The University of Utah will ask lawmakers next year for enough money to not only restore its medical school class size but expand it by another 20 seats over the next two years.
U. officials have calculated the annual cost of such an expansion, a potential increase of 40 students in each class of the four-year program, at $12.2 million. In a "cost-sharing" proposal, the university will ask the state to cover $9.6 million, which would bring Utah more in line with levels of state support enjoyed by most public medical schools, said Vivian Lee, the U.'s senior vice president for health sciences.
"That's 160 extra bodies to be trained at any given moment. The physicians feel it is the right thing to do. We have a physician shortage coming. We have a great curriculum. It's the perfect time to get more kids in the pipeline so they'll be physicians when we need them," said Lee, who is midway through her first year at the helm of the university's $2 billion medical enterprise.
She also expects to seek approval to act on a $30 million pledge from an anonymous donor to establish a school of dentistry at the U.
According to the Utah Medical Education Council, Utah will soon face a shortage of certain medical providers, notably in primary care and family medicine. Rural areas will feel the pinch even more.
Despite this impending need, the U. shrunk its medical school class from 102 to 82 slots in 2010, two years after Medicaid recalculated the way it reimburses U. health services. The result was a $10 million hit in clinical revenues the U. taps to subsidize medical education.
That hit came the year after the medical school revamped its curriculum to place greater demands on faculty time. The goal was to immediately integrate basic science with clinical experience, rather than relegating first- and second-year students to large lecture classes. The result was a vast improvement in the quality of instruction but at a greater cost, said Lee, who has no intention of abandoning the new model as a way to accommodate more students.
Faced with declines in tax receipts two years ago, the state was in no position to backfill the Medicaid loss. But revenue projections indicate there should be additional money to spread around for the first time in nearly four years.
The U. proposal likely will enjoy a serious reception when the Legislature convenes in January, but Lee's request will be competing with other corners of Utah's higher education system, long saddled with pay freezes and booming enrollment.
"We have to restore that [medical school] class size. That's a must," said Sen. Stephen Urquhart, R-St. George, co-chair of the Legislature's Higher Education Appropriations Subcommittee. "I look forward to working with it. In Utah higher ed, do we do anything better than medicine? It's one of our premier things. It's something we need to strengthen."
Urquhart said he knew such a proposal was coming, but doesn't know the particulars. He wasn't ready to comment on Lee's notion to increase the class size beyond 102.
The state's current financial support of the medical school, about $26.5 million a year, accounts for just 4 percent of its budget, far below the national mean of 14 percent, according to Lee. The school operates graduate programs in biomedical informatics, public health, genetic counseling, and physician assisting, in addition to its M.D. program.
At nearly $30,000 a year for resident med students, the program is more expensive than many others in the country. Raising tuition, already $1,000 above the national average, to cover the U. medical school's financial needs could have the unintended consequence of pushing graduates away from practice areas that pay less, but that society needs more, officials say.
"We don't want our students to be so indebted that they won't want to go into primary care," Lee said.
Under state policy, 75 percent of the seats of each entering class are reserved for Utah residents, eight seats are reserved for residents of Idaho, and the rest go only to those who can demonstrate substantial ties to Utah, typically Brigham Young University graduates or students with family here. Last year, 1,500 would-be students applied for the school's 82 seats, but that ratio is still far less than the national average because "our responsibility is to train the people who will serve the community here," Lee said.
Demand for doctors
A cut in Medicaid reimbursement forced the University of Utah to downsize its medical school class from 102 to 82 slots in 2010. University officials want to not only recover the lost slots but expand future classes to 122. That could boost total enrollment in the four-year program to 488, an increase of 50 percent. The university plans to ask lawmakers to help fund the increase to cope with a looming shortage of physicians.