In January, the U. plans to ask the Legislature for $10 million to both hire new faculty and pay existing faculty to teach more hours.

It's a plan that has been in the works since 2001, when the U. began looking at what it would take to boost enrollment.

"The class size has been about 100 for as long as anyone can remember," despite the fact that applications to the school have continued to rise, said Kim Wirthlin, vice president of marketing and affairs for the U.'s Health Sciences Center.

Last year, for example, 1,269 people applied for admission; about 500 were qualified, but only 102 were accepted.

The biggest limiting factor in expanding, the school realized, was too little space.

So first, the Legislature gave the U. $33 million to put toward its $39 million Health Sciences Education Building. It opened in 2005, supplying 156,700 square feet of additional classrooms, laboratories and lecture halls.

If the school now gets the new funding for teaching, it would likely enroll its first 30 additional students in 2009.

"The other thing we needed to have is the faculty physicians who could accommodate more students," Wirthlin said. "So now we're in a position where we can make that work as well."

Over four years, the School of Medicine would swell by 120 students, increasing its total enrollment to 528 students from 408, Wirthlin said.

More medical education

The U. will join the ranks of more than half of the nation's medical schools that either have increased or are planning to increase the number of students they admit. The changes are in response to a call by the Association of American Medical Colleges [AAMC] for a 30 percent growth in enrollment by 2015.

Between 1980 and the mid-1990s, national advisory groups issued reports projecting surpluses of physicians, according to a 2006 AAMC report. As a result, U.S. medical school enrollment remained flat for about 22 years.

During that time, however, the U.S. population swelled by about 71 million people. When the surplus failed to materialize, the nation's advisory groups reversed course.

Now recognizing a potential physician shortage - as high as 200,000 physicians by 2020 - they've called for more medical schools and increased enrollment, according to a 2006 report by the Utah Medical Education Council.

By 2020, Utah - one of the top 10 fastest-growing states in population- is expected to see its populace surge by 45 percent, according to the UMEC. At the same time, many of the state's physicians are retiring. To provide the same level of service, the UMEC projects the state will need to add about 270 physicians to the work force each year, for a total of 1,862 physicians.

"As the only medical school in the state, we have a responsibility to do what we can to meet the work force need, and we're now in a position to do it," Wirthlin said.

Required: residencies

But David Squire, executive director of the UMEC, said increasing the number of student slots at the medical school by itself will not solve the physician shortage.

Unless the number of residency programs in the state - currently 57 - also is expanded by 30 percent, those students will be forced to leave the state to complete their training.

This is important, Squire said, because about 60 percent of the time, residents will locate their practice within 20 minutes of where they complete their residency.

"We have made a cry or call to increase the number of residencies in this state for some years now, and, as always, it comes down to who should pay for that," he said.

It costs about $150,000 to train a resident, and most of that is paid for by the private sector, he said.

The federal government put a substantial amount of money into residency positions until 1997, when it capped spending at 1996 levels as part of the Balanced Budget Act, Wirthlin said.

"What that meant was if you wanted to start a new residency program or expand, you got no federal support," she said. "And these are very expensive programs."

For the U., it has meant finding revenue in its own system, getting support from the state or partnering with the private sector, including Intermountain Healthcare.

Wirthlin said U.S. Sen. Harry Reid is sponsoring a bill that, if passed, would allocate federal dollars for new residency slots around the country, including 28 in Utah.

lrosetta@sltrib.com