As a full-spectrum, rural family physician practicing in Montpelier, I was intrigued when reading about a possible for-profit medical school in Idaho. Growing up on a farm, I witnessed the difficulties of health care access. As a doctor who did almost all medical training in Idaho (University of Washington WWAMI medical student, Family Medicine Residency of Idaho — Caldwell Rural Training Track), I have a good understanding of medical training in Idaho with Idaho’s healthcare system. There is no question that Idaho needs more physicians. I applaud anyone who is trying to solve this problem.
However, because of my background, I question whether a for-profit medical school is going to solve our physician shortage and if this school could actually have unintended consequences.
I suspect that adding medical students will not translate into a significant increase in Idaho doctors for a few reasons. First, there will not be sufficient clinical exposure in Idaho to draw students back as doctors. This private medical school will be akin to the Caribbean medical schools that provide lectures for the first two years after which students are mostly farmed out to other states for clinical rotations. Secondly, after medical school, physicians must do residency training in a given specialty. There are only about 40 resident positions per year in Idaho, nowhere near the 150 students per year proposed in the new medical school. Studies show that the majority of doctors end up practicing within 100 miles of their residency or in the state of residency training. In essence, Idaho would have a medical school that would graduate 150 students a year, the majority leaving the state to further train with little chance for return. It would make much more sense to invest in creative ways to expand residency training.
I strongly believe that there will be unintended consequences with a for-profit medical school in Idaho. Having trained in Idaho during medical school and residency, I am well aware that there is already a shortage of quality clinical rotations with Idaho State University nurse practitioner and physician assistant students as well as WWAMI medical students and residents already vying for these opportunities. Adding 150 students each year to the equation only exacerbates an existing problem and likely decreases quality and quantity of training for all. I practice rural medicine because my clinical rotations gave me the necessary exposure and confidence to succeed. Without these opportunities, I would not be where I am today.
Idaho needs more primary care physicians who practice in rural and underserved areas. I suspect that the high tuition necessary in a for-profit school will saddle these students with so much debt that they will not be attracted to the lower-paying specialties of primary care.
I appreciate those who are trying to address Idaho’s physician shortage. However, I do not believe that a for-profit Idaho medical school will get to the root of our problem and it will likely have unintended consequences.
Lance Hansen is a full-spectrum, rural family physician practicing in Montpelier.