As the Utah state health officer, I am personally and professionally concerned about the health and welfare of the citizens in our communities.

We are fortunate to live in a state where our citizens enjoy good health. Recent surveys indicate Utah is the fifth healthiest state in the nation.

Unfortunately, I believe a recent decision made by the University of Utah's School of Medicine could compromise our overall health status. Citing budgetary constraints, school administrators are reducing the medical school's class size from 102 to 82 students per year.

Having seen my own department budget trimmed by more than $53 million in the past nine months, I understand the school's budgetary plight. However, training fewer medical doctors at our state school is a guaranteed prescription for poorer health.

Utah already ranks near the bottom of the nation (45th) in the number of primary care physicians per 100,000 residents. Additionally, the Utah Medical Education Council has documented shortages of several other types of specialty physicians in our state.

Over the past two legislative sessions a series of laws has been passed, all of which are designed to help the nearly 300,000 Utahns without health insurance gain access to more affordable and portable coverage. However, what good is health insurance coverage if there are not physicians available to provide the needed care?

Utah's educational system has prepared an exceptional number of highly qualified medical school applicants, and even with the acceptance of 100 students per year, hundreds more are turned away and must leave the state to pursue a career in medicine. Many of those who leave and become doctors do not return, denying Utah the benefit of their professional services.

The University of Utah School of Medicine has stated that of its 1,300 applicants for admission each year, more than 500 are well-qualified for admission. To further limit the class size will add to the serious shortfall in the number of physicians needed in our state and preclude some of our best and brightest young people from achieving their goal of practicing medicine.

The mission of the School of Medicine is clearly stated on its Web site, which is to provide 1) education, (2) clinical services and (3) research, in that order. This has long been the tradition of medical schools throughout the United States and we have all benefitted from their having balanced these noble endeavors in the past. However, the decision to reduce the class size clearly illustrates that our state's school has lost that balance, with education coming out on the short end.

I have to wonder how many faculty members, how many researchers and how many administrators are essential in order to train 100 students. Perhaps reductions in budgets in the other categories should be considered first, preserving the ability of the school to train at least 100 medical students per class.

I am not minimizing the challenges faced by any school of medicine in operating a high-quality educational and training program during tough economic times. But I urge the U. School of Medicine to reconsider its decision to downsize, and admit 20 more of the highly qualified students who have applied for admission to this fall's class.

David N. Sundwall is the executive director of the Utah Department of Health.