Dr. David Sundwall's editorial criticizing the decision to reduce the University of Utah School of Medicine's freshman class size shows a failure to understand the budget crisis that forced this decision.

It's unfortunate the state's chief health officer doesn't better understand the challenge, and importance, of providing future physicians with the best medical education possible. We agree with Sundwall that Utah faces a serious physician shortage. However, compromising the quality of medical education to preserve class size is not the answer.

This year the School of Medicine faced a financial "perfect storm" that cut state and federal funding of the school by 35 percent -- $12.5 million -- for the upcoming year. The 9 percent reduction in state funds created enormous challenges; however, the much larger problem was a decision by the federal government to prohibit the Utah Department of Health from using federal Medicaid money to fund medical education under a formula the medical school has relied on for the past eight years. This disallowance led to an immediate $10 million loss in funding for the medical school, a fact Sundwall should well know.

Contrary to what Sundwall suggests, the school has reduced costs and used reserve funds to try to accommodate these cuts. To help offset the budget cuts, all medical students will face a 15 percent tuition increase for the coming year. But this increase will help offset only a small portion of the funding loss.

The overwhelming majority of funding for the medical school comes from clinical revenue generated by University of Utah Health Care. In these difficult economic times, our clinical enterprise simply cannot contribute additional funding without sacrificing the availability of the very care Sundwall wants to bolster.

After many long discussions during which we explored myriad options, we were forced to make the painful decision to admit only 82 students instead of the 102 students admitted in the past. We're confident we made the right decision.

While the current economic storm is nearly unparalleled, it will pass. Once it does, we look forward to working with the new governor and lawmakers to find a long-term plan for sustained funding for the medical school. We're confident working together we can restore the class size to its former level and eventually expand it to meet the growing need for physicians in the state.

Dr. Lorris Betz is University of Utah senior vice president for health sciences, CEO of University of Utah Health Care and executive dean, University of Utah School of Medicine. A second signatory, Dr. David Bjorkman , is dean of the University of Utah School of Medicine.