What’s the first thing a primary care doctor addresses when they meet with a 28-year-old female patient with trouble staying asleep, fatigue, a lack of appetite, headaches and skin flare-ups like acne and eczema?

CU Boulder employee and University of Colorado Colorado Springs graduate student Mary Gately posed that question to a group of high schoolers on the UCCS campus Jul. 27 during the Colorado Area Health Education Center’s HOPE Institute, an annual summit administered through the center and the University of Colorado Anschutz.

A sleep specialist, a dermatologist and a nutritionist were among the answers given by students participating in the session looking at different health care professions. Along with highlighting different roles and positions in the field, the hypothetical patient served as an example of the complex, interprofessional approach of today’s health care system.

“Sometimes you go to the doctor and they don’t quite have an answer for you, or they just kind of leave it there because they have a huge caseload of other clients and patients that they have to serve,” Gately told the students.

She explained that referring a patient to the appropriate professionals from a team of collaborators can both provide more effective and immediate care and alleviate workloads.

“And that’s the beauty of it. It not only would be able to save time for yourself, as a provider, but also save time and energy for the client and overall health care that we have in the U.S,” Gately said.

The summit began in 2022 to expose rural and other underrepresented students in Colorado to health care career options that they may not otherwise have access to.

The weeklong career exploration camp is held at UCCS and CU Anschutz, where students from across Colorado participate in hands-on activities and Q&A sessions with health care professionals. Colorado AHEC is federally funded by the Health Resources and Services Administration, with matching support from CU Anschutz, and covers the costs for participating students.

This year, about 60 students engaged in labs and writing sessions that dove into nursing, pharmacy, emergency services, sports medicine, anatomy, neuroscience and dental medicine before the week culminated with a mock health care conference at UCCS’s Berger Hall with information booths for college and hospital programs across the state.

The HOPE Institute’s goal is to build a stronger health care workforce for these underserved areas and serves as one example of the recent initiatives to bolster this overall workforce.

In the years following the COVID-19 pandemic, which caused widespread burnout across medical professions, state incentives, college-hospital partnerships and philanthropic efforts have all increased to ease the process for incoming health professionals, both physically and financially.

State statute has declared a shortage of qualified health care workers throughout Colorado and created the Primary Care Office within the state Department of Public Health and Environment. The office works to reduce the health consequences of limited access to health care in rural and underserved communities across the state.

Colorado also designates health care professional shortage areas through the state board of health based on factors including population, geographic area and estimated health service needs based on the two.

Since then, more medical simulation labs have developed at community colleges, while new financial incentives have covered a large portion of the costs for those looking to enter the field.

Now a medical school student and HOPE Institute volunteer, Ken Huynh grew up in Aurora with a family that qualified for Section 8 housing, which led to a concurrent enrollment opportunity at Arapahoe Community College (ACC) in Littleton once their application was approved.

While he admitted that balancing this schoolwork with caring for his family was the hardest thing he’s done, he said that having a career path become visible to him through both existing programs and mentor guidance was what he needed to begin his career.

“If we can get students the resources that they need, the students will be set to go,” he said.

New additions

In recent years, community colleges across Colorado have rounded out their medical pathways by investing in new lab spaces for in-demand jobs. Adding on to recent expansions to nursing, dental hygiene and surgical technology programs, Pikes Peak State College (PPSC) in Colorado Springs opened the lab for its new diagnostic medical sonographer program at its Center for Healthcare Education and Simulation last month.

During a ribbon-cutting ceremony, PPSC President Lance Bolton said there are currently 1,500 job openings in Colorado for trained sonographers, who specialize in diagnostic imaging through ultrasound technology. Two-hundred of these vacancies are considered “urgent.” Nationwide, employment of diagnostic medical sonographers is projected to grow 13% by 2034, the U.S. Bureau of Labor Statistics reported.

The program will host 17 students this fall and 20 more in the upcoming spring semester. For incoming student Christa Watts, this new option proved to be a perfect solution after trying and failing to enroll in Red Rock Community College’s sonography program for the last two years.

A stay-at-home mom for the past 15 years in Monument, Watts saw sonography as an opportunity to start her career, with the location and the familiarity with PPSC sealing the deal.  

“And I was also a surrogate, which was another experience I got to have at a fertility clinic in seeing how they use sonography,” she said. “Which is really exciting because you get to help people who are struggling to have kids.”

In Cañon City, Pueblo Community College’s (PCC) Fremont Campus unveiled a new simulation center for its nursing program. The 2,700-square-foot facility was funded by a $2 million donation to the PCC Foundation and has two simulation hospital rooms with adult and child manikins, two control rooms and a nurse’s station.

While this program is already the college’s largest, the new space will allow students to complete their courses and simulation exercises in one location instead of traveling to other medical facilities in Cañon City, Florence and Pueblo, each with limited space and resources, to complete their clinical work.

“The situations will be realistic, as they were before, but we’ll be able to partake more in these simulations because we’ll have an actual room to pull meds from,” said nursing student Annalise Tunstall. “There are things that just work better in a bigger setting like that so that we (the nursing students) can work as a team.”

Tunstall is currently on track to graduate with an associate degree in nursing next spring before completing the NCLEX exam to become a registered nurse. A lifelong Fremont County resident, she hopes to remain in and serve her rural community.

Recruitment work

Along with its higher education institutions investing in future employees, the state’s employers have taken their own measures in developing today’s workforce.

In 2022, UCHealth announced its Ascend Program, which covers all tuition expenses for current employees completing partnering nursing programs, clinical certificates, GEDs, high school diplomas and other select degrees. The only requirement is to be employed by the hospital system for at least 90 days.

Ascend was started partly in response to the pandemic, but mostly to address ongoing shortages and shifting pipelines and encourage long-term employment, said UCHealth’s vice president of total rewards, Nicole Schell-Dreyer, who oversees the program.

She explained how retail and virtual learning settings, along with the traditional hospital setting, have changed their talent pipeline, while career-advancement opportunities have attracted more people to their positions.

Colleges and universities that have partnered with the program include PPSC, PCC, University of Northern Colorado, ACC, Laramie County Community School in Wyoming and, more recently, Colorado State University Pueblo. Schell-Dreyer said they are strategic about who they decide to partner with to ensure that their communities are benefiting from this training initiative.

Out of over 34,700 people employed by UCHealth, about 2,400 people are currently enrolled in the program, with its most popular career tracks being nursing, medical assistant, phlebotomy, pharmaceutical technician and medical billing and coding.

With UCHealth contributing to this funding in-house, Schell-Dryer said the hope is that employees’ completion of the program will yield a return on investment that will sustain itself.

“We, as an organization, have made a commitment to these 2,400 people and beyond, that we’re going to invest in them in the hopes that they have aspirations to stay with UCHealth in the long term,” she said.  

Impact to date

In 2022, the state financial aid program, Care Forward Colorado, began reimbursing students enrolled in qualifying health care certificate programs at community and technical colleges for their tuition, fees and materials. It also covered additional costs for transportation, childcare and rent.

Colorado Gov. Jared Polis announced that over 10,000 Coloradans utilized the program and over 2,600 Certified Nursing Assistants, 3,500 emergency medical technicians and 1,100 medical assistants emerged from it by 2025.

While the state funding for this program ceased in fall 2024, the Colorado Health Service Corps remains an option for primary care providers working in designated health professional shortage areas. Accepted applicants receive funding to pay off their qualifying educational loans.

CDPHE’s current shortage area map indicates that some areas, like Denver metro and eastern Eagle County, are experiencing minimal shortages while large swaths of the state, mostly in rural areas, continue to experience significant needs.

While Colorado has begun to see some recovery in some areas, such as behavioral health care investments, don’t go looking for any statewide trends, said Stephen Holloway, director of the Primary Care Office.  

“The truth of the matter is that most Coloradans don’t think about the scale of the state, they think about the scale of their community and what the needs are for themselves and their families,” he said.

While it doesn’t monitor every employee’s date of completion, due to ongoing start and stop times, UCHealth’s Ascend program has been “very successful,” Schell-Dreyer said. This has included UCHealth’s first class of nurses earning their Bachelor of Science in Nursing degrees from Regis University last fall and career trajectories in other positions.

Emerging positions and vacancies they look to invest in the future include imaging modalities and support technician roles, though Schell-Dreyer echoed Holloway’s point.  

“We can come to the table with part of the equation and part of the answer to the question and the academic institutions have to help us with the rest of that,” she said.

“And it also comes down to different needs across the state. Something that’s needed in northern Colorado might be needed in southern Colorado and vice versa.”