UNC, ECU want to add medical students

They say satellite campuses will counter a shortage of doctors

The state's two public medical schools want to add students and create regional campuses to deal with a predicted doctor shortage in North Carolina.

A UNC-Chapel Hill proposal would add 70 medical students to each entering class, with 50 doing their final two years of work in Charlotte and 20 finishing their degrees in Asheville. The medical school's first-year class would grow from 160 to 230 students.

East Carolina's Brody School of Medicine in Greenville is working on a proposal to increase its first-year class from the current 73 to as many as 120, said Dr. Nicholas Benson, a vice dean. The school is considering one or two regional campuses in the eastern part of the state.

UNC's proposed expansion would cost $239 million in one-time construction at the three locations and $40 million a year for added faculty and staff. The proposal has yet to be approved by the UNC Board of Governors or funded by the legislature, but UNC-CH wants to start admitting more students in 2009 or 2010, said Dr. Bill Roper, CEO of the UNC Health Care System.

Roper cautioned that the plan remains preliminary.

"It could get refined, changed, slimmed down or expanded," Roper said. "The state needs to find out how much we collectively can afford."

The proposal has already expanded. Talks between UNC's medical school and Charlotte's Carolinas Medical Center started in December 2006, with the school considering only an outpost in Charlotte. Roper pointed out that Charlotte is the largest city in the United States without a medical school.

About six months ago, the university was approached by hospital officials, community leaders and legislators from the Asheville area, asking for the school to consider a second satellite campus. UNC-CH officials said yes.

Then, late last year, East Carolina's Brody School of Medicine expressed interest in growing, and UNC President Erskine Bowles directed the two campuses to work together on their ideas, Roper said.

Teams from both schools have met several times in what they describe as a cooperative relationship, despite the history of a bitter battle in the 1970s when ECU established a medical school over the objections of supporters of the Chapel Hill campus.

"It's very clear we need more doctors in this state, and we want to be part of the solution," said Benson of the Brody school. ECU had already planned to increase each class to 80 students, but the new approach could mean 40 more students.

Benson said it was too early to provide cost estimates or possible locations of satellite campuses. "We will be concentrating on the east, and Chapel Hill will be looking westward," he added.

Thinking longterm

North Carolina had about 19 doctors for every 10,000 residents in 2005 -- on par with the national average, according to the N.C. Institute of Medicine, an organization that studies health policy. But an institute study last year predicted a shortage in the future, with the overall doctor-to-resident ratio dropping by 21 percent by 2030.

The decrease will happen at a time when the median age of the population is expected to increase.

"Unfortunately, it's a national problem and most states are dealing with this," said Mark Holmes, vice president at the institute. "We really need to think about real long-term strategies."

In 2006, the Association of American Medical Colleges recommended that U.S. medical schools increase their enrollment 30 percent by 2015, churning out 5,000 more graduates annually.

In North Carolina, some geographic areas and disciplines are likely to suffer more than others. Rural counties and inner cities have historically experienced shortages, and deficits emerged in psychiatry, general surgery and among doctors who deliver babies. Eight of 10 counties with the lowest per capita supply of primary care doctors are in the eastern part of the state.