The University of Nevada School of Medicine

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The University of Nevada School of Medicine
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The University of Nevada School of Medicines
Report to Governor Guinns Commission on Health
Care
James E. Rogers Chancellor, Nevada System of
Higher Education John A. McDonald VP Health
Sciences and Dean
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• A First Step In The Dialogue
• Medical Education A Quick Primer
• The Core Problem The States Health Care Needs
• Current Snapshot Of The University Of Nevada
  School Of Medicine
• What Does The State Need Us To Be?
• Our Emerging Vision The University Of Nevada
  Health Sciences Center
• Questions And Discussion

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Medical Education A Quick Primer

• Nationally, 126 schools of medicine graduated
  16,648 students in 2004, average class 132
• University of Nevada School of Medicine has a
  graduating class size of 52
• The University of Nevada School of Medicine is
  small, focused on primary care, with limited
  specialty training programs and limited research
• The state needs us to be a complete medical school

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Graduate Medical Education (Residencies and
Fellowships)

• Three to ten years post-MD
• Regulated by the Accreditation Council on
  Graduate Medical Education (ACGME)
• 70 of physicians practice where they completed
  their final training
• Residency and fellowship programs are the most
  efficient way to build a state-wide physician
  workforce

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Building a new residency program
Years 1 and 2
Recruit Faculty and Staff Create Curriculum
Prepare Program Information Form apply for site
visit
Year 3
Program Site Visit, RRC Review
Years 3 and 4
Provisional Accreditation Advertise for residents
Year 4 or 5
First Class Starts
Year 7 or 8
First Class Finishes
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Nevadas Physician Workforce Crisis

• Nevada ranks 48th in the nation in physicians
  per 100,000 population
• This severely limits access to care for Nevadans

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UNSOM Our Heritage and Current Status
In sum We are not what we need to be. Nevadas
population and their health needs are growing and
changing UNSOM (and the other health
professional schools at UNR and UNLV) need to
grow and change accordingly
Founded in 1969 Among smallest of medical
schools in the nation Limited Graduate Medical
Education programs NIH Funded Research Rank 101
out of 126 schools, due to small size and scope
of faculty
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Plastic and Reconstructive Surgery Restoring
hope where there was none
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Saving Hannahs Hand
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Nevadas Gap in Medical Education
State Population (millions) Medical School Class Residency Fellowship Programs Total Residents Fellows Faculty State Poverty
NM 1.9 76 37 479 617 17.5
UT 2.5 104 38 534 906 9.6
AZ 5.9 107 41 348 645 13.8
NV 2.4 52 12 194 189 10.2
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Nevadas gap in residency training programs
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Nevadas gap in fellowship training
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Nevadas physician pipeline is the smallest in
the US
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Expanded Graduate Medical Education Requires
Resources

• Direct Costs Salaries and hospital-based costs
  typically funded by Federal Government (CMS) or
  Veterans Administration
• Major Issue CMS funded slots are capped
• School of Medicine also incurs costs and needs
  resources to support expanded education
• Infrastructure (space, technology, support staff)

FACULTY
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What Does Nevada Need Its Medical School to Be?

• A key part of the solution to the States
  healthcare workforce shortage
• A source of primary and specialty care physicians
  trained to work in teams with other health care
  providers
• A contributor to the Nevadas economic
  development through biomedical research
• A partner for innovative private-public
  partnerships Ruvo Institute, Lili Claire,
  Center for Chronic Fatigue Syndrome, NVCI

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What Does Nevada Need Its Medical School To Be?

• Focused on the health needs of Nevadans
• A training ground for physicians and residents
  trained in the most current, best practices for
  patient care
• A medical school that remains accessible and
  affordable for the best of Nevadas future
  physicians
• A source of great pride for Nevada

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Our Emerging Vision The University of Nevada
Health Sciences Center

• A Health Sciences Center is a University-based,
  integrated set of health professional education
  and biomedical research programs, aligned with
  supportive patient care programs and facilities.
• Health Sciences Centers, on a national basis, are
  highly diverse, take many forms, and fulfill
  their missions in a variety of ways.

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A Health Sciences Center is not just buildings.
It is

• Shared missions of health professional education,
  biomedical research, patient care, and community
  health improvement
• A medical school and other health professional
  schools (Nursing, Public Health, Pharmacy,
  Dentistry, etc.)
• An aligned teaching hospital (or more than one),
  deeply committed to the success of the academic
  programs and faculty
• Guided by leadership devoted to the common
  missions and working within an organizational
  structure empowered to make decisions and commit
  resources

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Our Emerging Vision The University of Nevada
Health Sciences Center

• Quality faculty with breadth and depth across
  the disciplines and passionate career commitments
  to teaching and research form the core of a
  Health Sciences Center.

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What Will The University of Nevada Health Science
Center Do for Nevada?

• As Nevada changes, its health care system needs
  to change. A robust Health Sciences Center will
• Educate more physicians and health professionals,
  improving access to care
• Develop programs to improve the populations
  health
• Bring research dollars and talent into the State

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What Will The University of Nevada Health Science
Center Do for Nevada?

• Enhance the States access to research-based care
  and prevention
• Anticipate and meet critical needs of a rapidly
  growing and aging population
• Build Nevadas national reputation as a state
  with outstanding health care for all

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Governors Commission UNHSC Planning
We need to work together to Articulate the major
health policy issues for the State Define a
process to solve these problems Address how to
finance graduate medical education Improve the
health of Nevadans Develop a shared vision of the
benefits of a health sciences center
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Questions and Discussion