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In business education regent fuels north-south tension in call for med school By Paul Takahashi staff writer Regent Mark Doubrava's proposal for a new medical school at UNLV likely will exacerbate longstanding north-south tensions in higher education amid a fierce debate over equitable funding for Nevada's seven colleges and universities. Doubrava — a local ophthalmologist who specializes in cornea transplants — recently announced his plans for Nevada's higher education leaders to explore the possibility of a second statefunded medical school that would exclusively serve Southern Nevada. Currently, four-year medical students at the University of Nevada School of Medicine — located at UNR — complete their classwork in Reno during their first two years of study. Some students then move to Las Vegas to complete their medical clerkship at University Medical Center during their final two years. Despite recent efforts to increase the medical school's presence in Southern Nevada — from purchasing a house in Las Vegas for Dean Tom Schwenk to proposing a $220 million academic center near UMC — the Nevada System of Higher Education hasn't done enough for the medical and patient communities in Southern Nevada, Doubrava said. A medical school at UNLV would help solve Las Vegas' doctor shortage and improve the quality of health care in the state's population center, Doubrava said. "It's difficult for a Reno (medical school) program 450 miles away to service the needs of and integrate in the (Las Vegas) community," he said. "Because of its clinical activity at UMC, the Reno school of medicine has a foot in Clark County. But it has no legs, no heart, no vision (in Las Vegas)." nnn When the University of Nevada School of Medicine was created in 1969, there was debate over where the state-sponsored medical school should be located. At the time, Las Vegas had a population of about 300,000 while Reno had a population of about 120,000. Because UNLV was just 15 years old at the time, the decision was made to open the medical school at UNR, the state's land-grant university founded in 1874. However, as Las Vegas continued to add population exponentially and became the economic engine of the state, the lack of a medical school dedicated to Southern Nevada became troublesome, Doubrava said. Las Vegas, which today has a population of 2 million people, is the only major U.S. city of its size without a traditional | 15 APRIL 2013 20130415_VI17_F.indd 17 | leila navidi speaking from experience: Dr. Mark Doubrava is an advocate of building a second medical school in the state -- one that would serve Southern Nevada. public, M.D.-granting medical school. The closest public medical school is in California, at University of California's Riverside campus. (Touro University Nevada, with its campus in Henderson, is a private medical school that grants doctor of osteopathic medicine degrees.) Medical schools are often a positive catalyst for the communities they serve, Doubrava said. They spawn innovations in health care as a result of university medical research. They often have free or low-cost clinics that boast equipment normally too specialized and expensive for local physicians' offices. The school could attract biotechnology companies and other medical companies to Southern Nevada. A UNLV School of Medicine also could bring more federal research dollars to the state. Medical tourism could be the next big economic boost for Las Vegas, already an entertainment destination for millions of people around the world. "That's pretty much a no-brainer," Doubrava said. A medical school in Las Vegas also may help more local students become doctors and surgeons, said Doubrava, a UNLV graduate who went to the University of Nevada School of Medicine. nnn Representatives in higher education, the Legislature and the medical community seemed open to discussing Doubrava's proposal but expressed some skepticism over the cost and effort of starting a new medical school at UNLV. Doubrava said he doesn't know how much a UNLV medical school would cost. The UNR medical school has an annual operating budget of about $160 million, about $30 million of which comes from the state. Board of Regents Chairman Jason Geddes said it would be difficult to ask the Legislature to fund a second medical school in the state. Gov. Brian Sandoval requested a flat budget for higher education over the next two years, and he didn't grant a $40 million request by regents to restore faculty pay that had been cut in the recession, Geddes said. "We have a lot of needs in this state for higher education," said Geddes, a UNR graduate. "How do we balance all of those needs?" nnn Chancellor Dan Klaich said serving the health care system in Southern Nevada was "absolutely critical" for the Nevada System of Higher Education. Although Klaich agreed UNLV must be involved in improving medical education in Las Vegas, the UNR graduate questioned the need for a second medical school in the state after five years of severe budget cuts. "I personally don't think it's the best answer," said school of medicine dean Tom Schwenk. "I think I can run an excellent school of medicine that can serve the whole state." Schwenk favors one medical school with campuses in Reno and Las Vegas that complement each other. Although accreditation may be tricky, the twocampus solution would allow students to gain experience in both rural and urban medical settings, he said. needed more doctors. However, building a medical school wasn't the way to do it, Hardy said. "The way to get more doctors is to have more residencies," he said. "What we need is more clinical rotations." Statistics show that cities only keep half as many doctors with a medical school, Hardy said. However, many doctors decide to settle down in the community where they serve their three- to seven-year residencies, he said. However, by 2016, the number of medical students will outweigh the number of residency slots in Nevada, which means students will be forced to look out of state for residency opportunities, Hardy said. nnn Doubrava understands he may be bringing up simmering north-south tensions with his proposal but said he was adamant there needed to be a separation between Northern and Southern Nevada when it came to medical education. "Any potential research dollars and benefit that the Southern Nevada campus would generate gets funneled to Reno as credit towards their status as a tier-one university. What Reno will continue to do is browbeat UNLV and say, 'We're the flagship land-grant institution. We've got the med school.' That's got to stop." Southerners are wary of donating to the medical school, fearing it will go to Reno. Northerners are skeptical of their donations going to Las Vegas, Doubrava said. "It doesn't matter how great of a dean you have, in this current structure, it's not going to work," Doubrava said. "We don't get along because we don't have the same vision up north." Latin Chamber of Commerce EXPOSURE REFERRALS LEADS nnn State Sen. Joe Hardy, a longtime doctor from Boulder City who recently became a professor at Touro University, agreed with Doubrava that Las Vegas (702) 385-7367 lvlcc.com 17 4/11/13 2:58:50 PM