With a second for-profit medical school opening in Utah, the state will be training hundreds of new doctors a year

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When Taylor Purcell learned he was accepted into Noorda College of Osteopathic Medicine, he canceled his interviews at other medical schools.

“Noorda was my top choice,” Purcell said of the new, for-profit medical school set to begin classes in a few weeks in Provo.

Purcell was hardly alone in his review. More than 2,100 students applied for just 90 slots this year, even though the school has yet to teach a single course, much less graduate a class or place any alumni in medical residency training slots.

“A track record may provide some people comfort, but to me it’s, ‘What are you doing right now? What is your plan for the next year?’” Purcell said. “Noorda is so gung-ho about this first class. It was all of about five minutes before I realized, meeting with faculty and seeing their plan — I have a lot of confidence.”

As demand for physicians in the Mountain West grows along with the region’s population, more and more prospective doctors, like Purcell, are forgoing the assurance of long-established medical schools at public and nonprofit universities.

Instead, for-profit medical schools are playing an increasing role in filling Utah’s clinics and hospitals.

With the launch of Noorda in Provo and an increase in slots at the Rocky Vista University campus in Ivins, a majority of the incoming medical students in Utah this fall now will be attending for-profit medical schools.

Hundreds of students are enrolling in Utah’s three medical schools

Just four years ago, there was only one option for medical school in Utah: the 125 slots at the University of Utah.

Rocky Vista University College of Osteopathic Medicine doubled that capacity when it opened to 125 students in 2017 in Ivins, and now will admit 148 students, said Catherine Lewis Saenz, spokeswoman for Rocky Vista. And Noorda will grow from 90 to 180 students per incoming class by 2023, said the school’s spokesman, Cory Maloy.

Meanwhile, with the help of a recent $110 million donation, the U. has plans to expand its medical school to 155 students per class in three to four years.

At that point, there will be room for more than 480 new medical students each year in Utah — a nearly fourfold increase in less than a decade.

Expanding the number of doctors in Utah has for years been a goal of health officials and health care systems here. But with about 216 physicians per 100,000 residents, Utah was ranked 44th in the nation in 2019, according to data from the Association of American Medical Colleges.

The shortage is even more acute in Utah’s rural communities; most of the people in central Utah don’t live within 30 miles of a hospital, and some in the state’s western reaches live more than a three hours’ drive from the nearest doctor.

[Read more: Montana medical school clash revives for-profit vs. nonprofit debate]

Increasing medical school capacity could help significantly with the shortage because doctors tend to stay in the state where they trained — and Utah retains a relatively high rate of its medical school graduates. Research shows about 44% of those who graduate medical school in Utah end up practicing in the state — the 15th highest rate in the nation.

Purcell said staying in Utah is a high priority for him, and one of the reasons he applied to only seven medical schools, all in the Mountain West. He moved around a lot during his childhood but remained in Sanpete County during high school. He attended Brigham Young University and Utah Valley University for his undergraduate degree, and now he and his family live in American Fork.

“I just loved living here,” Purcell said. “I love the states out here, so when I was applying to med schools it was all Utah, Nevada, Arizona. It just so happened Noorda was starting its inaugural class during my first application cycle.”

But medical school capacity isn’t the big “chokepoint” for the number of physicians, said Dr. Mark Harris, who oversees the University of Utah’s residency programs. For Utah to keep the nearly 500 med school graduates it will be producing annually in a few years — and benefit from adding them as health care providers — they will need residency training to actually become doctors.

“There are a lot of medical school graduates who are not finding a residency position,” Harris said. “There aren’t enough residency positions for all of the applicants.”

But Utah doesn’t have enough residency training slots

The U.’s residency programs, for example, receive about 100 applications per slot, Harris said. Federal funding for residency training is set to increase in coming years, he noted, but it may not be enough.

“They’re slowly coming to the realization that the government needs to be stepping in to help with this,” Harris said, “or else the shortfall is getting worse.”

The U. is “collaborating” with Noorda to prepare a proposal for state funding for more residencies in Utah, Harris said — especially in smaller hospitals in rural communities.

That is motivated partly by the coming rise in graduates from Utah’s for-profit medical schools. Students at Noorda and Rocky Vista graduate as doctors of osteopathy — D.O.s — rather than doctors of medicine, or M.D.s.

Traditionally, most D.O.s have gone into primary care. For example, at Rocky Vista University, where 105 students graduated in May in the first-ever class at the Ivins campus, just over half were entering primary care residency programs.

That makes the graduates of the two for-profit medical schools good potential fits for residencies in rural hospitals, where family doctors are especially needed.

“A lot of these people went into these specialties with the goal of doing that, so we figure we can increase the uptake of these positions,” Harris said. “A lot of these rural places have a hard time recruiting, certainly from back east but also from our own backyard.”

But most rural hospitals in Utah don’t have residency programs. And because doctors are even more likely to practice where they completed their residencies than where they attended medical school, opening residency options in rural communities could be crucial to retaining doctors there, Harris said.

“We want to develop programs where general surgery residents and family medicine residents can get out into these communities,” Harris said. “Noorda is interested because they want places for their graduating class to go. We’re working with them to try to convince the Legislature to put up some cash to try to help some of these smaller hospitals who might be interested in starting a residency program. This will be a great solution for our rural underserved communities.”

Risks vs rewards of attending a new medical school

But for Utah’s new flurry of med school diplomas to ultimately land on the walls of Utah clinics and hospitals, the new, for-profit medical schools also will have to prove themselves competitive enough for their graduates to secure residencies.

“That’s definitely a downside for those first few years: You are an untested product,” Harris said.

But he said the newness of the schools are the only potential liability — not the for-profit structure.

“There are medical schools, for profit or otherwise, around the country, who are seen as fantastic,” Harris said, “and there are schools, for profit and otherwise, who are seen as bad.”

Noorda’s parent company is Wasatch Educational, Inc., a Utah corporation organized in 1999 that also owns the Rocky Mountain University of Health Professions, according to its website. Wasatch Educational President Michael Skurja Jr., and Vice President Richard P. Nielsen, both physical therapists and co-founders of Rocky Mountain University, began by offering graduate education to physical therapists.

Rocky Mountain says it first received regional accreditation in 2010, which was reaffirmed last year, and it now offers training in areas from athletic training to nursing to speech pathology and other areas. Noorda is opening in buildings at the Timpanogos Technology Center, where Rocky Mountain University also is located, but the owners plan to build a campus across the street from the center, with support from bonds sold for Utah’s first Public Infrastructure District.

Students at Noorda and, until now, at Rocky Vista, committed to medical schools that did not have full accreditation; that only becomes available after a school graduates its first class.

“That was definitely something that I had to spend a lot of time considering and working through,” said Jake Allinson, who graduated in May with the first class at Rocky Vista’s Ivins campus. “You definitely don’t want to get there, get committed and have accreditation fall out.”

But Allinson said he was drawn to the sense of welcome and attentiveness he felt during his interview. That overwhelmed the risk of entering a medical school in its first year of operation, he said, and the somewhat elevated cost.

Tuition at Rocky Vista is about $60,000 per year, with Noorda charging $56,000; in-state tuition at the U. med school is just under $42,000, with out-of-state students charged about $78,000.

“Most of the interviews I’d been on at that point, I felt like I was trying desperately to sell myself to the schools,” Allinson said. “When I came here, I sat down and had lunch with the dean, talked to the professors, they all seemed interested in what I could bring to the table ... but also what they had for me.”

For Allinson, the risk of enrolling at a brand-new school paid off; he started his residency last week at Eastern Idaho Regional Medical Center in Idaho Falls. In fact, Rocky Vista’s first graduating class in Ivins reported a residency placement rate of 96% — the same as the U.’s medical school.

Allinson, whose first hospital job was groundskeeping at Central Valley Medical Center in Nephi and who attended Southern Utah University as part of the school’s “Rural Health Scholars” premed program, is now on exactly the career trajectory health experts hope can replenish Utah’s hospitals. After completing high school, college, medical school and his residency in small Western towns, he’d like to find one where he can practice family medicine.

“That’s generally what I would like to do: spend most of my life in smaller cities,” Allinson said. “It’d be ideal to do that.”