Back to Front PageVOLUME 6, NUMBER 4

Need It or Not, Florida Gets a New Medical School

When the charter class of medical students enters Florida State University's new School of Medicine in 2001, it will mark the first time a new medical school has opened in the state in 30 years. FSU will also be the first new U.S. allopathic medical school in nearly 20 years; Mercer University School of Medicine graduated its charter class in 1986.

The new medical school will have no affiliated teaching hospital. Instead, students will receive much of their practical patient care experience in nursing homes and rural clinics, with an eye toward serving the school's stated mission of expanding Florida's population of primary care physicians and improving geriatric care. And university officials maintain that without the expense of a hospital, they can operate the school on an annual budget of $34 million, one-eighth of rival University of Florida College of Medicine's total operating budget. The FSU plan is built on the Michigan State model and was designed by MSU Professor Emeritus Tom Johnson.

Why a new medical school in Florida now? That's the question many inside and outside the state are asking. Backers of the plan-including Florida House Speaker John Thrasher (R), an FSU alumnus who championed the deal that created the new medical school in the state legislature-argue that the $50 million-plus medical school project is merited because rural areas of the state need more doctors and elderly Floridians, in particular, are underserved.

"Believe me, we do not have access to the same quality of health care in our areas that many of you do," state Rep. Dwight Stansel (D) told the Florida House Health Care Services Committee in March. Stansel's district includes five of the 13 counties identified as "underserved." Florida Gov. Jeb Bush (R) also supports the plan.

Many others, however, including members of FSU's Board of Regents, attribute the decision to politics, saying there's no need for a new medical school and no shortage of physicians in Florida. "In 1975, Florida had 185 physicians per 100,000 people," says Robert Watson, M.D., senior associate dean for Educational Affairs at the University of Florida College of Medicine and chair-elect of the AAMC's Group on Educational Affairs. "As of 1998, according to AMA statistics, the proportion had reached 283 physicians per 100,000 people. I don't quite see how there's a shortage." The deans of all three existing allopathic medical schools in Florida-the University of Florida, the University of South Florida, and the University of Miami-have publicly expressed skepticism about the FSU plan.

A study conducted for FSU by consulting company MGT of America found different numbers: 210 physicians per 10,000 people, below the national average of 224. Why the big difference? MGT used a calculation known as "age-weighting," counting every Florida resident aged 65 or older at least twice in order to reflect the disproportionate impact older people have on the health care system. FSU Provost Larry Abele calls that "a legitimate calculation," while the St. Petersburg Times calls it "a convenient calculation."

Even if the MGT figures are correct, medical educators point out that simply because a medical student trains in a rural area doesn't mean she will practice there. "The AAMC and several other organizations have shown fairly clearly that there are very few things schools can do to target graduates to practice primary care in rural, underserved areas," says Dr. Watson. "The fact of the matter is that schools that have an explicit, stated goal of producing primary care physicians are very fortunate if 35 percent of their graduates actually end up practicing primary care. And most of those don't end up practicing in rural areas."

FSU's Abele predicts that the new medical school will beat traditional expectations through recruitment strategies. "Studies show that if you recruit students from rural and inner-city areas, they are more likely to return to those areas and practice," he told the St. Petersburg Times. The Program in Medical Sciences (PIMS) at FSU, which provides the first year of medical school to about 30 students who complete their remaining three years at the University of Florida, does appear to steer slightly more of its graduates to primary care than students who complete the full four years at UF: 50 percent of PIMS grads choose primary care residencies, while 46 percent of other UF graduates opt for primary care.

Members of FSU's Board of Regents have said that the better, cheaper way to address a physician shortage in rural areas is through expanding programs and enrollment at the state's existing medical schools. But the Regents won't have much to say about the matter for long-during the same session in which it created the medical school, the state legislature voted to abolish the Board of Regents. - Gina Shaw

AAMC Home | Government Affairs | Newsroom | Publications | Meetings | Students and Applicants | About the AAMC | Search | Site Map
Questions and Comments | © 1995-2004 AAMC Terms and Conditions | Privacy Statement