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.

According to the recommendation made in 2008 to the legislature by The Texas Higher Education Coordinating Board (THECB), “optimally, the state should encourage growth of more first-year residency positions with a goal of 10 percent more first-year, entry-level residency positions than graduating medical students.” As there are already more medical graduates than residency slots, it will be a waste to invest in producing more medical graduates than the existing level before any sizable increase in residency slots. Texas will lose $200,000 of investment in each medical student who will move out of state for residency training.

According to Houston Chronicle in Oct. 17^th, Texas already loses 45% of medical graduates, who do out-of-state residencies; In another Houston Chronicle in Nov 3^rd, it cited a “TMA/medical schools survey showed that 38 percent of Texas graduates who completed residencies outside the state would have preferred to do that training in Texas if there had been slots in their specialty.”

Therefore, the priority of addressing the physician shortage is to increase the residency slots until there is more slot availability than the number of medical graduates. Interpreting the recommendations of THECB, an addition of 150-200 residency slots is needed before any additional increase of medical students. Texas is better off importing medical graduates than exporting them. Furthermore, The THECB will assess in 2015 whether additional enrollment increases are necessary. Moreover, the state has already committed financial resources to develop a much needed medical school in the Valley starting 2015. In conclusion, it is a travesty that there is a push for another medical school in Fort Worth unless the new school in Fort Worth is a private medical school.