By MICHAEL BRADLEY
Special to Delaware Business Times

Frank Mayer, 39, has a wife, two young children and a goal to practice emergency medicine in Delaware. Now in his third year at Philadelphia College of Osteopathic Medicine (PCOM), the Newark native is set to make that dream a reality.

"It's something I have wanted to do for a long time," he said. "I didn't think I would have the opportunity."
After graduating from the University of Delaware more than 15 years ago, Mayer became co-owner of a business. He sold the company a few years ago for a sum large enough to allow him to consider medicine. He then took the required science courses at UD and started looking into options for med school.

Since Delaware is one of five states nationwide, including Alaska, Montana, Idaho and Wyoming, without a medical school, Mayer had to look outside the state for options. But he wasn't alone: The Delaware Institute of Medical Education and Research (DIMER) helped Mayer enroll in PCOM's 2016 incoming class through assistance in the application process.

The program is the result of a decades-long effort by state officials to help Delawareans train as doctors and hopefully return to work in the state.

In the mid-1960s, the University of Delaware conducted a study about whether it should start a medical school. Due to what the study considered onerous operating costs ($50 million/year), the idea was scrapped. In 1969, DIMER was created by the state legislature to provide opportunities for state residents to have preferred access to medical school.

"A lot of physicians in the area at the time were alums of Thomas Jefferson [University Medical College] in Philadelphia, so an agreement was worked out to set up DIMER," said Sherman Townsend, who has been the program's chairman since 1995.

The first class of Jefferson students began in 1970, and in the middle of last decade, a similar relationship was forged with PCOM. The first class had just five students. This year, the program assisted 19 students, although Delaware still only pays for the original five ( $12,500/per student/year). Students must handle their own tuition and room and board costs, but DIMER does provide small grants to help. Most important is the "up leg" the students receive in the application process, according to Townsend.

"That's the real advantage," he said. "If you are from Delaware and apply to Jeff, you don't go into the pool with 11,000 applicants for 270 spots. You go into a pool with 75 Delaware residents per year for 20 positions."
After two years of classroom work, the students head to hospitals to complete their clinical rotations. Because Christiana Care Health System has established itself as a branch campus for both medical schools, students can take part in a "Delaware" medical school experience that provides state residents with the opportunity to complete all of their rotations at Christiana, thanks to DIMER.

Townsend estimates that Jefferson's annual budget is $300 million, of which $1 million, or .033 percent, comes from Delaware through DIMER. Meanwhile, 7.4 percent of the SKMC student body is from Delaware.
Each year about 9,000 students apply to PCOM for 590 spots, give or take. Having 19 positions available for Delaware residents "“ with a small applicant pool that is similar to that at SKMC "“ is quite a coup, given the applicant pool is worldwide.

"It's really incredible," Mayer said. "You get onto a special list of students and get more attention from the schools and more professional treatment than other applicants get."

Wilmington native Arjun Patel is a fourth-year student at SKMC who graduated from UD in 2015 and plans to specialize in internal medicine. He has enjoyed the opportunity to study in Philadelphia and apply what he has learned at Christiana.

"DIMER is a huge resource," Patel said. "Growing up in Delaware and not really having a medical school in the state can turn off some students. But knowing there is funding and other resources available to Delaware students gave me confidence to pursue a medical career.

"Looking back, in effect there actually is a medical school in Delaware," he added. "DIMER and Christiana Care have created health-care opportunities."

Dr. Lisa Maxwell, associate chief learning officer at Christiana Care, reports that while many students do an eight-week rotation or two at the hospital, about 40 students "“ 20 from each class "“ complete their entire two-year clinical stints at the Christiana branch campus. She sees the relationship as mutually beneficial, because Christiana physicians enjoy teaching, and the hospital gets to "introduce" itself to future doctors from two top-notch medical schools. They may enjoy their experience enough to work for Christiana or set up practices in state.

"For a lot of medical students, when they do one eight-week rotation, they do it at a hospital they have never been to before," Maxwell said. "Eight weeks later, they have to go to another hospital and have to start all over again, learning the culture, the electronic medical records system and where the cafeteria is. They're dealing with that while trying to learn how to become a physician."

As other hospitals grow, Townsend thinks they will want to become part of the DIMER branch campus system. With more hospitals in the program, more medical students could choose to stay in state after they graduate.

"Looking back as a fourth-year student, I see the systems DIMER has put in place to help students from Delaware succeed and learn from Delawareans who have established their careers in the state," Patel said.