Higher-ed panel hears of U link to rural MD crisis

On a more serious note, here are some main discussion points from the House higher-ed committee session on the University of Minnesota's medical school.

The main topic: How cuts to the U's medical school could worsen the shortage of doctors in greater Minnesota.

  • Expense. Medical resident Patricia Dickmann of the psychiatry department said the U is one of the top three most expensive medical schools in the nation. One classmate, for example,  is $200,000 in debt, she said -- not including debt from undergraduate education.

  • Rural MD shortage. Legislators and officials discussed the difficulty they have in enticing doctors and dentists to practice in rural Minnesota. (The threat of cuts to programs to boost the number of primary doctors has been discussed briefly on the House higher ed committee here.) The cost of starting a one-person practice can run $150,000, med school officials said, and debt like that on top of the $200,000 or so in med school debt lead many to believe they won't get enough business in sparsely populated towns to make up their loans. They said the state needs to support incentives (such a scholarships) for medical school students to practice in rural Minnesota.

Medical school Dean Aaron Friedman said:

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"It's not that easy to recruit physicians from other states. We have a responsibility and need to grow our own."

  • Budget cuts. After being gently pressed on how deeper cuts might affect the medical school, Friedman said:

I’m really worried that it would put some strains on our system ... that it would cause long-term problems for the state. ... We don’t have the flexibility in (raising) tuition, because our school is among most expensive. We might not be able to go to certain places, or hold certain clinics, or have a presence (in the state) such as the one we have with the rural physicians clinic.

Cuts would be curbed to some degree, however, by the schools' need to maintain certain programs to keep its accreditation, he acknowledged.

  • Student loan forgiveness. Legislators asked about a 2007 federal program that forgives loans after 10 years of payment and either public or nonprofit service. But Friedman said the "vast majority" of medical school loans are not federal loans, and private practices are not necessarily nonprofit, "so I don't think the majority of our students can capitalize on it in a significant way."

  • Faculty-student ratio. Rep. Mike Benson (R-Rochester) asked about the average student-faculty ratio at the med school, which is 1 to 5, and why it's so low. (I got the impression he figured raising it might lead to some cost-cutting.) Friedman replied:

"We have a responsibility to the state to be able to say, 'We've seen this person do (the work), and now this person can do the job (of a doctor).' That's not possible until someone lays eyes on what the person does. The student-faculty ratio is key to having that kind of faculty knowledge and (student) visibility. So it is different from the usual student-faculty ratio. It ensures the public that the people can do the job."

Friedman said the ratio was in line with other medical colleges as well.