New York Times: Medical Schools in Region Fight Caribbean Flow

For a generation, medical schools in the Caribbean have attracted thousands of American students to their tiny island havens by promising that during their third and fourth years, the students would get crucial training in United States hospitals, especially in New York State. But in a fierce turf battle rooted in the growing pressures on the medical profession and academia, New York State’s 16 medical schools are attacking their foreign competitors. They have begun an aggressive campaign to persuade the State Board of Regents to make it harder, if not impossible, for foreign schools to use New York hospitals as extensions of their own campuses.

The entire article can be read at New York Times

It is a very good article about the competition between US medical schools and off-shore medical schools for clinical training sites. New York State has been an attraction state for importing physicians and medical students from abroad. Some of the off-shore medical schools have big bucks, $100 million over 10 years, to pay the local hospitals for their students to do rotations.

Texas budget shortfall and addressing physician shortage

This is an interesting by Mike Norman from Star-Telegram

You ought to be able to cut $20 billion or more out of a two-year state budget that started out at $182.3 billion, right? That's what the Legislature apparently will have to do next year.The governor, lieutenant governor and current House speaker have been working on it for almost a year. It's an ugly task.

First,you don't really have all of that money to work with. More than half of it comes from federal grants and other sources that state leaders and legislators don't necessarily control, so you have to focus on "general revenue-related" funds.

That's $80.7 billion in the current budget. That number is already $1.6 billion less than what it was before the last Legislature worked on it, delivering a spending reduction for

only the second time since World War II.

You can read the entire article from Star Telegram.

This deficit number keeps rising as recently suggested to be $25 billion by Texas Tribune. A push for a new medical school in Fort Worth is unwise and uncalled despite the claims of “cost free” to the state. In 2010, Texas produced 1,404 medical graduates and has only 1,390 residency slots available.

Operational Cost Comparison between the allopathic and osteopathic colleges at Michigan State University

The following testimony by Dean Strampel givent to UNT Board of Regents in November 2009.

The Michigan State University College of Osteopathic Medicine experience started in the late 1950s among the members of the Michigan Association of Osteopathic Physicians and Surgeons with the idea to form a new school. The osteopathic profession “taxed” each individual physician $200 a year for ten years to create the Michigan Osteopathic College Foundation and the school started as the private Michigan College of Osteopathic Medicine in Pontiac in the 1969.  However, it quickly became evident that it was not financially viable, and the profession almost immediately began lobbying for the school to become a public institution.

                                                               

In the meantime, Michigan State University had formed an allopathic medical school, the College of Human Medicine, in 1966 because it was attempting to achieve AAU status and this was a requirement. Because of the strong lobby within the state from the osteopathic profession and the need in the state for primary care practitioners (particularly in rural areas), the Michigan legislature was receptive to funding an osteopathic medical school, and in 1969 Public Act 162 ordained that “A school of osteopathic medicine is established and shall be located as determined by the state board of education at an existing campus of a state university with an existing school or college of medicine.” Of the three schools that qualified, only MSU offered the fledging college a home, and in 1971, the private MCOM was moved to East Lansing. This simple decision has created an interesting environment.

Why is there such a rush in creating a MD school within 2 year time span even though the accreditation process timeline (less than two years) is unrealistic?

According to the Texas Higher Education Coordinating Board, the following residency programs in Family Medicine, Internal Medicine, General Surgery, Pediatrics, and Obstetrics/Gynecology are required for the establishment of an LCME medical school.  Currently, among the potential affiliated hospitals with UNTMD[1]:

• John Peter Smith Hospital has ACGME residencies in Family Medicine (dually accredited by ACGME and AOA), Emergency Medicine, Obstetrics/Gynecology, Orthopedic Surgery and Psychiatry (dually accredited by ACGME and AOA).
• Methodist Medical Center has ACGME residencies in Family Medicine (dually accredited by ACGME and AOA), General Surgery, Internal Medicine, and Obstetrics/Gynecology.
• Texas Health Harris Methodist Hospital, HCA Plano Medical Center and Plaza Medical Center are in the planning process of starting up ACGME residency programs.
• Cook Children’s Medical Center and Baylor All Saints Medical Center are not interested in establishing residency programs.
• None of the potential affiliated hospitals is planning to establish a residency program in Pediatrics.  Would this pass the LCME requirement for accreditation?

Questions about the validity of hospitals' concerns for training DOs

The following letter dated on December 22nd, 2008 by Greg Smith, D.O., PhD, MDiv, FACOFP, TCOM Class 1983

I would like to respond to UNT awarding the MD degree at TCOM. I feel I have a unique perspective to speak, in that I am currently the associate Dean at our nation’s newest Osteopathic Medical School. I have 160 students that are honored to be allowed to be part of the Osteopathic profession, and proud to know that they will be entering into the one profession, who turns out a majority of their physicians as primary care providers.  Chancellor Jackson, to a man and woman they are proud of their DO degree, and have chosen it over an MD degree! We a health care crises looming, and in fact here; our nation is in dire need of primary care providers and the Osteopathic profession in general, and TCOM in particular has always met that need. Furthermore, I travel yearly to China, at the request of the Chinese government, because they see the value of the Osteopathic profession, helping them change their physician training toward primary care, where now they are only specialty driven.

As I have helped set up our Osteopathic school, in a state that for 120 years has been predominated by MD's, I have found all the private and city hospitals to being open to both my medical students and future residents in the Osteopathic profession.