Regional Medical Center in Oxnard, California, and CHI Memorial Hospital Chattanooga. Morehouse School of Medicine has become the sponsoring institution for California Hospital Medical Center in Los Angeles, and CHI St. Vincent Hot Springs in Arkansas so that these established residencies benefit from the expertise provided by the Morehouse medical school.

In connection with the capacity expansions, Morehouse and CommonSpirit are partnering on developing faculty, recruiting students and building up the capabilities of "feeder schools" that can help prepare students for medical training. Morehouse and CommonSpirit also are organizing their facilities into a research-focused network. The network members will help each other to mine data for research and initiate and/or participate in studies.

Desire to serve
Dr. Chrissa Karagiannis is a member of the inaugural class of eight residents training in family medicine at Dominican Hospital, through the More in Common Alliance. She says she's wanted to be a physician since she was a child, when she witnessed the lifesaving impact of doctors when her grandmother had a stroke.

Karagiannis completed her undergraduate and osteopathic medicine studies close to home in the San Francisco Bay area. During medical school, she became aware of the More in Common Alliance. She says she was instantly interested because of the alliance's focus on cultivating a diverse pool of residents with a passion to serve vulnerable people. She also liked that the residency would expose her to many care venues. "I prayed that I'd get a match" with the program, she says, and was thrilled when she was selected.

She says the medical staff and other colleagues at Dominican have welcomed her and her fellow residents warmly. She is rotating through every medical department of the hospital and in one of its clinics, where she has a panel of patients she sees under her attending physicians' supervision.

She says she's building leadership skills and is excited to be among the trailblazers in a new residency program.

Fresh faces
Dominican President and CEO Dr. Nanette Mickiewicz says the program already is benefiting the hospital and promises to be a boon to Dominican and its surrounding community well into the future.

She says the residents are inspiring innovation among the medical staff, they bring a new energy to the campus, and they increase continuity of care for more patients. This is because the residents can see patients both in the inpatient environment as well as in the clinic environment for follow-up care upon discharge.

In the long term, Mickiewicz expects that some of these residents will want to practice in the community where they've trained. She says this will help alleviate a critical physician shortage. She notes there is a high cost of living locally so it is difficult to recruit and retain primary care and family medicine physicians, who are paid less than specialists.

Mickiewicz says that in recent years, Dominican has found that many Latino residents have suffered disproportionately negative health outcomes, and that is likely because they distrust the medical system. The very diverse class of residents now serving at Dominican includes Latinos as well as physicians like Karagiannis who grew up locally. Mickiewicz expects community members will be more trusting of clinicians who are from the community or who have a similar background.

Representation
Mallett says research shows that concordance between providers and patients improves the relationship.

She has high hopes for the communities where the alliance is active. "Maybe for the first time in a patient's life they will have a provider who has the same language, the same culture as them. There is an implicit trust that comes from a knowledge of a shared background," she says.

Karagiannis has witnessed this dynamic firsthand. While she is not Latino, she does speak Spanish, and she has seen that using her second language has improved her relationships with Spanish-speaking patients. She believes patients have a greater understanding of what is said in an appointment when the physician speaks their language.

"I have seen how much it means to patients" to have a provider who they can truly connect with, says Karagiannis. "I've seen that us residents are a diverse team, and we work well with the underserved. We truly care about increasing access to medical care. We truly care about improving the health of the community."