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Hopeful hometown heroes

Ohio State program seeks to help solve access-to-care issues in underserved areas

November 20, 2018

By Kimber Solana

Group photo of OSU dental students
First class: The Ohio State University College of Dentistry students, top row from left, Patrick Haren, William Vu, Fuad Farah, Brandon Whitecotton, John Savopoulos; bottom row from left, Rachel Salen and Brandi Lantz are part of the first class of dental students in the Commitment to Access Resources and Education Program, or CARE. Not pictured is dental student Eli Strahler.
Columbus, Ohio — Dental student John Savopoulos describes his hometown of Warren, Ohio, as a diverse, medium-sized city with a large middle class and a decent size affluent population.
"And unfortunately, a large group of individuals that fall in the poverty level and well below it," he said. "The middle and upper class populations don't have a problem accessing health care for obvious reasons, but the individuals in the lower bracket do."
Warren is the county seat of Trumbull County in northeast Ohio and is one of 49 counties in the state that are fully or partially designated as dental professional shortage areas. Mr. Savopoulos said the population-to-dentist ratio in Trumbull County is about 1,960-to-1.
In an effort prepare students from these underserved areas to return as dental professionals to their hometown or another underserved community, The Ohio State University College of Dentistry created the Commitment to Access Resources and Education Program, or CARE. The program educates students and reduces their education debt loads to facilitate their ability to practice in communities where the earning potential is lower.
The program selects up to 10 dental students from underserved communities. These students take an expanded curriculum that includes workshops, networking opportunities, mentoring and active community engagement. In return, students accepted into the CARE program are eligible for a scholarship of $10,000 in tuition assistance that is renewable annually if the recipient maintains a minimum grade point average of 3.4.
School officials are confident these dental students will be more likely improve to access to dental care by practicing in those areas after graduation.
Mr. Savopoulos was among eight first-year dental students to participate in the program, which was created in partnership with organized dentistry and the state legislature. To accommodate the addition of the CARE program's students, the college increased its incoming class size from 110 to 120.

Dr. Patrick Lloyd, the College of Dentistry's dean, said he's hopeful that the strategic approach will create one long-term solution to address the problem of access to dental care in the state.

"I believe that Ohioans should have access to the same level of educated oral health care practitioners no matter where they live or what their economic status is," he said.

Where do graduates go?

"Improving oral health throughout Ohio remains a challenge, especially with various factors — the level of student debt, exposure to underserved populations, resources, affordability — all of these things that affect where and how our graduates practice," Dr. Lloyd said.
Image of CARE logoThe 2015 Journal of the American Dental Association article, "Where Do Dental School Graduates End Up Locating?" solidified the dental school's decision to create the CARE program, Dr. Lloyd said. The study looked at the percentage of graduates from the classes of 2005 through 2014 who are practicing in the same state as their dental school, as well as the percentage who are practicing in a rural area regardless of their state of residence.
While there were a wide range of variations from one school to another, the study found that about 60 percent of The Ohio State University's dental school graduates remain in the state to practice. Of those graduates who remain in Ohio, only about 11 percent practice in rural areas.
Dr. Lloyd said the staff at the ADA Health Policy Institute provided data that showed that if a dental student came from an underserved area, there's a 42 percent chance they'll move back to those communities to practice. If they're not from an underserved area, there's only a 7 percent chance they will.
"Over time, this comprehensive approach will benefit Ohio's underserved patients who will have better access to care as these dentists return to communities in need after graduation," said David J. Owsiany, executive director of the Ohio Dental Association and serves on the task force that established the criteria for selecting dental students for the CARE program.
Expanded curriculum

Since August, the eight students in the CARE program have focused on self-awareness and learning from the college and university faculty, as well as dental associations speakers, who educate them about providing care for the underserved. The school plans to accept up to 10 students every year.
The expanded curriculum includes ongoing involvement in a college-based oral health care initiative that supports the needs of Ohio's underserved populations, such as Give Kids A Smile; assisting in the selection of future CARE program students; serving as peer mentors and ambassadors in recruitment events; and attending the dental school's training opportunities related to leadership, ethical decision-making and cultural diversity.
In addition, Dr. Lloyd said, the college believes the CARE program's students will make a positive impact long before they graduate. Their presence and knowledge will elevate their classmates' awareness of the need for more dentists in rural areas.
"We're not requiring the students to go back to their communities," Dr. Lloyd said, "Life happens, whether its marriage or military enlistment, or some other event that causes people to change their plans. But by expanding their knowledge on the access-to-care issue, these students will acquire skills, experience and expertise that will help them solve such problems in any community they choose to live and practice."

Returning home

To be accepted into the CARE program, students have to first be admitted into the college's DDS program. They also must be a current or former resident of a federally-designated dental professional shortage area in Ohio and have experience working or volunteering at a community-based program that supports a public need.
"These requirements were chosen because they were reliable predictors for students who would establish dental practices in underserved areas upon graduation," said Dr. Lloyd.
For as long as he can remember, Mr. Savopoulos said he's always wanted a career in the health care field, settling on dentistry in his sophomore year of high school.
"I personally found dentistry to be very appealing as a medical profession, not only because of the obvious medical/surgical component that is associated with it, but also because of the disease prevention component," he said.
Mr. Savopoulos added that in only a few months in the CARE program, he and the other students have heard from speakers about helping the underserved.
"I also am in the program with seven other great people who have excellent ideas that we often discuss in our meetings that help expand our understanding of the health professional shortage areas across the state," he said.
In four years, Mr. Savopoulos said he plans to take his skills as a dentist back to Warren, Ohio.
"I fully intend on returning home to practice as a general dentist," he said. "Warren has always been my home and will continue to be. Since there is a need for my future profession there, I have every intention of trying to at least partially fill this need."