Symposium on Medical Education — February 2016
By Rep. John Zerwas, MD
As physicians, we all share the common, formative experience of graduate medical education (GME). The time we spend in residency shapes our future and has an impact on our professional careers. I was fortunate to complete my residency in San Antonio; it is hard to imagine what roads my life would’ve taken had I been forced to complete my residency in another state.
Many Texas medical students face the possibility that their residency must be completed outside of Texas. Research indicates up to 50 percent of students who leave Texas for their residency do not return. On the contrary, of students who complete medical school and residency in Texas, close to 90 percent choose to remain, practicing relatively close to the area in which they completed their residency.
For a multitude of reasons, GME is a resource, investment, and process the state of Texas must continue to find a way to maintain and grow. The most paramount concern is addressing the statewide ratio of physicians to the general population, which is approximately 170 physicians for every 100,000 people, a number that is even lower in our state's underserved areas.
Through my past legislative experience serving on the House Committee on Appropriations as chair of the Health and Human Services Subcommittee, as well as the House Committee on Public Health, I have had the opportunity to work on many areas of health policy and budget that are in dire need of our state's financial support. This past legislative session, I made it a priority to continue to build on the legislature's commitment to GME by sponsoring Senate Bill 18.
SB 18 promotes GME expansion and places emphasis on Texas' most critical shortage areas. The goal of this legislation is to ensure that a residency slot is available for every Texas medical school graduate, with the ultimate goal being to achieve a 1.1 to 1 ratio of residency slots to medical school graduates. The bill encourages nonhospital entities, such as rural community clinics, to provide new residency programs by allowing them to partner with schools and hospitals to navigate the accreditation process. This bill also combines and streamlines existing residency expansion programs. Finally, SB 18 establishes a long-term funding source by creating a permanent endowment to support GME.
The state budget also provides $53 million for GME expansion programs to increase the number of first-year residency positions.
In January 2017, when the next legislature will convene and again consider the state's level of support for GME, three new medical schools — The University of Texas at Austin Dell Medical School, The University of Texas Rio Grande Valley Medical School, and the joint MD program administered by the University of North Texas Health Science Center and Texas Christian University — will be close to opening their doors.
The state of Texas must prepare for and invest the appropriate resources so all of those medical students are able to complete their residencies in Texas. As I prepare for the next session, not only will I continue to advocate for continued GME support and growth, but I will also maintain my full support for Texas doctors.
Rep. John Zerwas, MD (R-Houston), is one of four doctors in the Texas House of Representatives. Dr. Zerwas serves as chair of the House Committee on Higher Education.