Residencies bigger key to state’s health-care future

Medical schools serve a vital role in our community, including Touro University Nevada, the state’s largest college of medicine. As additional medical schools are being considered in Southern Nevada, it is essential that the facts associated with their development and resource utilization are clear and that the discussion is open and factual.

As the founding dean of the College of Medicine at Touro since its inception more than 10 years ago, and having been involved in academic medicine for more than 36 years, I have personal knowledge and understanding of what is involved in opening a medical school.

Touro has been and continues to be supportive of all efforts to improve access to and quality of health care for all Nevadans, including the addition of new medical schools. We have demonstrated this by our 10-year commitment in the community, providing patient care, medical education, community service and numerous partnerships throughout the valley.

I was dismayed to read the op-ed from the Las Vegas Metro Chamber of Commerce on the UNLV medical school in the March 8 Review-Journal (“Full funding of medical school an imperative”). Although I’m certain that the article was well-meaning, much of the information was built on persistent misperceptions.

First, it is important to note that completing four years of medical school is not the last step in the education and training of physicians. Before a physician can practice independently and serve the community, he or she must undertake graduate medical education, including further training in residencies and fellowships.

National data and Nevada statistics show that physicians overwhelmingly practice medicine near where they completed their GME. Nevada is sorely lacking in GME opportunities. Approximately 15 percent of Nevada’s medical school graduates remain in the state for that final step in their training. The majority of graduates of the two current medical schools leave the state, never to return here to practice. If the problem we seek to solve is a shortage of physicians to care for Nevada’s patients, the focus must be about expanding the breadth and number of GME opportunities. Adding additional medical school students through the expansion of medical schools, in the absence of developing and expanding GME positions, will only increase the number of graduates who leave our state and never return. And in the case of public medical schools, that will come at the expense of taxpayer dollars.

Second, the op-ed offered a statistic that is simply not true. The authors state that Nevada has approximately 9 medical students per 100,000 population. This figure was true 10 years ago. Today, through the efforts of Touro — a private, not-for-profit institution which uses no state funding — that number is actually 29. When Roseman University College of Medicine, also a private, not-for-profit institution, is fully operational in the next few years, that number will be nearly 40. This will put Nevada well above the national average for number of medical students per 100,000 population.

Furthermore, highlighting the issue that the creation of residency programs is the key to solving our doctor shortage, Nevada has only 12 medical residents per 100,000 population; nationally, that number is 37 per 100,000 population. Nevada’s low number of medical residents places our state among the lowest in the nation, as published in the Review-Journal just last month.

Touro has been a long-standing and proud member and supporter of the Las Vegas Metro Chamber of Commerce. We applaud the Chamber’s efforts to encourage the improvement and expansion of health care in Southern Nevada. However, it is important to ensure that the data we use is accurate when discussing these important issues — especially since it relates to the use of Nevadans’ tax dollars. Touro remains ready to be a resource to help Nevadans understand the full scope of health care education, expansion and access to health care. Any plan to improve the health care of our community and all of Nevada must involve a collaboration and partnership between the private and public sectors.

Mitchell Forman, D.O., is founding dean and a professor at the Touro University Nevada College of Osteopathic Medicine.