The University of Texas Rio Grande Valley

UTRGV School of Medicine

“I want to put a ding in the Universe.” - Steve Jobs

What do a Brent’s, a Hopcroft-Karp, and a Mersenne Twister have in common? They are all computational algorithms, but none are as important in the life of a medical student as the algorithm in the big computer in the sky responsible for Match Day. On Match Day, after 4 years of college and 4 years of medical school, students finally find out where they will train as a resident physician for the next 3-7 years depending on the discipline of their choice. The 2015 Match saw 41,334 total applicants competing for 30,212 positions in 4,756 programs. One of the trends noted is that the number of medical students committing to primary care rather than medical subspecialties increased for the fifth straight year and this year UTRGV is in the mix – (see our recent news release on Match Day) -making a big ding out of UTRGV’s thing … our primary care focus. 

UTRGV programs are focused on the future, making outstanding doctors to be in the frontline of care. Doctors in primary care diagnose and treat physical illnesses, manage chronic ones, teach prevention, and detect-treat-triage mental illnesses and addictions – the essence of integrated care. Though more physicians will be needed in all fields, by the time UTRGV School of Medicine graduates its fifth class of medical students and celebrates its 10th anniversary the current shortfall of primary care doctors as will soar to 70,000.

While dinging, expanding our existing residency training programs and ringing in the new academic year with four new residency training programs, what kinds of things does the UTRGV School of Medicine Dean think about?  Here are a few: What was the cost of medical education to these new trainees arriving in the Valley and entering into their professional life? What is their debt as they enter this last phase of training? We worry about having enough residency training spots for students, but what about the financial burden on the students? Before the match, is debt an undue coercive influence on their choice of medical discipline? What about after the match or later? Will these students wonder if they made the right choice entering primary care?

So nationally how we all try to  make a ding on this thing? Well, what about providing tuition relief and ideally considering a debt free class? You might wonder why medical schools should consider these options.

  1. In the third and fourth years of medical school, students are an integral part of the care team. To name a few, they draw bloods, they start life-saving intravenous and arterial lines, they suture wounds, they deliver babies, and they counsel and support those in distress (be they patients or family members).
  2. Many will have spouses and some will be buying houses and having children.
  3. Scholarships help and loans are obligatory – but the debts from these loans are burdensome for years to come.

You can easily see why choice of specialty may be influenced by debt. All options should be on the table to facilitate entry into primary care. All should therefore try to enhance any strategies that, beyond scholarships, provide tuition relief. For example, in addition to philanthropic efforts, extending the American Opportunity Tax Credit to apply beyond college to a medical education and receiving a partial rebate for tuition in 3rd and 4th years would be possible strategies. The rebate concept is no different than that established by sponsorchange.org in certain venues. In essence, through volunteerism, college graduates donate their skills and experience to assist with non-profit projects in exchange for student loan repayment. Medical students have limited if any time to volunteer and a rebate seems reasonable. Educationally, using non-traditional instructional formats resulting in cost savings without jeopardizing quality education should be formalized and researched. In the private sector, more favorable interest rates or requiring service obligations are helpful. At the legislative level, one could support any and all efforts to support stable funding for medical education to limit tuition increases. And, this last one will require major regulatory changes but if one could complete graduation requirements in medical school early, rolling acceptance into residency training to start working and earning money sooner rather than later makes sense too.

And there you have it, my perspective for dings in our Universe. But as per the dinger of life, Yogi Berra, once said while giving directions, “It's not too far, it just seems like it is."

Felicidades to all our UTRGV residents and their families!

Dr. Francisco Fernandez
Inaugural Dean, School of Medicine and Vice President for Medical Affairs