Task force: Graduate medical education a key to solving Nevada’s doctor shortage

Officials say recommendation won’t affect UNLV medical school plan

While UNLV continues to form a budget proposal for its medical school, a governor’s task force has recommended that the state spend $12 million to expand Nevada’s medical graduate programs.

The 11-member task force, formed by Gov. Brian Sandoval in March, recently issued a draft report saying it made the recommendation after discovering that the state suffered from a deficiency of doctors. About 80 percent of Nevada medical school graduates leave the state for training and often don't return, the report said, while residents' access to health care in the state ranks at the bottom of the nation.

To fix the issue, the board said the state should expand the graduate medical school program by providing a one-time grant that would allow certified institutions to pay for personnel, equipment and facilities for new programs. Creation of the graduate school positions must take priority over expanding current undergraduate medical schools in the state, the group said.

The task force's findings, however, will not have any impact on UNLV's bid to obtain state funding for a medical school, said Mike Willden, chief of staff for Sandoval. They are separate items, he said, and the UNLV school was not a factor in the task force's work. The group, he said, was formed specifically to examine medical graduate programs.

Barbara Atkinson, UNLV school of medicine planning dean, said everything remains on track to get the university’s funding proposal for an undergraduate medical school on the governor’s budget for consideration by the 2015 Legislature. It would be the first public granting M.D. program in Southern Nevada, where more than 2 million people live.

"I think the governor really knows that Las Vegas needs an academic health center; it’s his challenge, really, to fund it," Atkinson said. "Our challenge is to find philanthropy to support it also because we’re not asking the state for everything it takes to build this school. We’re asking the state for ongoing support for the basic education part."

Pending approval from the 2015 Legislature, the funding for expanding the graduate medical education program would be split across the state based on population, with $9 million going to Southern Nevada and $3 million going to Northern and rural Nevada by 2016.

The graduate program enables doctors to receive training at hospitals and is required for a doctor to earn their degree. There are 111 first-year residency graduate positions in the state, but Nevada will produce 200 medical school graduates from University of Nevada School of Medicine and the private school, Touro University, this year.

The task force found that the majority of physicians practice within 70 miles of where they train, meaning Nevada is losing a vast majority of potential doctors once they graduate.

The money would give health care institutions incentive to create more positions or start a graduate medical school program to keep graduating doctors in the state, according to the report. Those positions would also increase the number of physicians in the state to treat residents.

"There is little value for the state in educating and graduating medical students if the vast majority of them will leave Nevada for residency positions," the report said. "Although this problem cannot be completely fixed, it can be alleviated with the creation of more GME positions."

The governor will consider the board’s recommendation and put it through the budgeting process before it is finalized in September, Willden said.

But the state will still need more physicians, and that’s UNLV’s focus, Atkinson said. The amount of funding UNLV will request for the medical school won’t be determined until a board meeting Friday, but Atkinson said both programs need funding for Nevada to improve its health care.

“This state is very short on both new doctors and GME slots,” Atkinson said. “I’m very much of the opinion that the state needs both. It’s not an either/or.”

Last year, UNLV’s Lincy Institute commissioned the Tripp Umbach research institute to conduct a report on the impact of a medical school in Las Vegas.

The study found that Nevada has a severe shortage in doctors, ranking 45th in the country in the number of physicians per 100,000 population. The undergraduate program in Las Vegas combined with an expanded GME program would ensure the state would keep 70 percent of its doctors to help a growing population, according to Tripp Umbach.

Meanwhile, a medical school in Las Vegas is projected to be a $1.2 billion economic boost to the city by 2030.

The state needs doctors, and Atkinson believes the governor will be able to find funding for both undergraduate and graduate programs.

“Anybody who sees that can see that Las Vegas has grown, and it’s time to have enough doctors here to be able to get timely appointments and enough specialists to take care of things,” Atkinson said. “You shouldn’t have to leave town for a liver transplant for a city this size.”

Note: This story has been updated to reflect University of Nevada School of Medicine's most recent report on first-year residency positions for 2014.