Faced with a looming physician shortage, Michigan's medical schools have significantly increased enrollment and regional universities are planning to build medical schools to create a fresh pipeline of doctors for aging baby boomers.
The flurry of medical school activity in the state is unprecedented; for two decades, the number of medical schools in the nation remained at 125. Now Michigan alone is poised to gain three more as Oakland University, Central Michigan University and Western Michigan University are in varying stages of creating medical schools.
Meanwhile, three of the four medical schools in Michigan are in the midst of expansion projects. Michigan State University's medical schools are growing to new regions of the state and Wayne State University has increased its class size. First-year enrollment among the four schools will increase 44 percent by 2010.
But the boom in medical education also has raised concerns about whether the efforts will really stave off a physician shortage when the number of residency slots for medical school graduates isn't increasing at the same pace. And some doctors have called for a moratorium on new medical schools in Michigan until the state figures out the impact they will have on existing schools, residency slots and clinical opportunities for students.
"We really don't want six new schools popping up all around us and we are all going to be competing for funds," said Dr. Robert Frank, associate dean at Wayne's medical school, who added that the state needs to review whether building schools is needed. "If it turns out it's a good idea to build new medical schools, then so be it."
'More activity' in Michigan
A Michigan State Medical Society study found that the state will be 6,000 physicians short by 2020. Michigan's shortage equates to an 11.9 percent gap between supply and demand, compared to a nationwide gap of 7.9 percent over the same time period, according to a separate study by the Blue Ribbon Committee on Physician Workforce.
"Everyone is in agreement we have a significant shortage coming and Michigan will have a bigger shortage than other states," said Denise Holmes, an associate dean at MSU's College of Human Medicine, which is nearly doubling its enrollment by 2013.
The recognition of a physician shortage sparked a call from the Association of American Medical Colleges for a 30 percent increase in medical school enrollment by 2015. The vast majority of medical schools have responded, but few quite like Michigan.
"There is definitely a lot more activity in Michigan than in most other states," said Edward Salsberg, director of the Center for Workforce Studies for the medical college association.
For years, the number of medical schools did not grow, a result of a perception there were too many physicians. Florida State University cracked the dry spell when it became the 126th medical school to earn full accreditation in 2005.
Now nine U.S. schools are in the midst of receiving accreditation for the new schools.
Why the surge?
"The two P's, more or less," said Dr. Dan Hunt, co-secretary of the Liaison Committee on Medical Education that accredits the schools. "Medical schools form not necessarily for educational reasons but because of politics and pride."
College presidents may look to a medical school to boost the prestige of a university, spark economic development and better compete for research dollars.
CMU and Oakland said they would rely on private donations, not tax dollars, to fund the start-up of their schools. Tuition would sustain the operating costs.
But some leaders at the current medical schools fear greater competition for state appropriation dollars. Wayne, MSU and University of Michigan have lobbied hard to be funded separately from the 12 other state universities, because, in part, the three institutions housed the state's only medical schools and bring in sizeable research dollars.
CMU President Michael Rao said he's motivated by sense of duty to address the needs of the 2 million people in northern Michigan and the Upper Peninsula.
"I'm absolutely convinced that our region faces very serious consequences if we don't address the physician shortage here and northward," Rao said. "I know Central Michigan University is the best hope for taking care of those serious needs."
Adding schools may not help
More than 1,500 Michigan students applied to U.S. medical schools in 2007: 28 percent enrolled in Michigan's schools, 13 percent went out of state, but the majority -- 58 percent -- didn't enroll in any accredited M.D. school, according to figures from Central.
Limited capacity at current medical schools has prompted many of U.S. students to head to the Caribbean for training.
More medical education means Michigan students will have greater opportunities to stay in the state, said Virinder K. Moudgil, Oakland's senior vice president for academic affairs. "There's plenty of room for all of us," Moudgil said.
Some experts say increasing enrollment and starting medical schools will do nothing to address the physician shortage unless Congress increases the caps on residency programs in the country.
Hospitals receive federal funding through Medicare for their residency programs.
Meanwhile, the Michigan State Medical Society's policy-making body passed a resolution this year saying no medical schools should be established after Oakland University until the state studies the potential impact on existing medical schools and residency slots. Medical school deans are expected to meet and formally submit a request to the state for review, according to the society.
WMU is not discouraged. A feasibility study is under way to determine whether a medical school is a good idea. So far, President John Dunn has no indication it wouldn't be successful and said it would ultimately enhance the quality of health care in the region. People -- "that's really what this is all about," Dunn said. "This is not about who's right and who's wrong."
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