USA to increase med school numbers
Mobile Register, December 7, 2004 Section: B Page: 1
Author: Jeff Amy

USA to increase med school numbers Medical school to increase numbers

College hopes to admit class of 70 in fall semester The University of South Alabama hopes to increase the number of students in its medical school by 10 percent, starting as early as this fall.

Dr. Robert Kreisberg, dean of the USA College of Medicine, said the school hopes to admit a class of 70 in August, up from the 64 it has admitted in the past.

Right now, the four-year medical program has about 250 students, because a few typically drop out along the way. The whole university has about 13,500 students.

The move comes as some national authorities warn that the United States is facing a physician shortage in the future. The nation could be 85,000 doctors short of what it needs by 2020, according to a report done for a congressional advisory panel by Edward Salsberg, head of the Center for Health Workforce Studies at the State University of New York, Albany.

That was a major turnabout. The advisory panel, known as the Council on Graduate Medical Education, had forecast a physician surplus for years, in part based on assumptions that insurers would manage doctor usage in such a way that the typical person would see a physician less often. But demand for physicians has continued to rise, confounding those predictions.

In the wake of that report, the advisory panel called for medical schools to graduate 3,000 more students each, an increase of about 20 percent over the current level of 15,000 to 16,000 annual graduates from non-osteopathic medical schools.

National leaders say there are already shortages of physicians in rural areas, as well as specialty doctors in urban areas. Past federal estimates have said that most areas need at least 145 doctors per 100,000 residents, although even those numbers have been attacked as too low. While Alabama's urban areas, including Mobile and Baldwin counties, topped that threshold in 2001, rural areas of Alabama has 78 physicians per 100,000 people, barely half the suggested threshold.

USA's medical school, founded in 1973, has been among the smallest in the nation. In 2002, it was the 12th smallest among the 125 accredited medical schools in the United States, according to figures kept by the American Association of Medical Schools. That doesn't count the 23 schools that train osteopathic physicians using different methods.

Kreisberg said that the school could absorb a slightly higher number of students without any major budget or faculty increase. Kreisberg said USA has about 210 medical faculty members right now, including those who teach basic sciences to first-year and second-year students, and clinical faculty members who tutor upper-level medical students.

Clinical faculty also teach USA's roughly 200 residents, medical school graduates who are receiving additional clinical training. Kreisberg said the school doesn't need more faculty to teach more students' but that he'd like to see the school increase its total faculty to 250 over the next few years, reversing a trend of falling faculty numbers.

USA had planned to increase its class size to 80 in 1996, but pulled back, according to accreditation documents. According to the Liaison Commission on Medical Education, which accredits medical schools, a school must notify LCME any time it increases class size by 10 percent or more in one year, or 20 percent or more over two years.

Accreditation officials will visit USA this week to follow up on criticisms in the school's last reaccreditation report, and Kreisberg said he planned to tell the delegation of USA's plans.

It won't take much effort for USA to find a few more applicants with the smarts to go to medical school, said Mark Scott, the medical school admissions director.

Nationwide, medical school applicants fell 28 percent from 1996 to 2002, according to the American Association of Medical Colleges. But the decreases turned around in 2003, and applicants rose again this year. Even at the low-water mark, the typical medical school had 22 applicants for each available space.

Scott said the same trend has been seen at USA, with applications peaking around 1,500 a year in the mid-1990s, and falling to about 700 or 800 a year. Scott said USA had 814 applicants last year, and expects about 900 this year. Of those, the school will interview only about 200. Scott said the school is likely to make admissions offers to people a little further down the list of those interviewed to increase class size from 64 to 70.

"The people we interview that don't get in, from an academic standpoint, are always very highly qualified," Scott said.

Over the long run, if medical school graduates are going to increase nationwide, there will have to be more residency slots to train them. Kreisberg said USA had no plans for an overall expansion of its residency program.

He said nationwide, and at USA, there would probably have to be an expansion of the federal program that funds residency training for there to be large expansions.

He said residents can't bill directly for services, and that each resident costs USA about $60,000 a year in salary, benefits and malpractice insurance premiums.

This article reproduced with special permission from the Mobile Register.