Your medical school field guide for a rapidly changing ecosystem

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Texas Med Ed, 2019

Your medical school field guide for a rapidly changing ecosystem

By Nayana Shahane

 

A new medical school is popping up in or near every major metropolitan city in Texas. New medical schools have either opened or will open soon in Dallas, Austin, San Antonio, and Houston. The surprising boom in medical schools is a response to reverse the shortage of medical professionals occurring during a population explosion in these cities and their suburbs.

There are currently 12 medical schools in Texas and three more scheduled to open in the next couple of years. The most recent additions are The University of Texas at Austin Dell Medical School, which will graduate its first class in 2020; The University of Texas Rio Grande Valley School of Medicine, which opened in 2016; and the University of the Incarnate Word School of Osteopathic Medicine, which opened in 2017. Texas Christian University and the University of North Texas Health Sciences Center School of Medicine — awarded preliminary accreditation — is scheduled to open in July 2019 with a starting enrollment of 60 students and anticipated growth to 240 students by 2022. Two more schools, Sam Houston State University Proposed College of Osteopathic Medicine (seeking pre-accreditation from the Commission on Osteopathic College Accreditation) and University of Houston College of Medicine are planning to open in 2020.

According the Association of American Medical Colleges 2017 Physician Workforce Data Report, there were 7,632 medical or osteopathic students and 7,997 residents in Texas. Those numbers reflect a better ratio of students to graduate medical education slots than in previous years. However, as additional medical schools open and student enrollment grows in the next few years, it’s increasingly likely that Texas won’t have enough residency slots to accommodate its newly minted MDs and DOs in coming years. The state is at risk of losing a significant investment in the education of medical students as they struggle to match to a residency position. Most physicians put down roots near their residency location and if Texas doesn’t have the positions, those doctors will pursue residency training in other states.

In 2017, the Legislature passed a law that new publicly-funded medical schools must have a plan to ensure there are an adequate number of first-year residency positions for their expected number of medical graduates. Senate Bill 1066 by Sen. Charles Schwertner, R-Georgetown, was one of a number of investments lawmakers have made in recent years to expand GME positions, but at the rate the state is adding medical schools, offering enough residency slots is still a major concern.

There’s no question the state needs more doctors. Texas’ growing population is outpacing the production of new physicians. Other problems include the shortage of physicians in rural and impoverished communities, and the anticipated number of physicians retiring from the workforce in coming years. According the Association of American Medical Colleges 2017 Physician Workforce Data Report, Texas ranks 41 out of 50 states with 219.4 active patient care physicians per 100,000 population.

Of particular concern is the potential shortage of primary care physicians. The same AAMC report ranks Texas 47th in the country with 65.4 active patient care primary care physicians per 100,000 population.

All the new and proposed medical schools seek to address these problems in various ways. For example, UIW School of Osteopathic Medicine is in one of San Antonio’s poorest neighborhoods. They plan to open a student-run medical clinic and implement a “case management program,” which pairs students with families on Medicare, Medicaid, or the federal health insurance exchanges.

The newest public medical school, the University of Houston College of Medicine will be the first new medical school in the Greater Houston area since 1972. The school is dedicated to increasing primary care physicians for Houston and its surrounding urban and rural areas, especially the underserved communities. Their goal is to have 50 percent of their graduates pursue primary care. A portion of the school’s funding was approved by the Texas House of Representatives and they are awaiting approval from the Senate. The university has already formed a partnership with Lone Star Circle of Care and opened a new health clinic on UH-COM campus in April 2019. LSCC is a Federally Qualified Health Center and a registered nonprofit that provides high-quality care to uninsured and underserved patients in Central Texas.

Plans for residency positions are detailed in their 2018 College of Medicine Report. UH has joined as an academic affiliate partner with Hospital Corporation of America Gulf Coast Division, to develop eight new residency programs and 103 new first-year residency positions by 2020, with anticipated further growth in first-year and total residency positions.

SHSU Proposed College of Osteopathic Medicine will be located in Conroe, about 40 miles south of the main campus in Huntsville and is pending pre-accreditation from the Commission on Osteopathic College Accreditation. SHSU-COM has not requested any state funding, and was approved by the Texas Higher Education Coordinating Board on that premise. Although SHSU is a public university, the proposed college of medicine will be privately funded. The land has been donated by the Johnson Development Corporation and the first three years of operating expenses have been covered by private donation.

UIW and SHSU are osteopathic medical schools and have chosen their locations to connect with underserved populations. Both schools have proposed plans for providing and increasing residency positions.

The new medical schools have ambitious plans to increase the state’s physician-to-patient ratio and access to primary care for underserved Texas residents. It may be several years before that long-term vision is actualized. In the meantime, the population and the need for primary care physicians in Texas continues to grow.

 

Texas Medical Schools — 15 and counting

With all the new schools coming on line, here’s a snapshot of the Texas medical school roster as it stands today.


Baylor College of Medicine

Location: Houston

Degree: MD

Date of origin: The school opened in 1900 in North Texas. In 1903 it became affiliated with Baylor University. In 1943 it joined Texas Medical Center in Houston. In 1969 it separated from Baylor to become independent.

Total number of students: 723

Public/private: Private

GME: 80 residency and fellowship programs

Mission: “Baylor College of Medicine is a health sciences university that creates knowledge and applies science and discoveries to further education, healthcare and community service locally and globally.”

Fun fact: Community Health Programs, part of Baylor College of Medicine’s Family and Community Medicine Department in Houston, is “committed to being a force for health in the community and establishing a patient-centered medical home for patients.”

Their faculty group partners with community-based organizations to provide high quality, evidence-based care to underserved areas and to help promote wellness initiatives in neighborhoods near community health centers.




Texas A&M Health Science Center College of Medicine

Location: Bryan-College Station, Dallas, Houston, Round Rock, Temple

Degree: MD

Date of origin: 1977

Total number of students: 700 at 5 campuses

Public/private: Public

GME: Programs located throughout the state

Mission: “We were created to boldly serve. For more than 40 years, this mission has not wavered. Our purpose is to treat those among us with the greatest need, and in areas often forgotten by others. We’re challenging age-old beliefs about how medicine is delivered, where it’s delivered. Connected by our values and staunch desire to do more, we’re leading the way for a better future for all.”

Fun fact: The Texas A&M Health Science Center A&M Rural and Community Health Institute is a health extension center offering programs that promote safe, effective health care practices. The mission of ARCHI is to improve access to health care and reduce disparities in health status and outcomes by improving the quality and safety of health care.




Texas Tech University Health Sciences Center School of Medicine

Location: Lubbock, with regional campuses in Amarillo, El Paso, and Odessa

Degree: MD

Date of origin: 1969

Total number of students: 729

Public/private: Public

GME: 33 programs across Lubbock, Amarillo, and Permian Basin

Mission: “As a comprehensive health sciences center, our mission is to enrich the lives of others by educating students to become collaborative health care professionals, providing excellent patient care, and advancing knowledge through innovative research.”

Fun fact: In 1969, 19 of the counties surrounding Lubbock had no physicians. The area had only one-third of the national physicians-to-patients ratio and 23 of the surrounding counties had no hospital. Today, TTUHSC has graduated more than 28,000 health care professionals. Of those, 24 percent remain in the 108-county service area. The school is the first in the nation to offer a three-year family medicine accelerated track.




Texas Tech University Health Sciences Center Paul Foster School of Medicine

Location: El Paso

Degree: MD

Date of origin: 1973 as a regional medical campus for Lubbock 3rd and 4th year medical students. In 2009 it opened as a 4-year program with preliminary accreditation. In 2013 it became a fully accredited and independent institution.

Number of students per class: 100

Public/private: Public

GME: 9 residency programs with openings for approximately 205 residents

Mission: “The mission of the Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine is to provide an outstanding education and development opportunities for a diverse group of students, residents, faculty and staff; advance knowledge through innovation and research; and serve the needs of our socially and culturally diverse communities and regions.”

Fun fact: As part of its curriculum, the PLFSOM requires all students to learn medical Spanish language skills. It is the only medical school in the U.S. with this requirement.




The University of Texas Medical Branch School of Medicine

Location: Galveston

Degree: MD

Date of origin: 1891

Number of students per class: 230

Public/private: Public

GME: 23 residency programs; 36 fellowship programs

Mission: “UTMB will strive to create tomorrow’s medicine today by discovery and application of new knowledge, and by inspiring lifelong learning and clinical excellence. We will accomplish this mission through innovative leadership and a steadfast commitment to scholarship and service excellence by:

Educating and inspiring skilled physicians and scientists who are dedicated to lifelong learning and reflect the diversity of the people whom we serve.

Enhancing the well-being of our global community by expanding the frontiers of our basic and applied scientific knowledge and its translation from the bench to the bedside.

Improving the health of all individuals by providing outstanding evidence-based, compassionate, culturally fluent patient care, which recognizes the utmost importance of human interest, values and dignity.

Sharing our talents to form partnerships with others—individuals, communities, governments, foundations, schools/universities and industries—in the service of our community, our state and the world.”

Fun fact: UTMB was the first medical school in Texas. The Ashbel Smith building is the oldest medical school building in Texas. Nicknamed “Old Red,” it is listed on the National Register of Historic Places and marked with a Texas Historical Commission placard.




The University of Texas Health Science Center at Houston McGovern Medical School

Location: Houston

Degree: MD

Date of origin: 1969

Number of students per class: 240

Public/private: Public

GME: 28 residency programs; 100 fellowship programs

Mission: “To educate a diverse body of future physicians and biomedical scientists for a career dedicated to the highest ideals of their profession; to provide outstanding patient-centered care; and to conduct innovative research that benefits the health and well-being of the population of Texas and beyond.”

Fun fact: In August 1982, James “Red” Duke, MD, professor of surgery, aired the first televised program that would eventually evolve into an internationally syndicated health segment for television.




The University of Texas Southwestern Medical School

Location: Dallas

Degree: MD

Date of origin: 1943 as Southwestern Medical College. In 1949 it became part of The University of Texas system.

Number of students per class: 230

Public/private: Public

GME: 20 residency programs

Mission: “Promoting health and a healthy society that enables achievement of full human potential. We:

EDUCATE physicians, scientists, and caregivers optimally prepared to serve the needs of patients and society.

DISCOVER research that solves for unmet needs by finding better treatments, cures, and prevention with a commitment to ensuring real world application.

HEAL best care possible today, with continuous improvement and innovation for better care tomorrow.”

Fun fact: The school has graduated 6 Nobel Prize recipients since 1985.




University of North Texas Health Science Center at Fort Worth/Texas College of Osteopathic Medicine

Location: Fort Worth

Degree: DO

Date of origin: 1970

Number of students per class: 230

Public/private: Private

GME: 4 residency programs; 2 fellowships

Mission: “Create solutions for a healthier community by preparing tomorrow’s patient-centered physicians and scientists and advancing the continuum of medical knowledge, discovery, and osteopathic health care.”

Fun fact: TCOM is a leader in training physicians skilled in comprehensive primary care and rural medicine. Over 60 percent of TCOM’s graduates practice primary care medicine. TCOM was recently honored by TAFP as the only medical school in Texas to place at least 25 percent of 2018 graduates in family medicine. It was the 20th year TCOM received the honor, which the Academy created in 1993 to encourage medical schools to increase the number of graduates entering family medicine residencies.




The University of Texas at Austin — Dell Medical School

Location: Austin

Degree: MD

Date of origin: 2016

First graduating class: 2020

Number of students per class: 50

Public/private: Public

GME: 13 residency programs; 8 fellowships

Mission: “Revolutionize how people get and stay healthy by: Improving health in our community as a model for the nation; evolving new models of person-centered, multidisciplinary care that reward value; accelerating innovation and research to improve health; educating leaders who transform health care; and redesigning the academic health environment to better serve society.”

Fun fact: The Housing Authority of City of Austin is partnering with Dell Medical School at The University of Texas at Austin to launch the Health Catalyst Pilot Program. The program will care for more than 200 low-income families and individuals living at the Pathways at Booker T. Washington Terraces in East Austin, one of HACA’s largest subsidized housing properties.




The Joe R. and Teresa Lozano Long University of Texas School of Medicine at San Antonio

Location: San Antonio

Degree: MD

Date of origin: 1968

Number of students per class: 225

Public/private: Public

GME: More than 80 specialty or fellowship options

Mission: “The mission of the Joe R. and Teresa Lozano Long School of Medicine is to provide responsive and comprehensive education, research and service of the highest quality in order to meet the health-related needs of the citizens of Texas.”

Fun fact: The Long School of Medicine is part of UT Health San Antonio. It is one of the few universities with a cancer center funded by the National Institutes of Health, an NIH-funded aging center, and an NIH-funded clinical trials center. Only a dozen institutions in the country have all three.




The University of Texas Rio Grande Valley School of Medicine

Location: Edinburg, Harlingen, Brownsville

Degree: MD

Date of origin: 2016

First graduating class: 2020

Number of students per class: 50

Public/private: Public

GME: 7 residency programs with 3 more coming soon

Mission: “Educate a diverse group of medical students and future biomedical scientists. Develop physicians who will serve across all disciplines of medicine. Bring hope to patients and communities by advancing biomedical knowledge through research. Integrate education and research that advances the quality and accessibility of health care. Engage with the Rio Grande Valley communities to benefit Texas and the world.”

Fun fact: As a part of a grant from United Health Foundation,  the School of Medicine purchased its Unimóvil mobile clinic to bring comprehensive primary care to people living in underserved communities who struggle with access to health care. Unimóvil also provides another opportunity for medical students, medical residents, and students in the UTRGV College of Health Affairs to train and serve the community.




University of the Incarnate Word School of Osteopathic Medicine

Location: San Antonio

Degree: DO

Date of origin: 2017

First graduating class: 2021

Number of students per class: 162 in opening class

Public/private: Private

GME: 5 residency programs are in development with the Texas Institute for Graduate Medical Education and Research.

Mission: “UIWSOM’s mission is to empower all members of the medical education community to achieve academic, professional and personal success and develop a commitment to lifelong learning through excellence in learner-centered, patient-focused education, justice-based research and meaningful partnerships of osteopathic clinical service across the spectrum of undergraduate, graduate and continuing medical education. The development and application of osteopathic principles of medicine across four years of physician training will promote culturally, linguistically, and community responsive care for all patients to enhance patient safety and improve patient outcomes.”

Fun fact: Every first-year medical student earns an emergency medical technician certification. That allows members of San Antonio Street Medicine, a volunteer student organization at UIWSOM, to provide basic medical care such as dressing wounds and taking vitals for San Antonio’s homeless residents.




Texas Christian University and University of North Texas Health Sciences Center School of Medicine

Location: Fort Worth on both campuses

Degree: MD

Date of origin: 2019 pending accreditation

First graduating class: 2023

Number of students per class: 60 in first class; 240 by 2022

Public/private: Private

Mission: “Our mission is to transform health care by inspiring Empathetic Scholars. Our graduates will be compassionate, empathetic and prepared to discover the latest knowledge in medical care and equipped with the tools to ask and answer the medical questions of the future. Along with the ability to ‘walk in a patient’s shoes,’ these physicians will excel in the science of medicine. Outstanding communicators and active listeners, empathetic scholars are life-long learners and highly valued as physicians, colleagues, leaders and citizens in their community.”

Fun fact: The curriculum is wholly centered on the patient, allowing students to retain the empathy with which they start medical school. During Week 1 they begin seeing patients and have one-on-one mentoring with physicians. Physician Development Coaches  will foster a coaching relationship that will contribute to student professional identity formation while providing an additional layer of support toward the student’s academic success.




Sam Houston State University Proposed College of Osteopathic Medicine

Location: Conroe

Degree: DO

Date of origin: 2020*

First graduating class: 2024*

Number of students per class: 75 to start, with increase to 150 over several years*

Public/private: Public, although 100% self-funded

Mission: “The mission of the Sam Houston State University Proposed College of Osteopathic Medicine is to prepare students for the degree of Doctor of Osteopathic Medicine with an emphasis toward primary care and rural practice, to develop culturally aware, diverse and compassionate physicians, who follow osteopathic principles, that are prepared for graduate medical education, and will serve the people of Texas with professionalism and patient-centered care.”

*All class sizes and potential start dates are contingent upon final approval from the Commission on Osteopathic College Accreditation.




University of Houston College of Medicine

Location: Houston

Degree: MD

Date of origin: 2020 contingent on accreditation

First graduating class: 2024

Number of students per class: 25 to 30 in first class with plans to grow to 480 by 2027

Public/private: Public

GME: Arrangement with Hospital Corporation of America to serve as academic affiliate in plan to develop 8 residency programs and 103 new first-year residency positions by 2020. Plan to have 309 total residents by 2024

Mission: “The UH College of Medicine will be accountable for improving the overall health and health care of the population of not only Greater Houston but also other urban and rural areas of Texas that face significant doctor shortages by: Educating a diverse group of physicians who will provide compassionate, high-value (high quality at reasonable cost) care to patients, families and communities, with a focus on primary care and other needed physician specialties, such as psychiatry and general surgery. Conducting interdisciplinary research to find innovative solutions to problems in health and health care. Providing integrated, evidence-based, high-value care delivered to patients by inter-professional teams. Engaging, collaborating with, and empowering patient populations and community partners to improve their health and health care.”

Fun fact: Health Matters is a radio series produced by the University of Houston College of Medicine empowering listeners to lead healthy lives. Host and founding dean, Dr. Stephen Spann, along with doctors from the medical school, provide practical health care information to the community.