Federal cap on residencies may limit proposed medical school

Central Michigan University's hope to divert the state's predicted physician shortage is not unique.

However, it comes with one complication.

A federal cap on residencies, which are paid for by Medicare and designed to train doctors post-graduation, has been in place since Congress implemented it in 1996. The cap varies by hospital.

New and expanding medical schools statewide aim to combat Michigan's anticipated shortage of 6,000 physicians by 2020 with more students, but could face setbacks, should the cap remain.

"More medical students, as a general statement, would be of value," said Michael Sandler, president of the Michigan State Medical Society. "(But) in order to address the physician shortage you need to raise the federal cap, period."

The Balanced Budget Act of 1997 froze medical school residencies to 1996 levels, leaving residencies constant between 1997-2002 at about 98,000, according to the American Medical Association.

CMU officially started its pursuit of a medical school last September, but it is not alone.

Western Michigan University also is in the planning stages of a new school and Oakland University is set to launch the William Beaumont School of Medicine in fall 2010.

Michigan State University's College of Human Medicine plans to expand its enrollment in Grand Rapids to 200 students and its College of Osteopathic Medicine will open new centers at the Detroit Medical Center and Macomb Community College in June.

Marsha Rappley, dean of MSU's College of Human Medicine, said two actions must be taken to counter a growing shortage of medical professionals.

"Nationally, we increase the number of graduates, but there is still a limit to the number of graduates who can receive training," she said. "We have to increase the class sizes and increase the number of medical residency slots."

In 2006, the Association of American Medical Colleges called for a 30 percent increase of enrollment by 2015 for medical schools across the country.

"Since that time, medical school enrollment has increased 11 percent," said Clese Erikson, AAMC director of workforce research.

Based on the AAMC's recommendation, it is predicted that 5,000 additional medical students will crop up annually. The association's 2008 studies predicted that there will be about 750,000 doctors nationwide by 2025, or about 159,000 fewer than the country needs.

Sandler said University President Michael Rao met before the MSMS board last month and was questioned about his considerations of the federal cap.

Director of Media Relations Steve Smith said CMU will be an advocate for the increase of a federal cap.

"Basically, what we plan to do is incorporate that residency cap into our plan," he said. "There are other schools that are in the same phase and they are also working on that."

Western Michigan University is currently investigating a timeline for completion of its desired medical school, but hopes to arrive at the next phase of development by the summer, said Cheryl Roland, WMU executive director of university relations.

"Our community has a long history of health science and health education," she said. "There haven't been any new medical schools for quite some time now."

Pat Grauer, director of public relations at MSU, said the university's planned expansion of its College of Osteopathic Medicine will prove to be cost-effective.

Being paid through tuition, she said, the college will graduate an anticipated 100 new physicians in four years.

Based in metro Detroit, Grauer said the expansion could increase health care options to those local residents.

"Detroit, in particular, has low access to health care," she said. "Fourteen out of 27 training hospitals are in the Detroit area."



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