Budgets pinch med schools

With a newer school at FSU and others coming to UCF and FIU, the state's decades-old programs seek a "fair share."

By Shannon Colavecchio-Van Sickler, Times Staff Writer
Published February 11, 2008

TAMPA - The state leaders who embraced new multimillion-dollar public medical schools in Orlando and Miami insisted their creations would not diminish Florida's investment in existing medical schools.

But two years later, Florida's public university system is losing tens of millions of dollars because of a statewide revenue shortage. And the state's oldest public medical school is in trouble with national accreditors because its state funding has dropped as enrollment climbed - leaving its lecture halls and student clinical facilities overcrowded.

"Our accreditation's in jeopardy," said University of Florida medical school dean Dr. Bruce Kone. "It's a real crisis, and we need some tangible evidence that the state is going to increase its support."

So as the legislative session nears, UF and University of South Florida officials are lobbying hard to make sure their decades-old medical schools don't suffer so the newer ones can flourish.

They want about $16-million more each year in state money - $9-million for UF and $7.4-million for USF - to put themselves on more equal footing with the medical programs at Florida State University, the University of Central Florida and Florida International University.

Moreover, UF and USF administrators want the state to develop a policy that ensures all public medical students enjoy the same state investment in their education, no matter which school they attend.

"We're not asking them to take away money from other medical schools," Kone said. "We're asking them to grow the pie and give us our fair share."

Tough budget year

Kone and UF president Bernie Machen met with state House Speaker Marco Rubio last month to talk about their concerns. Kone also met with the governor's chief of staff and Senate President-designate Jeff Atwater. Rep. Joe Pickens of Palatka visited the medical school last month.

Meanwhile, USF president Judy Genshaft has repeatedly declared medical school funding one of her priorities for the legislative session that begins March 4.

But now is not the best time to be asking lawmakers for more money. Florida's budget is bleeding red, with an expected $2-billion deficit for the 2008-09 year.

"Everything is going to be tough this year, and that's a capital EVERYTHING," Pickens said. "I certainly agree that UF is deserving of some additional funding, and I think USF is probably in the same boat. But nothing is going to change the fact that this is a difficult budget year."

And there appears to be no turning back on the fledgling medical schools at UCF and FIU. Administrators are hiring faculty and planning ambitious curricula. Last week they got the green light to recruit their first student classes.

UCF and FIU split $10-million in startup money from the state last year and are asking for an additional $18-million this year, for a total of $28-million - a request endorsed by Gov. Charlie Crist.

The schools are expected to cost $500-million over the next decade. Supporters say the investment is worth it because the schools will produce much-needed doctors in a growing state with many elderly residents and families.

"We've been given some very strong, positive support," said Steve Sauls, vice president for government relations at FIU. "Am I concerned about the funding for universities this coming year? Yes. But I believe it's all about economic development, and this medical school for us is a major economic development initiative."

Critics argue the best solution to a doctor shortage would have been to increase the number of residency slots, since many doctors settle down where they complete their residencies - not necessarily where they graduate from medical school.

Just 14 percent of Florida's doctors graduated from a Florida medical school.

Uneven spending

Meanwhile, the state is still spending millions to build up the medical school it approved seven years ago amid much controversy and political maneuvering.

Since 2000, the state has spent $200-million for the college of medicine at FSU, an initiative so contentious it triggered the dissolution of the state Board of Regents, the university system's former governing board.

FSU's $43.9-million in state dollars this year translates to about $120,000 for each of its 357 students. Enrollment will be capped at 480 students by 2010.

In contrast, UF gets less than $30,000 per student from the state, even though it costs the medical school $73,000 a year to educate each aspiring doctor. The average cost nationally of educating a medical student is $58,267.

USF gets slightly more than UF per student, though administrators could not provide an exact figure.

For the rest of their operating costs, the two schools rely on student tuition and revenues from faculty medical practices.

The newer programs get most of their annual operating dollars from the state.

UF has increased its enrollment by 25 percent to 540 students in the past five years, yet state money dropped by 40 percent during that period, Kone said.

National accreditors sent UF a letter this summer warning that if state money continues to decline, "it is likely to compromise the quality" of the medical school. They said lecture halls are too crowded and the library resources "challenged."

UF and USF officials say they just want a common funding formula that levels the playing field for all of the schools and their students.

"Both USF and UF have received reductions in general revenue in the past few years," said Patricia Haynie, associate vice president for USF Health. "The concern we have is that, with the development of additional medical schools, there might be additional reductions. The fact is there are now several schools, and each needs a certain amount of base state funding to satisfy accreditors."

Kone said his medical school's dependence on revenue-generating medical practices puts too much pressure on faculty who should be focusing on teaching and research. UF has hired more nontenure-track medical school faculty - practicing doctors, not professors - who can teach students while bringing in revenue to support the medical school's operations.

"Our research is suffering," Machen said.

The number of UF clinical faculty jumped from about 330 to 611; tenured and tenure-track faculty dropped from 632 to 565.

"Clinical faculty are not engaged in academia and research," Kone said. "We're fast going from a flagship medical school to a trade school."

Shannon Colavecchio-Van Sickler can be reached at svansickler@sptimes.com or 813 226-3403.