It's Academic

June 2015 

Legislature Approves $53 Million for GME Expansions

This legislative session, graduate medical education (GME) was a big winner. The legislature has sent to the governor for his signature a budget bill allocating $53 million for GME expansion grants over the biennium, up from the current $14.3 million. This includes:  

  • $3.5 million for GME planning and partnership grants;
  • $32.55 million for creating new first-year GME positions at $75,000 per resident per year (of that amount, $12 million is specifically for new GME positions that prepare physicians for entry into primary care practices);
  • $9.75 million to enable filling of accredited but previously unfunded GME positions; and
  • $7.2 million for continued grant support to residency positions created with state grants during this budget cycle.  

The bill appropriates an additional $7 million for primary care physician pipeline programs. This includes $4 million in additional dollars for existing family medicine residency programs, for a total of $16.78 million (a 31-percent increase over current funding) and $3 million to revitalize the Statewide Primary Care Preceptorship Program. The preceptorship program has not been funded since 2011.  

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TMA Honors Academic Physician Leaders

Jose Manuel de la Rosa, MD, of El Paso received the Platinum Award, the top honor in the TMA Award for Excellence in Academic Medicine, during TexMed 2015. 

The multilevel award program, created in 2012 by TMA’s Subcommittee for Academic Physicians, recognizes academic physicians who are consummate teachers, role models, and medical professionals. A physician selection committee chooses the Platinum winner from a pool of physician applicants in the Gold-level recognition category. Physicians can self-submit applications or nominate others for Bronze-, Silver-, and Gold-level recognition, based on their years in an academic position.

“I am honored to be recognized for doing what I love,” Dr. de la Rosa said. “As a pediatrician, I felt compelled to teach; not only teach the families I cared for, but the students navigating their way through medical school. This award is icing on a career I truly have been blessed to live.”

Throughout his more than 25-year career, the board-certified pediatrician has mentored a host of medical students, residents, and physician faculty. 

Dr. de la Rosa serves as provost and vice president for academic affairs at Texas Tech University Health Sciences Center-El Paso, where he continues to teach. He also oversees Student Services, Educational Affairs, the Office of Diversity Affairs, and the Office of Global Health Affairs. He was the founding dean of the Paul L. Foster School of Medicine, leading the school through the accreditation process. Prior to the medical school’s creation, he served as regional dean of the El Paso regional academic health center. For several years, he oversaw residency training at his institution.  

As founding dean of the first medical school on the U.S.-Mexico border, Dr. de la Rosa has been instrumental in developing a unique curriculum that prepares students to practice medicine on the border and beyond, said Kathryn Horn, MD, an associate professor at the health sciences center, who nominated him for the award program. 

Dr. de la Rosa helped establish the Kellogg Community Partnership Clinics, school-based clinics run by medical students that provide health services to colonia residents in the El Paso area. He also designed a community medicine curriculum — now a nationwide model — that teaches cultural sensitivity, awareness, and competence in medicine. And he championed a requirement that all medical students at the school take medical Spanish. 

“Dr. de la Rosa works tirelessly to meet the health care needs in El Paso and beyond,” said Dr. Horn. “He strives to eliminate social barriers so that all residents have access to the health care they need.”

Dr. de la Rosa received his medical degree from Texas Tech University Health Sciences Center School of Medicine-Lubbock. He completed his residency at Baylor College of Medicine in Houston. He received a Master of Science degree in clinical epidemiology from Harvard School of Public Health. 

Dr. de la Rosa was among 18 physicians TMA recognized at its annual meeting through the academic award program. A total of 45 academic physicians have been recognized through the program during the past three years. 

Award for Excellence in Academic Medicine 3220.500wide

From left, Jose Manuel de la Rosa, MD; Rodney B. Young, MD, chair of the TMA Council on Medical Education; and Kathryn Horn, MD, of Texas Tech University Health Sciences Center-El Paso

Excellence in Academic Medicine 2015 Winners

Front row: Elizabeth A. Nelson, MD; Christine E. Koerner, MD; Rodney Young, MD, chair of the TMA Council on Medical Education; Jose Manuel de la Rosa, MD; Charleta Guillory, MD; Carl David Rowlett, MD
Back: Charles E. Cowles Jr., MD; David Mercier, MD; Gilbert Handal, MD; Carlos R. Hamilton Jr., MD; Arlo F. Weltge, MD 

Not pictured: Lindsay K. Botsford, MD; Patricia M. Butler, MD; Troy Fiesinger, MD; Shkelzen Hoxhaj, MD; Felix Hull, MD; Girish P. Joshi, MBBS, MD; Richard Strax, MD; and Lucas Wong, MD.

2015 Gold-level achievement recipients  

  • Jose Manuel de la Rosa, MD, Texas Tech University Health Sciences Center-El Paso (also selected for the Platinum Award);
  • Charleta Guillory, MD, Baylor College of Medicine, Houston;
  • Carlos R. Hamilton Jr., MD, The University of Texas Health Science Center at Houston;
  • Gilbert Handal, MD, Texas Tech University Health Sciences Center-El Paso; and
  • Arlo F. Weltge, MD, The University of Texas Health Science Center at Houston.

2015 Silver-level achievement recipients 

  • Patricia M. Butler, MD, The University of Texas Health Science Center at Houston;
  • Charles E. Cowles Jr., MD, The University of Texas MD Anderson Cancer Center, Houston;
  • Troy Fiesinger, MD, Memorial Family Medicine Residency Program, Sugar Land;
  • Shkelzen Hoxhaj, MD, Baylor College of Medicine, Houston;
  • Felix Hull, MD, community preceptor, The University of Texas Medical Branch at Galveston-Austin Programs;
  • Girish Premji Joshi, MBBS MD, The University of Texas Southwestern Medical Center; 
  • Christine E. Koerner, MD, The University of Texas Health Science Center at Houston;
  • David Mercier, MD, The University of Texas Southwestern Medical Center;
  • Elizabeth A. Nelson, MD, Baylor College of Medicine, Houston (now at The University of Texas Dell Medical School);
  • Carl David Rowlett, MD, The University of Texas Health Science Center at Tyler; 
  • Richard Strax, MD, Baylor College of Medicine, Houston; and
  • Lucas Wong, MD, Baylor Scott & White/Texas A&M Health Science Center, Temple.

2015 Bronze-level achievement recipient: Lindsay K. Botsford, MD, Memorial Family Medicine Residency Program, Sugar Land.

TMA will accept nominations for the 2015-16 award cycle from Sept. 1 through Dec. 7, 2015. Learn more about the TMA Award Program for Academic Excellence.

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TMA Awards Scholarships to Minority Medical Students 

Nine minority students entering Texas medical schools this fall each will receive $5,000 scholarships from TMA. Students were recognized at TexMed 2015 for their academic achievement, commitment to community service, and deep desire to care for Texas’ increasingly diverse population.  

The TMA Educational Scholarship, Loan, and Awards Committee chose winners from a competitive field of promising future physicians. 

TMA created the Minority Scholarship Program to help diversify the physician workforce to fulfill the needs of Texas’ diverse population. The scholarship encourages minority students to enter medicine by lightening their medical school financial burden. Since 1999, TMA has awarded 101 scholarships totaling $505,000, thanks to generous gifts from donors to the TMA Foundation. 

The 2015 TMA Minority Scholarship recipients are as follows.  

  • Lillian Ene of Rockwall graduated from the University of North Carolina, Wilmington. She will attend Texas Tech University Health Sciences Center-Lubbock to become a pediatrician or emergency physician in rural Texas. Her scholarship is funded by the Nueces County Medical Society (CMS); Travis CMS; Rose D. Jackson, Palestine; Jaime D. Sandoval, MD, PA, Corpus Christi; and Andrew and Sukie Desire, Wichita Falls.
  • Jennifer Espinales of Harlingen graduated from The University of Texas at Brownsville and will attend The University of Texas Medical Branch at Galveston. She plans to become an internal medicine physician. C. Enrique Batres, MD, Sugar Land, and Mark J. Kubala, MD, Beaumont, funded Ms. Espinales’ scholarship.
  • Hillary Evans of Buda is a graduate of Saint Edward’s University in Austin. She will attend The University of Texas Southwestern Medical Center in Dallas to become an internal medicine physician. Dallas CMS; Diane and Clifford Moy, MD, Frisco; and physicians and their families funded Ms. Evans’ scholarship.
  • Kimberly Farias of Waco graduated from The University of Texas at San Antonio and will attend the University of North Texas Health Science Center at Fort Worth. She plans to become a pediatrician. Her scholarship was made possible by Tarrant CMS; E. Thomas Wightman, MD, Arlington; Irvin Robinson, MD, Fort Worth; Roberto and Aguiela Bayardo, Houston; and physicians and their families.
  • Samuel Garcia of Horizon City graduated from The University of Texas at El Paso and will attend Texas Tech University Health Sciences Center Paul L. Foster School of Medicine in El Paso. He plans to become a cardiologist. Mr. Garcia’s scholarship was funded by Hidalgo-Starr CMS; El Paso CMS; Roberto and Aguiela Bayardo, Houston; and physicians and their families.
  • Peris June Nganga of Irving graduated from The University of Texas at Dallas and will attend The University of Texas Health Science Center at San Antonio to become a primary care physician. Her scholarship is funded with gifts from H-E-B and Rajam Ramamurthy, MD, and Somayaji Ramamurthy, MD, both of San Antonio.
  • Efrain Rodriguez of Mission graduated from The University of Texas-Pan American in Edinburg and will attend The University of Texas Health Science Center at Houston. He will study to become a family physician. H-E-B and Gregory R. Johnson, MD, Houston, funded Mr. Rodriguez’s scholarship.
  • Ruth Woldemichael of Amarillo graduated from Rice University in Houston and will attend Texas A&M Health Science Center in College Station. She plans to specialize in family or internal medicine. Ms. Woldemichael’s scholarship was made possible by McLennan CMS; Libby and Bruce Malone, MD, Austin; Charli and Jim Rohack, MD, Galveston; Roberto and Aguiela Bayardo, Houston; and physicians and their families. 
  • Adam Garibay of Austin graduated from The University of Texas at Austin and will attend Baylor College of Medicine to become a primary care physician. His scholarship was made possible through donations from Harris County CMS and Houston Academy of Medicine; Pamela and Art Klawitter, MD, Needville; Gregory R. Johnson, MD, Houston; and physicians and their families.   

The TMA Minority Scholarship program is supported by the TMA Foundation, the philanthropic arm of TMA, thanks to generous major supporters and gifts from physicians and their families. 

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TMA Encourages Another Look at Tight Restrictions on External Moonlighting

At the urging of the TMA Council on Medical Education, members of the TMA House of Delegates adopted new policy on moonlighting by residents at its annual meeting on May 2 in Austin. 

With the adoption of resident duty hours in recent years, medical schools and residency programs have generally placed more restrictions on, and in some cases even prohibitions against, external moonlighting by residents. Both the TMA Council on Medical Education and its Committee on Physician Distribution and Health Care Access recently studied the issue. The groups acknowledge moonlighting is not for every resident. But for some, including the more senior residents, it can have substantial professional and personal benefits, they say. Residents can gain broader clinical experience in various practice settings and provide greater access to care for underserved communities. 

This work must be done in compliance with institutional guidelines defined by the sponsoring institutions, and residency program directors must serve in the critical role of assessing the competencies needed to balance residency training and moonlighting. 

Within these parameters, the new policy encourages medical schools and residency training programs to reconsider policies that impose strict limitations or prohibitions on moonlighting. 

The council’s full report is available on the TMA website.  

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TMA Renews Emphasis on GME Growth to Match Medical School Expansions 

TMA’s Council on Medical Education and Committee on Physician Distribution and Health Care Access asked the TMA House of Delegates during its annual meeting May 2 to adopt additional policies in support of an expansion of the state’s graduate medical education (GME) system. The growth is needed to respond to the projected 33-percent increase in medical school graduates expected by 2022, as shown in the graph below.   

In its report to the House, the council and committee also emphasized the need to build the state’s physician supply commensurate with the health care needs of the population. 

 grads

TMA adopted new policies at TexMed 2015 in support of:

  • An increase in GME capacity to achieve the target goal of 1.1 entry-level GME positions for each Texas medical school graduate;
  • Legislative efforts to provide additional state monies for GME expansions;
  • Continued state funding for residency positions for the duration of training;
  • Continued monitoring and reporting by the Texas Higher Education Coordinating Board on GME capacity in the state in comparison with medical school enrollments; and
  • Funding to the Texas Higher Education Coordinating Board to provide the needed administrative support for successfully implementing the GME expansion programs in a timely manner.  

Continued efforts are needed to increase the number of primary care physicians and psychiatrists in the state, including funding for the family medicine residency program; new community-based psychiatry residency track positions; and revitalization of the Statewide Primary Care Preceptorship Program.

Read the full report.

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 TMA Says No to Missouri-Style Assistant Physician Licensing Category 

At TexMed 2015, the TMA House of Delegates adopted a policy position that opposes any potential state legislation to establish an assistant physician licensing category. Missouri passed a law that established a licensing category for assistant physicians in 2014 with support from the Missouri State Medical Association. It requires only a medical degree, without a single day of residency training, to qualify an assistant physician for practice in an underserved area in “primary care,” under a collaborative arrangement with a fully licensed physician. 

In response, TMA adopted the following policy: 

The Texas Medical Association opposes the creation of special licensing pathways for physicians who have not completed a year of residency training. Further, TMA recognizes primary care as encompassing specialties that require the completion of a full residency training process in the relevant specialties. TMA opposes lower standards of licensing for physicians and other health professions in medically underserved areas.

Supporters of the Missouri law say it allows medical school graduates who are unable to match to a residency position an opportunity to contribute toward patient care in underserved communities. TMA’s Council on Medical Education recognizes there has been a recent increase in the number of graduates unable to match and is tracking this trend in collaboration with Texas medical school deans. 

For 2015, 40 Texas medical school graduates did not secure a match, slightly more than in 2014 when 32 were unmatched. Each medical school is expanding its efforts to help fourth-year medical students maximize their opportunities in the annual Match. And recently, the legislature approved $53 million for GME expansion grants over the biennium, up from the current $14.3 million, as noted in “Legislature Approves $53 Million for GME Expansions” in this newsletter. 

TMA acknowledges no proposals have been put forward for establishing an assistant physician licensing category in Texas. The House adopted the policy should such proposals be forthcoming.  

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Progress in Expanding Texas GME Capacity 

The 2013 Texas Legislature created several new grant programs to expand the state’s graduate medical education (GME) capacity. TMA’s Council on Medical Education took a look at the progress made to date in creating new positions, in collaboration with the Texas Higher Education Coordinating Board, the agency charged with administering the grant programs. A total of 195 GME positions are currently supported through the grant programs in 11 different medical specialties, as shown in the table below. In the first year of the biennium, 25 positions were supported. This increased to 170 in the second year. Almost half of the newly supported GME positions were in internal medicine, followed by 12 percent in family medicine, and 12 percent in psychiatry.   

GME1 Chart

 

As of April 22, 2015. Note: Percentages may not add to 100 percent due to rounding.
Source: Texas Higher Education Coordinating Board
Prepared by: TMA, Medical Education Department

Geographically, the highest percentage of funded GME positions is in Houston, with a total of 59 funded positions, or 30 percent of the state’s total, as shown in the table below. The Rio Grande Valley had the second highest number of funded positions, a total of 35 for Hidalgo and Cameron counties, for 18 percent of the state’s total.

gme2 chart


As of April 22, 2015. Note: Percentages may not add to 100 percent due to rounding.
Source: Texas Higher Education Coordinating Board
Prepared by: TMA, Medical Education Department

A total of 12 counties received funding for GME expansions during the biennium, including most of the state’s largest metropolitan areas. 

TMA’s advocacy efforts in conjunction with many partners won state legislative support for continued funding of these newly created GME positions and for even greater expansions during the 2016-17 state biennium. 

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 FSMB Offers Physician Assessment, Remedial Education Resource

The Federation of State Medical Boards (FSMB) Directory of Physician Assessment and Remedial Education Programs offers a valuable resource for physician assessment and remediation, including in the areas of clinical competence, mental health, substance abuse, ethics and boundaries, and prescribing and behavioral concerns. 

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USMLE Fact Sheet Outlines Changes to Medical Licensing Exam

If you’d like to keep up with changes to the United States Medical Licensing Examination (USMLE), check out the 2015-16 fact sheet that provides a step-by-step outline of what is different about the test and what will stay the same. The fact sheet will be updated as new information becomes available. To receive updates, subscribe to the USMLE Announcements RSS feed at www.usmle.org/announcements.  

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This Month in Texas Medicine

The June issue of Texas Medicine features a cover story on Congress’ permanent and immediate repeal of the flawed Sustainable Growth Rate (SGR) formula used for years to pay physicians who see Medicare patients. In the issue, you’ll also find the latest on litigation over the ownership of Knapp Medical Center in Weslaco, information about an initiative aimed at preventing 1 million heart attacks and strokes by 2017, findings from a report that reveals the toll gestational diabetes takes on the state’s Medicaid program, and vendor contract guidance for physicians in private practice. Check out our digital edition.

Check out our digital edition.

You can subscribe to RSS feeds for TMA Practice E-Tips, TMA news releases, Blogged Arteries, and Texas Medicine. More

It's Academic is for physicians in academic settings. For more information about TMA’s efforts on behalf of medical education and academic physicians, visit the TMA Council on Medical Education’s Subcommittee for Academic Physicians page and Advocacy page on the TMA website.

Please share with your colleagues who are not TMA members and ask them to join.

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    The State legislature is unable to support the existing medical schools adequately. Another institution, no matter where it is located, would put more unnecessary strain on already stretched finances. Find the money to treat the ones you have better before straining draining resources.
    William E. Powell, M.D.

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