The Texas Higher Education Coordinating Board examined this bill and states the following:

The Coordinating Board recognizes there is a long-term need for a medical school in South Texas/Rio Grande Valley and converting the existing LRGV-RAHC would fulfill that need. However, prior to the establishment of a new health-related institution, significant progress must first be made in acquiring top faculty, securing substantial and ongoing funding, and building first-rate facilities to educate students and conduct cutting-edge medical research. Establishing a new health-related institution requires the long-term commitment of local, regional, and state constituencies. All three would have to commit considerable financial support and share a common vision for the institution’s establishment.

In forIn order to develop a health-related institution of the highest quality, the Coordinating Board recognizes that the institution would have to establish and provide new funding for the following essential components.

1.  Medical residency programs in pediatrics, obstetrics/gynecology, and general surgery should be planned and opened without delay, while adhering to the quality standards of the Accreditation Council on Graduate Medical Education. To begin the process to plan for these residency programs, staff estimates the new cost for the biennium of $1 million.

2.  Establish specialty-oriented residency programs, for example, neurology (11 residents), psychiatry (22 residents), and emergency medicine (16 residents).  Staff estimates the new cost of planning and development for these residency programs for the biennium at $1 million. A critical first-step for this piece of the future institution’s development would be to hire recognized faculty who would begin the planning and development of these specialty-oriented residency programs.

3.  Develop and open a Clinical Simulation Center to contribute to the high quality of the institution. Staff estimates the new cost to plan for the center at $500,000 for the biennium.

4.  Draft a Master Plan to transition the LRGV-RAHC to The University of Texas Health Science Center South Texas. The plan should be a collaborative effort of The University of Texas System, The University of Texas Health Science Center at San Antonio, and the LRGV-RAHC. Staff estimates the new cost to draft a Master Plan for the transition at $1 million for the biennium.

5.  Continue to increase basic science and clinical faculty at the LRGV-RAHC.  Attracting leading researchers and practicing physician educators to the area will provide the LRGV-RAHC the necessary personnel to eventually transition to The University of Texas Health Science Center South Texas.  Staff estimates new cost for the biennium of $8.5 million, which would support the addition of 40 basic science and 50 clinical personnel.

          These five items would require additional new general revenue funding of $12 million for the biennium.

          The Special Item funding of $24 million in state general revenue provided to The University of Texas Health Science Center at San Antonio to support the faculty, staff, and administration in place at the LRGV-RAHC must be continued as plans for the new medical school are developed and implemented. This funding should be maintained to support the existing operation and educational efforts of the LRGV-RAHC. The eventual conversion of the LRGV-RAHC into a new health-related institution of the highest quality would require that the existing relationships between the LRGV-RAHC and The University of Texas Health Science Center at San Antonio and other University of Texas component institutions be maintained.

The Coordinating Board recognizes that funding another health-related institution would require a new on-going financial commitment for the state.  Staff estimates new funding costs of $12 million for the first biennium. However, state general revenue commitments would rapidly increase in subsequent years with the implementation of new residency programs, addition of the clinical simulation center, and increased numbers of basic science and clinical personnel.  Further, when The University of Texas Health Science Center South Texas is established, staff estimates that the additional permanent annual state general revenue commitment would exceed $99 million.

Other State Commitments

The state commitment to existing health-related institutions should not be reduced as a result of the recognition that a new medical school in South Texas is warranted. Recognizing the need for more physicians in the state, Texas medical schools initiated expansions and are on track to meet the national goal of an enrollment increase of 30 percent by 2015. The 80th Texas Legislature supported medical school expansion efforts and provided increased formula funding for graduate and undergraduate medical education. Special item funding of $48.5 million was provided to establish a new medical school, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine (TTUHSC El Paso).

Slated to open with an inaugural class of 60 medical students in fall 2009, TTUHSC El Paso will be the first new medical school opened in Texas in more than 30 years. The new medical school was created by converting Texas Tech University Health Sciences Center Regional Academic Health Center in El Paso into a complete health science center, similar to the proposed conversion of the LRGV-RAHC. The new TTUHSC El Paso, Foster Medical School has provisional accreditation from the Liaison Committee on Medical Education and will remain in that status until the first class graduates in spring 2013. 

Other expansions of medical schools also are taking place.  Beginning in 2009, Texas A&M University System Health Science Center medical students may attend all four years in Temple. Also, an expansion effort by Texas Tech University Health Sciences Center will allow medical students to complete their third- and fourth-year in Midland/Odessa. This is also the case in Austin, where 60 medical students from The University of Texas Medical Branch will complete their third- and fourth- years of training.

Medical school enrollment increases may result in greater numbers of physicians educated in Texas who remain in Texas to practice. However, even with increased medical school enrollments and planned residency expansions, it is likely that Texas will continue to be a net importer of physicians, providing opportunity to increase the number of Texas programs attempting to meet the demand.  Currently, approximately 44 percent of the practicing Texas physicians graduated from a Texas medical school.

Coordinating Board, 2008 Projecting the Need for Medical Education in Texas

The Coordinating Board’s 2008 update on medical education in Texas reported that the LRGV-RAHC was in the process of developing new residency programs in pediatrics, obstetrics/gynecology, and surgery. Such a foundation would serve as the basis for the South Texas region to further develop a plan to eventually offer a full medical program in the area. The report concluded that if the Texas Legislature fully supports the existing commitments in the state and decides to establish an additional medical school, the South Texas region would remain a feasible location.

Final Considerations

There is documented need to develop a medical school and health-related programs in the South Texas/Rio Grande Valley. However, prior to a transition of the LRGV-RAHC to The University of Texas Health Science Center South Texas, the LRGV-RAHC should continue building on its strong relationship with UTHSC SA. The Special Item general revenue funding of $24 million to UTHSC SA should be maintained to allow the needs of the State and the region to be served in the short term.  New funding of $12 million should be provided to develop and transition the LRGV-RAHC to The University of Texas Health Science Center South Texas. The Coordinating Board recommends that The University of Texas System in conjunction with the LRGV-RAHC and UTHSC SA draft a master plan in anticipation of the development of The University of Texas Health Science Center South Texas.