Physicians are stressing the need to create a pipeline that gets more young Mainers to study medicine in the wake of a recent study finding that creating a public medical school in Penobscot County is not financially feasible.
Maine must “figure out a way to increase the number of young people going into medicine, and particularly going into physician fields,” Dr. James Jarvis, director of clinical education for Northern Light Eastern Maine Medical Center, said.
The crux of that strategy could include the University of Maine System, the state and local hospitals working together to increase graduate medical education opportunities, including residency openings, in Maine. By having more openings, students could train in Maine and be more likely to stay in the state as a professional even if they didn’t attend a medical school in the state.
That recommendation comes from a feasibility study submitted to the Maine Legislature on Jan. 5. The study found that building a public medical school is not financially feasible due to the more than $200 million needed to start such an endeavor.
However, the study also lays the groundwork for how the state can take other steps to close its health care gap, as more than 220 physicians are needed to fill vacant positions throughout Maine. That shortage has led to climbing costs for hospitals hiring travel staff and falling doctor-to-patient ratios across the state.
The findings and recommendations of the study weren’t surprising, Jarvis said, but the focus shouldn’t be the financial hurdle of a new medical program.
“I do agree with the study’s findings that it would be wonderful to increase the number of opportunities for graduate medical education, but the problem is that we need to have a pipeline. It becomes that chicken or the egg kind of situation,” Jarvis said.
Expanding residency positions would be easier with a public medical school, Jarvis said, which would also be easier with expanded residency openings.
Jarvis has been recruiting students to Maine for residency programs for 17 years, he said. In that time, expansions have been talked about but not acted upon because an increase in students isn’t guaranteed.
Northern Light currently offers 38 residency and fellowship positions, Jarvis said, and will increase that to roughly 50 in coming years. The program could hold 100 additional students, but a growing student base and support from the hospital system and physicians would be needed to sustain the positions, Jarvis said.
Bringing more students and increasing openings would be easier if a pipeline was established as the study recommends, Jarvis said.
If the recommendation was followed, a pipeline would include the state, schools and hospitals combining funding and resources to offer undergraduate medical education and graduation education without building a new school and offer incentives for students to practice in Maine.
Increased state funding for residency programs, more graduate medical education offerings from the University of Maine System and hospitals offering more spaces could combine to add more physicians to Maine, the study said.
Another option could include buying seats at out-of-state public medical schools that would be filled by Maine students. This recommendation could be quicker than other options at filling the workforce gap, Sally Weiss, vice president of workforce policy and strategic initiatives for the Maine Hospital Association, said.
Idaho and Delaware currently buy seats for their residents as a way to send residents to medical school without building one in state. This option “aligns with the state’s fiscal reality,” the study states.
The seats could be coupled with a service commitment in Maine that would require students in those seats to return to Maine to practice medicine, the study said.
This option could lead to more physicians staying in Maine, Weiss said, because nearly 60% of students who complete their residency stay in the state where they trained, according to the Association of American Medical Colleges. Without that in-state training, a medical school wouldn’t guarantee that students would stay in Maine, Weiss said.
“It would be a shame to build a public medical school and graduate medical students and send them out of state for training and never get them back,” Weiss said.
With the study presenting multiple options, Weiss and Jarvis both said it would be important for the stakeholders interviewed for the study to come together to talk about the findings.
The study was conducted by Tripp Umbach, a medical consulting firm, and submitted by the University of Maine System. It found that the University of Maine is well-positioned to lead such a school in the next five to 10 years.
UMaine is constructing a taskforce to go over the findings, but President Joan Ferrini-Mundy said the university didn’t know who would be on it when asked on Jan. 5.
Although the study said the findings should be reconsidered within the next three years and a medical school could be feasible in five to 10 years, both Jarvis and Weiss said 10 years may be too late for a change.
“I think 10 years is too far out, but I’d suffice to seven years for a reassessment. Maybe by then you already would’ve done some things as a state to strengthen that pipeline and feel more confident,” Weiss said.