IU, Marian set to launch wave of docs

Between the new Marian college of medicine and an enrollment expansion at the Indiana University School of Medicine, the state will see 88 percent more med students by next fall.

The key issue then will be whether they stay in Indiana once they become physicians.

Despite state funding that was slow to materialize, the IU medical school has quietly been expanding its incoming classes, even with the opening of the state’s second medical school set for later this year.

IU has added about 70 more students at its eight satellite campuses around the state, boosting its newest incoming class to about 350 total. It will enroll 364 students by fall 2014, and IU intends to maintain that size going forward.

Marian’s College of Osteopathic Medicine, meanwhile, will enroll 162 students in its first year after receiving a flood of applications.

Together, the two medical schools will enroll 526 students per year—up from the 280 the IU medical school had enrolled each year before it began expanding.

Dr. Craig Brater, the dean of the IU medical school, said the flood of new students should turn into enough doctors to stem the state’s physician shortage.

But success hinges on having more hospital systems around the state add or expand residency programs. Medical school graduates must complete such programs—typically lasting about three years—before they are able to practice on their own.

“The chokepoint is the residencies,” said Brater. “So if we can get more residencies online, then I think we’ll be fine.”

Brater cited an effort already under way in Lafayette, where two hospital systems are working to add residency programs to serve a growing number of medical students being trained there.

In 2006, the IU medical school conducted its own analysis of physician needs in Indiana. It found that Indiana was short by about 3,500 physicians and that that gap would persist at least through 2025.

The school used that study to lobby the Legislature for $5 million per year in extra funding to expand medical training in Indiana.

Lawmakers eventually approved $3 million per year, but that money was held back by Gov. Mitch Daniels due to falling state revenue.

The IU medical school received $1 million from the state toward its expansion last year and will receive $3 million this year. It also has received $4.2 million in funding from the Indiana University Health hospital system, which is separate from the IU medical school.

Brater said IU was able to expand even without much state aid because it already had the satellite campuses and faculties in place in Bloomington, Evansville, Fort Wayne, Gary, Muncie, South Bend, Terre Haute and West Lafayette.

Although all students from those campuses used to come to Indianapolis for their third and fourth years, now they can remain at a satellite campus for their entire third year and then, perhaps, do their practical work outside of Indianapolis in their fourth year.

“The reason is we already had the infrastructure,” Brater said. “We haven’t had to hire any new faculty. We were able to build it on the margin.”

Another key test for meeting Indiana’s physician needs will be the percentage of medical school graduates that go into primary care.

Over the past two decades, reductions in reimbursement for primary care, coupled with higher debt loads for medical students and a desire to work manageable hours, have pushed more medical students away from primary care.

Marian’s medical school hopes to address that need, since graduates of osteopathic medical schools tend to go into primary care at higher rates than graduates of allopathic medical schools, such as IU.

Brater said IU is doing its part, too, trying to sign up more primary care practices near its satellite campuses to show that doctors can go into primary care and still work manageable hours.

“The number one factor is the perception of lifestyle," Brater said of reasons med students shun primary care. “Part of the challenge is pairing up people with a primary care person to see that you can still have a life.”