Educating medical students for Alaska.

Because Alaska does not have its own medical school, it has become part of WAMI (Washington, Alaska, Montana, Idaho), an educational agreement with the University of Washington School of Medicine (UWSM). Each year, 10 Alaskans are accepted into the entering class of UWSM and spend their first year at the University of Alaska Anchorage (UAA). UWSM third- and fourth-year medical students can obtain some of their clinical experience in Alaska. To meet the needs of Alaska, students are chosen based on academic and personal records, as well as the likelihood of their returning to Alaska for practice. To this end, over the last seven years 30% of accepted students have come from rural communities and 10% are Alaska Natives. The curriculum for the first year includes several sessions dedicated to Alaska health problems, cross-cultural issues, and Alaska's unique rural health care delivery system. Students do two preceptorships--one with a private primary care physician and one with a physician at the Alaska Native Medical Center. Additionally, students have the option to spend a week at a rural site to learn about the community's health care system. An Alaska track is being developed whereby an Alaskan UWSM student can do most of the third year in state via clerkships in family medicine, obstetrics/gynecology, psychiatry, internal medicine, and pediatrics. All UWSM students at the end of their first year can elect to participate for one month in the R/UOP (Rural/Underserved Opportunities Program), which includes several Alaska sites. The overall goals of these approaches are to educate UWSM students, especially Alaskans, about the state's health needs and health care system and to encourage UWSM graduates to practice in the state.

C. Earl Albrecht and the struggle against tuberculosis in Alaska.

This paper outlines the contributions of C. Earl Albrecht in tuberculosis control in Alaska during his term as Territorial Commissioner of Health from 1945 to 1956. Tuberculosis, called the "Scourge of Alaska," had spread by the end of World War II to every corner of Alaska, with especially devastating effects on the Alaska Natives. When Dr. Albrecht became commissioner, the epidemic was at its peak. With an obvious zest for battle, he organized a campaign on many fronts, with initial emphasis on case-finding, establishing a tuberculosis register, and making available hospital beds both for orthopedic and pulmonary tuberculosis. Later, BCG vaccination, ambulatory chemotherapy, and chemoprophylaxis were added to the battle plan. The results were strikingly successful. He became an eloquent spokesman and advocate for health in both Juneau and Washington, and was successful in obtaining greatly increased territorial and federal appropriations, not to mention surplus military buildings, ships, and supplies. He was also notably effective in bringing together into a functional team such diverse agencies as the U.S. Public Health Service, the Bureau of Indian Affairs, the Territorial Department of Health, and various voluntary health organizations.