Dr. Ransom testifies before the Senate that MD faculty members do not want to teach his DO medical students

Commentary and Fact Check

When asked about the plan for the MD school, for which no funding request was submitted to the Legislature, Dr. Ransom replied that he had all the funding necessary for the new school and would not ask the state for a dime for the first 5 years. Dr. Ransom estimated that the start-up cost and operational cost of the new MD school would be only $21.5 million and he had garnered $25 million in pledges from the community to sustain the school free of charge to the state for the first 5 years (2011-16).

Fact check:

§  The UNTMD plan calls for admitting the charter class in 2013; therefore, from 2013-16, MD students enrolled during those years would normally receive the appropriation funding from the state, which would amount to a total of $30 million. Is it the intention of Dr. Ransom to ask or not ask the state for that funding? If he waived the $30 million from the state, how would he cover the operational cost of the new school unless he had the intention of raising more money or diverting resources from TCOM?

• The Foster School of Medicine in El Paso cost $100 million to the state in addition to a donation of $50 million.
• UT South Texas Medical School, approved by the legislature in 2009, won’t receive funding from the legislature until 2015.  The Texas Higher Education Coordinating Board (THECB) estimates the cost to be $98 million.
• THECB estimated in 2008 that the start-up cost (e.g., administrative and faculty costs) for a new medical school of 60 students per class is $92.6 million, without including the cost of a 160,000 square-foot building.
• Across the nation, the average cost of a new medical school is $100-150 million.[1]

According to Dr. Ransom, four major hospitals pledged $2.5 million each to the new MD school; this amount is very generous.

Fact Check: $2.5 million is a sizable amount, but not so much more than Dr. Ransom’s salary, which is close to $1 million. For instance, Seton Health System and UT Southwestern plan to invest $1.5 billion to establish a medical school and center in Austin.   $2.5 million per hospital and a total of $25 million from various donors, versus $1.5 billion: Which number is more realistic and shows the real support from the community?

Senator Bob Deuell, himself an MD, asked about the merits of another medical school, as the discrimination against DOs by MDs is almost non-existent. Dr. Ransom replied that “culture” is the primary reason why MDs want to teach MD students and DOs want to teach DO students.

Fact Check: About 2/3^rd of DO graduates are trained in ACGME/MD residency programs. DOs are professors and chairs at MD schools, and vice versa. My personal mentor in retinal surgery is an MD, a person for whom I have the utmost respect, and I still emulate his bedside manner. A desire by physicians to work only with medical residents who earned the same degree title has more to do with short-sighted discrimination by a handful of old MDs than it does with DO vs. MD “culture.”  Indeed, it is shameful to think that the majority of MD educators are narrow-minded and discriminatory. It is also shameful for educators to not stand up against the discriminatory culture. The MD community and medical organizations recognize the qualifications of the DO training and accept DOs for memberships or further training in residencies or fellowships.

Local hospitals would open only 100 residency slots if there were an MD school. This number sounds like a lot, but in reality, it only offers about 30 entry-level slots as it takes at least 3 to 5 five years to complete a residency.

As other medical school presidents urged the Senate to keep adequate funding for their medical schools because of patient safety concerns and the accreditation maintenance of their schools, Dr. Ransom was asked about the LCME accreditation process of his UNTMD plan and whether it would be approved. He implied there had been frequent communications between him and the secretariat of LCME during the preliminary development of UNTMD business plan and that he believed the accreditation process would be about 1.5 years long.

Comment: Dr. Ransom’s body language betrayed his testimony as he touched his hair and his neck; he also drank a glass of water while answering the accreditation process.

 
          

Senator Deuell questioned whether Dr. Ransom had neglected his primary mission of being the president of UNTHSC instead of devoting his main efforts to creating another medical school. When questioned about the recent drastic drop in students’ board scores on step I and III, Dr. Ransom claimed that TCOM students have been among the top on the board scores, although not necessarily at the very top, for the past several years. 

Fact check: TCOM students had scored the highest on the boards, COMLEX I and II, from 2005-2009, and COMLEX III from 2008-09. In 2010, TCOM students' board scores on COMLEX I dropped to the second place.

Comment: His body language betrayed his statement as he touched his hair and drank water again.

Dr. Ransom may have been too busy with his push for an MD school that he did not know the fact his students had been the top in the nation, or he did not want to admit his failure or poor performance because he neglected his primary mission instead of driving good professors away.

In September 2010, UNT Health Group had 99 DOs and 71 MDs, in his testimony, 2/3^rd of the clinical faculty members are now MDs. Another explanation is that he may not know the difference between being the top and among the top, or he just believes that his TCOM students are just above average that he need to recruit MD students.

Dr. Ransom reasons that the existing infrastructure of UNTHSC can accommodate up to 2,500 students. A medical library, classrooms, and anatomy laboratory already exist. He argues the anatomy lab can be shared among 220 DO students, 70-100 PA students, PT students and 100 future MD students because there is gap time, during which students may not use the anatomy lab because of scheduling.

Comment: Where does he plan to find space to accommodate/ store a cadaver for every 4 students, i.e., 25 cadavers for the MD students unless the virtual anatomy lab and dissection?

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[1] O’Reilly, Kevin.  “New medical schools open, but physician shortage concerns persist.”  American Medical News, March 29, 2010.  Accessed December 26, 2010.  URL: http://www.ama-assn.org/amednews/2010/03/29/prl20329.htm.