About half of the future doctors graduating this year from the LSU medical school in New Orleans discovered Friday they will remain in Louisiana for residencies, but school leaders said more would have stayed if not for the looming threat of devastating state budget cuts to health care and higher education.
In recent years, medical leaders have pointed out to state lawmakers that Louisiana residents — already plagued with more health woes than people in other states — are growing older and sicker while their doctors are aging as well.
Keeping medical school students in the state for their medical residencies increases the likelihood of them staying and becoming people’s future family doctors and specialists. But in the weeks leading up to Friday, Steve Nelson, dean of the School of Medicine at LSU Health New Orleans, said a number of anxious students asked him if they should go elsewhere, given Louisiana’s grim budget situation.
He told them he was confident the state government would find a solution. But he could not guarantee it.
“The people here are very passionate about their state; they really love Louisiana. They would prefer to stay here if they can,” Nelson said. “If they want to go (out of state) because they want a difference experience, that’s one thing. But we don’t want them to go because they think they have to go in order to become the doctor they want to become.”
The result was that 51 percent of the medical school’s 182 graduates decided to stay in Louisiana, a total that Nelson was still pleased with, though the percentage is down from previous years. Last year, 56 percent stayed in Louisiana for residencies, and the figure has been as high as 63 percent in 2012.
At Tulane University, 21 of the 24 in-state students who are graduating this year will complete their residencies in Louisiana. Tulane had a similar size graduating class to LSU Health New Orleans. Forty percent of the 109 seniors at LSU Health Shreveport will complete at least part of their residencies in Louisiana.
On the receiving end of residencies in Baton Rouge, Our Lady of the Lake, Baton Rouge General, Woman’s Hospital and Oschner Health System all celebrated the new classes of doctors that will start training with them in July.
At Our Lady of the Lake, about 100 current residents and staffers crowded into a lecture hall as their future colleagues were announced with videos and fun facts.
Our Lady of the Lake officials touted that all of its residency programs had maxed out and that more than 50 new residents — from medical schools in state, out of state and as far-flung as the Caribbean and Australia — would be joining its programs. They include doctors specializing in psychiatry, internal medicine, emergency medicine, general surgery, otorhinolaryngology and pediatrics.
Our Lady of the Lake has about 192 residents rotating through its program on any given day.
“To train our own and keep them in our community is a great thing,” said Kathleen Crapanzano, Our Lady of the Lake’s program director for psychiatry.
Baton Rouge General filled its 10 residency spots for internal medicine and eight residency spots for family medicine.
Woman’s Hospital filled all four of its OB-GYN residencies with matches Friday, while the Ochsner Health System also received more than 60 matches for all of its facilities.
Medical school and residency leaders say they are especially trying to address the state’s doctor shortages in primary care. Nelson said LSU created a rural tract for students who are interested in practicing in rural and underserved communities.
They also expanded the New Orleans medical school with programs for third- and fourth-year students to do clinical rotations at hospitals in Baton Rouge and Lafayette.
Nelson said the training medical school students and residents are exposed to largely affects how they will practice, which shows the importance of exposing future doctors to both rural and urban environments.
Half of the LSU Health New Orleans graduates are entering primary care residencies.
“If there’s one goal of doing all these things, it’s to grow the primary care base,” said Kevin Reed, the LSU medical school’s associate dean for the Baton Rouge campus. “The key to really good, effective health care is to have the primary care quarterback for it.”
One of the ideas that some believe could increase the number of primary care physicians is to build a medical school in Baton Rouge. The Baton Rouge Area Foundation has commissioned a feasibility and economic impact study about building such a school that Pittsburgh-based consulting firm Tripp Umbach is performing.
The medical school is one of the components of BRAF’s proposed health district, where all of the city’s hospitals would come together for increased research and a designated hospital corridor in the Essen Lane/Bluebonnet Boulevard/Perkins Road area.
BRAF’s research on the creation of the medical school focuses on the possibilities of expanding the two-year LSU program in Baton Rouge into a full, four-year medical school or building an independent and different medical school. One derivation of the second option would be an engineering-based medical school with doctorate programs that focus on bio-innovation.
State Sen. Dan Claitor, R-Baton Rouge, said he wants to turn the idea of a medical school in Baton Rouge into a reality. But he questioned if the state should be the one responsible for running it and funding it, given the state’s cuts to its two publicly funded medical schools already.
“I don’t want to go down the path that we’re looking around the state like we’re doing now with universities and saying, ‘Look at all of this duplication of effort,’ ” Claitor said.
He added that he would be interested in seeing the private sector come together naturally to build on it or that maybe a partner like Tulane could step forward.
“We have not yet discussed or explored Tulane’s involvement in any proposed medical school in Baton Rouge,” said Lee Hamm, senior vice president and dean of Tulane School of Medicine, in a statement.
Nelson said it would be more financially prudent to expand on LSU Health New Orleans’ two-year program in Baton Rouge instead of building a medical school from scratch. But as far as the LSU medical school taking the lead on it, he said the school has more active needs right now, like its funding and partnerships, that are taking the priority.
He also worried that the number of medical school students graduating could outpace the number of residency spots available each year. Right now, about 1,000 graduating medical students nationwide already are unmatched.
Warnings about health care shortages already have caused medical schools to increase class sizes. More students also are pursuing degrees at newer osteopathic medical schools and medical schools in foreign countries, particularly in the Caribbean.
“You have more and more people competing for a number of positions that, at some point, are going to max out if they aren’t funded,” said Charles Hilton, the associate dean for academic affairs at LSU Health New Orleans.
As a whole, Hilton said the high number of residents already practicing in Baton Rouge prompts the question as to what added benefits the city could glean from building a four-year medical school.
“You’re getting most of the benefits without the headaches,” he said.