Make Sure GME Capacity Mirrors Enrollment Growth

TMA Testimony by Cynthia Jumper, MD

Senate Higher Education Committee
Senate Bill 1378

March 27, 2019

Thank you, Chairman Creighton and committee members, for allowing me to testify today. My name is Dr. Cynthia Jumper, and I am a pulmonologist from Lubbock. Today I am testifying on behalf of the Texas Medical Association and its nearly 53,000 members across the state of Texas in support of Senate Bill 1378.

Following are some points I’d like to discuss with you today.

  • SB 1378 fixes an unintended weakness in an otherwise very good law. Last session, SB 1066 was passed to require new public medical schools to plan for the graduate medical education (GME) needs of their future graduates. This legislation provides an important link between medical school enrollments and GME capacity.
  • It makes no sense to enroll medical students who will likely have little chance of staying in the state for their residency training when they graduate from medical school due to a shortage of GME. We will simply be setting up medical schools to provide physicians for other states. I say this because of the strong relationship between where a physician trains and where they enter medical practice. Most physicians begin their medical practice within 100 miles of where they do their GME. 
  • This helps to demonstrate how important it is to have ENOUGH GME positions for Texas graduates. Medical schools do NOT produce physicians ready for practice, GME does.  
  • Through your leadership and support, Texas has reached the state’s target ratio of 1.1 to 1 for the number of entry-level GME positions for each Texas graduate. This is an important achievement. It took hard work to get here, and we do not want to lose the progress we have made. 
  • The weakness in an otherwise very good law is that it requires new medical schools to plan ONLY for the GME needs of their inaugural class. This is short sighted and this is what SB 1378 will fix. Allow me to explain:
  • It is rare for a medical school to start out with a large class, they typically start smaller and build up.
    • The Texas Tech University Paul L. Foster School of Medicine in El Paso currently has a class of 100. This is two and a half times more than their inaugural class of 40.
    • University of Houston plans to open with 30 students in 2020 and add 30 for each of the subsequent three years to reach 120 students – this is four times their inaugural class. 
    • The Texas Christian University/University of North Texas partnership for a new medical school in Fort Worth has also announced plans for future growth.
  • As the current law reads, it requires new schools to plan ONLY for the smaller initial number, which our examples show can be one-fourth of the target enrollment – this means we would fall far short in planning for the state’s GME needs.  
  • We cannot afford that kind of shortfall. The state invests about $180,000 in state formula funding for each student over four years of medical school – we do not want that investment to be used to train doctors for other states.
  • SB 1378 is a simple fix. Please require our new medical schools to plan for their FULL class size by passing SB 1378. 

Thank you for allowing me the opportunity to speak before you today.

Last Updated On

March 26, 2019

Originally Published On

March 26, 2019