Heck, school officials address Nevada doctor shortage
They were invited to find their golden tickets, but the fourth-year students of the University of Nevada School of Medicine already had gone a long way toward punching their own.
The “Charlie and the Chocolate Factory” theme was part of the school’s celebration of Match Day, the third Friday of March when aspiring doctors learn the residency, internship or fellowship program where they will continue their training to become licensed physicians.
More of the students in UNR’s graduating class this year are headed for medical facilities in California than Nevada, however, and nearly 32 percent of the class of 2015 will leave the state for programs not offered in Nevada such as dermatology, neurology and pathology.
Efforts are underway to change that and address the ratio of doctors per capita in Nevada. Health care providers, medical school officials, hospital executives and patient advocates have been lobbying for Gov. Brian Sandoval’s $10 million proposal for residency training for medical school graduates. If approved by the Legislature, the money could be used to help create programs similar to the program being created at Mountain View Hospital in Las Vegas. The hospital’s parent company, HCA Healthcare, has committed $2 million to create a program that’s scheduled to have its first 25 residents working next summer and could grow to as many as 150 residents by 2019.
U.S. Rep. Joe Heck, R-Nev., and Southern Nevada medical school officials gathered Tuesday to tout the importance of creating or expanding residency programs to give doctors-in-training more opportunities in hospitals and clinics in Nevada. Residency training location is a strong indication of where physicians will set up their practice after their residencies, and expanding such opportunities could lead to more availability of health care professionals in the future.
“We’re looking at innovative ways to try to increase the number of residency slots across the country,” Heck said Tuesday at Touro University Nevada, which graduates about 130 medical students each year in its doctor of osteopathic medicine program.
Heck, an emergency physician, was joined by Shelley Berkley, Touro’s CEO and senior provost; Dr. Barbara Atkinson, founding dean of UNLV’s medical school; and Dr. Mark Penn, founding dean of the Roseman University of Health Sciences medical school. Atkinson and Penn are in the planning stages of their schools, which are on track to begin graduating 60 medical students apiece by 2021.
Several references were made to the public perception that new medical schools translate to more doctors being licensed to practice, but opportunities for graduate medical education are an important part of the physician training process.
“Medical schools were told to increase their enrollments, but there were no increases in graduate medical education,” Atkinson said. “Without that, we haven’t solved any problems.”
Heck and U.S. Rep. Kathy Castor, D-Fla., have introduced legislation to create a federal grant program for states to create residency programs or increase slots in existing ones. The legislation would establish a $25 million grant fund administered by the Centers for Medicare and Medicaid Services for teaching hospitals and accredited graduate medical education training programs in states with fewer than 25 medical residents per 100,000 of population. Nevada has about 12 medical residents per 100,000, and the U.S. average is 37 per 100,000.
Last week, the University of Wisconsin Population Health Institute reported that if every person in Clark County was being seen by a primary care physician, each of those doctors would have 1,829 patients. Nevada sits near the bottom of states in terms of doctors per capita, often a key statistic in health care ratings. The U.S. Centers for Disease Control and Prevention puts Clark County primary care providers, which includes nurse practitioners and physician assistants, at 63.7 per 1,000 people, and the U.S. median is 48.
While Nevada consistently scores near the bottom in the number of doctors per capita, the state ranked 25th in a study examining the best climate for doctors to start their practices. Wallethub.com, a personal finance website, identified 12 objective measures to evaluate the attractiveness of states for medical professionals. The data were separated into two categories: opportunity and competition, and work environment.
Wallethub.com projects Nevada to have the fewest physicians per capita in 2022, providing the least competitive business environment for practicing physicians. Nevada ranked 42nd in the mean annual wage for physicians but 10th in terms of the monthly average starting salary for doctors.
The highest-ranking states in Wallethub.com’s study were South Carolina, Minnesota, Texas, Mississippi and Kansas. In last place was Rhode Island, followed in ascending order by New Jersey, Oregon, New York and Maine.
The UNR students gathered recently to learn what the future holds included Holly Villamagna, a 26-year-old matched to a residency in internal medicine in Las Vegas. Her dream came true because her fiance, UNR Medical School grad Jonathan Floriani, 27, is in a psychiatry residency that includes work at Rawson-Neal Psychiatric Hospital in Las Vegas. Tears welled in Villamagna’s eyes after she learned she would be near Floriani for the continuation of her medical training.
“This is one of the most exciting days in the life of a medical student,” Dr. Deborah Kuhls, associate dean of academic affairs, told the family, friends, faculty and staff.
Sixty-nine students matched with residency institutions in specialties ranging from neurology to otolaryngology, physicians who diagnose and treat disorders of the ears, nose, sinuses, voice box, mouth and throat. The class of 2015’s top specialty choices were anesthesiology, emergency medicine, general surgery and internal medicine.
Twenty-two of the graduates will enter primary care specialties. UNR had 107 graduates matched into its 12 residency programs and to start their training in June in Reno, Las Vegas and rural Nevada.
