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Medical school falls short of mission of producing doctors to stay in state

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opinion Fargo, 58102
West Fargo Pioneer
(701) 241-5487 customer support
Fargo North Dakota 101 5th Street North 58102

Chapter 15-52 of the North Dakota Century Code states that "the primary purpose of the University of North Dakota School of medicine and health sciences is to educate physicians and other health professionals and to enhance the quality of life in North Dakota."

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As parochial as this may sound, the only reason North Dakota started a medical school was to "enhance the quality of life" by producing doctors who would practice in North Dakota. Unfortunately, most of the graduating students are not staying here. Case in point: of the 55 students who were graduated last year, only seven are doing their residency in North Dakota.

This is a disastrous situation because students who leave the state to do their residency seldom come back. This large outmigration means that the medical school is serving the rest of the country more than it is enhancing the quality of life in North Dakota.

Before the present legislative session, the school asked for an appropriation of $29 million for a new building so that it could increase the number of students. The Board of Higher Education cut this request to $1.8 million with instructions to train more doctors but without any new construction

Before the board or the legislature will approve more construction, the medical school will have to demonstrate that it can raise the number of in-state residencies significantly. And with five times more applicants than openings, the school is in a strong position to dictate residency requirements, e.g. more in-state residencies with better distribution throughout the state. 

Instead of begging out-of-state students to stay in North Dakota, we should be recruiting and admitting more students who do not need to be sold on the North Dakota lifestyle. We need to make it known across the state that all qualified students - especially those without the money - can think of going to medical school and then put up the scholarships and incentives to make it happen. 

Statistics indicate that medical students born in North Dakota are at least 10 times more likely to practice in North  Dakota  and students doing their residency in North Dakota are hundreds - yes, hundreds - of times more  likely to stay.

The medical school also has to deal with a political problem. If it expects more money for buildings or programs down the road, it will need to bring the whole state into its program planning, development and implementation. Unless this is done, western legislators will have little reason to support construction money or anything else for a Red River Valley institution. 

The state law provides for a 15-member advisory council but the council is of little help because it doesn't represent the whole state very well. This was the judgment of Board of Higher Education Chancellor Bill Goetz when he proposed the formation of a new committee to study the situation. When asked why he didn't use the existing advisory council, he said he wanted better representation from other parts of the state.

With an old population growing older, North Dakota is seeing Medicare and Medicaid grow by leaps and bounds. The need for doctors throughout North Dakota is becoming more critical as each year passes.  New strategies to recruit and keep doctors are sorely needed. Seven out of 55 tells us that.  

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