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Nov 28, 201712:00 PMOpen Mic

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Wisconsin needs to reform its medical school admissions procedures

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Based on our share of the U.S. population, even after the expansion of the Medical College of Wisconsin (MCW) to 261 seats and the UW School of Medicine to 170 seats, if you include M.D and D.O. medical school seats in the national total, we have a shortage of approximately 65 medical school seats. A comparison of 2001 medical school seats and classes in Wisconsin with the same data for 2016 shows that medical school seats in Wisconsin have grown by 80 seats from 351 to 431. Unfortunately the number of nonresidents in those seats grew by 92 students from 107 to 199. In the fall of 2016, 51% of the first year medical students of the Medical College of Wisconsin and 38% of the first year medical students at the UW School of Medicine were nonresidents.

The Association of American Medical Colleges tracks every state’s rate of retaining physicians who: 1) go to medical school in that state; 2) go to a publicly owned medical school in that state; 3) finish their training as a resident or fellow in that state; and 4) attend medical school in that state and finish their training in that state. The State of Wisconsin retains 70.14% of the physicians who graduate from a Wisconsin medical school and finish their residency/fellowship training in Wisconsin. The retention rate falls to 35.2% for physicians who graduated from an out of state medical school but finished their training in Wisconsin. The retention rate falls even further to 22.5% for physicians who graduated from a Wisconsin medical school but finished their training outside Wisconsin. Only 30.55% of active physicians who graduated from a Wisconsin medical school finished their training here.

In many of the residency programs at the University of Wisconsin Hospital, the vast majority of residents have no prior significant connection with the State of Wisconsin. According to the UW Emergency Medicine website, only four out of 37 UW emergency medicine residents went to medical school in Wisconsin. According to UW’s Department of Urology website, only one of 15 urology residents went to medical school in Wisconsin.

Wisconsin needs to expand the number of medical school seats in this state by opening a second state-owned medical school and it must limit the number of nonresidents in the UW School of Medicine to 15% of each entering class. The UW Foundation has approximately $350 million sitting in various accounts as a result of the Blue Cross Blue Shield giveaway in 2004 and 2007. That would capitalize a second state-owned medical school quite adequately. The Wisconsin Legislature should statutorily limit the number of nonresidents in the entering classes at the UW School of Medicine to 15%. That percentage would be great enough to cover federally funded M.D./Ph.D. students as well as nonresident members of underrepresented minority groups.

Wisconsin needs to expand the number of residency slots by at least 125. That could be funded by a $40 million increase in the state’s hospital tax. That increase would approximate 0.2% of Wisconsin’s hospital revenues. Furthermore, the top echelon of the UW Madison’s administration needs to know that the current practice of shunning the graduates of the state’s medical schools from the UW Hospital’s residency programs is simply unacceptable.

Based on its share of the U.S. population, the state of Michigan has vastly more than its share of medical school seats, all of which sit at state-owned campuses, and vastly more than its share of residency slots. Assuming a 50 hour work week, if the 11,280 Wisconsin physicians whose wages were surveyed by the BLS had been paid at the same rates as Michigan physicians, they would have been paid $725,598,000 less per year. Through lower insurance premiums, lower copays, and lower taxes those savings would have worked their way into the bank accounts of the citizens of this state.

John Gillis is a semi-retired CPA who lives in Madison.

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