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UT Medical school would improve Valley care

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Posted: Sunday, August 18, 2013 10:58 pm

The influx of students to a new regional medical school is expected to boost what is now a low doctor-to-patient ratio in the Rio Grande Valley and help physicians improve medical services to residents.

The Valley medical school will also create new research opportunities locally, said Dr. Leonel Vela, regional dean at the Regional Academic Health Center in Harlingen.

Medical students will be able to participate in research projects that could provide insight into the Valley’s particular needs. And patients from the Valley will also be able to be part of clinical trials here, Vela said.

The Valley, along with the entire state of Texas, has long dealt with an inadequate number of doctors as the population has grown, experts say.

According to the most recent estimates compiled by the Texas Medical Association, in 2011 Texas ranked 44th in the nation with a ratio of 245 physicians for every 100,000 residents.

Efforts have been made to attract more physicians to the state, and the new medical school in the Valley is expected to help efforts here to match the pace of population growth.

The Texas Medical Association website states that Texas licensed 3,630 new doctors in 2012, the highest number of any year on record. That was a stark contrast to the 2,088 doctors licensed in 2001.

Experts said this increase was largely attributable to 2003 tort reform legislation, with a constitutional amendment that limited hospital liability for non-economic malpractice damages.

“Up until that passing, there were people leaving in the middle of their practice,” Dr. Stephen Brotherton, president of the Texas Medical Association, said. “That’s been solved. So that made a big difference and it made a huge difference in (the Rio Grande Valley).”

However, experts said the reform raised the issue of training and keeping new physicians locally.

“We have been educating doctors for other states for a while, and it’s actually a mistake we have made in the past,” Brotherton said. “We have not enough residency spots for all of our medical school graduates and it forces them to go elsewhere, and unfortunately a lot of them stay there and don’t come back.”

In June, Gov. Rick Perry signed a bill into law merging the University of Texas at Brownsville and the University of Texas-Pan American and creating a new regional medical school, with half the students going to the RAHC in Harlingen.

The decision to create the medical school is expected to address the need to increase the number of physicians here and retain them.

“We start with a notion that South Texas has been very much short of physicians for a long time,” said Dr. Kenneth Shine, executive vice chancellor for health affairs for the University of Texas System.

“So, the University of Texas has long had a desire to provide opportunities for students in South Texas and to educate them in South Texas so that they may be educated in staying there,” Shine said.

The expected influx of medical students, and the consequent recruitment of more physicians who are expected to remain in the region, bring another level of medical service to the region: local residents will be able to participate in medical trials conducted here, providing insight into particular medical needs in the Valley.

Residencies and workforce impact

“The single most important impact is to help with the workforce needs of the community,” Shine said. “One of the reasons the hospitals are very interested in supporting residency positions is because they want a supply of physicians going forward.”

At the Regional Academic Health Center in Harlingen, more than a thousand students since 2002 have taken advantage of an internal medicine residency program at Valley Baptist Medical Center, as well as the family practice residency program at McAllen Medical Center.

However, with the development of the new medical school, the UT Health Science Center at San Antonio has worked with area hospitals and clinics to add residency positions to the existing and future programs.

“Several years ago we became interested in expanding the opportunities, and the first thing we had to do was substantially increase the number of residency positions,” Shine said.

In 2013, there were 1,761 residency programs in Texas, according to TMA officials. They said 1,682 of those were filled this year.

Texas would need to add an additional 400 residency positions to ensure a recommended 1.1 to 1 ratio of residency positions to medical students in the state, according to a 2011 TMA report.

Looking at the local region, Shine said, “We began to work with the hospitals in the region, and we now have commitments for an additional 115 residency positions. So over the next couple of years we will have a total of about 148 residency positions.”

The new residencies are likely to be in adult psychiatry, adolescent and child psychiatry, internal medicine, obstetrics and gynecology, family medicine and surgery.

“For us here, it is very important to develop these residencies. These students will now have a place to conduct their post-graduate studies, and a higher probability that they will stay here and set up a practice,” Vela, regional dean at the RAHC, said.

The new medical school also provides an opportunity to recruit new faculty, and officials say it will help bring additional and previously unavailable services to the region.

“When you recruit people to a medical school for faculty, you tend to recruit people in niches where there is high need,” Shine said. “So one of the reasons we are so excited about the new psychiatry residency, is there is an enormous shortage of psychiatrists, both adult and child psychiatrists in South Texas.”

He added: “Having students there means that you are more likely to be able to get faculty who are willing to teach psychiatry, to teach residents psychiatry, and to do research in psychiatry.”

Research and patient impact

Medical students will be able to participate in research projects to expand their education, understand the issues and needs of the community, and apply the new knowledge to future medical care.

Students who participate in medical research, especially students whose findings are published or who make presentations at state or national meetings, are better prepared for competition when applying to residency programs, experts said.

“The Valley has not, until relatively recently, been a major focus on biomedical research,” Vela said. “It just hasn’t been that way. That is changing and it is going to change even more.”

Along with continued research projects now available at the RAHC, officials said there are plans for new research in high priority health due to their prevalence in the local community.

“The first major activity in terms of new research opportunities is very much in diabetes and obesity,” Shine said. “We are searching for a new director of diabetes research, have a total of eight faculty positions and $7.5 million available to start up a diabetes program, which will be both laboratory and clinically based.”

While research provides students with valuable learning experience, experts said the work is ultimately done to serve patients. Patients who meet the criteria can, and some already do, participate in medical trials offered by researchers as they seek treatments for medical conditions.

“By having research centered here, it provides an opportunity for citizens who live in the Valley to participate in (medical) trials,” Vela said.

Instead of patients from the Valley traveling “to San Antonio, Houston, Dallas or somewhere else because they are interested in this particular area of research,” Vela said, the patients can be part of clinical trials conducted here.

One example of local research with patients directly involved, Vela said, is a study being done at the RAHC on the use of exercise and intervention to prevent the recurrence of breast cancer.


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