North, south disagree over Rogers’ med school plans

Thursday, Oct. 21, 2004 | 9:38 a.m.

Interim Chancellor Jim Rogers' proposal to expand the University of Nevada School of Medicine in Las Vegas through a UNLV and UNR partnership is being met with enthusiasm in the south and skepticism in the north.

UNLV officials say they see multiple benefits from replicating the Reno medical school's first two years of basic science work in Las Vegas, but UNR officials say they are concerned that the proposal isn't financially feasible.

The state would have to invest 10 to 20 years and untold millions to be able to offer the initial medical school coursework in Las Vegas, said Dr. John McDonald, medical school dean, and citizens might be better served if expansion efforts remained focused on the clinical training.

"We've made a very significant investment in biomedical facilities, faculty and staff, and biomedical equipment in Reno," McDonald said. "That would all need to be replicated (in Las Vegas) to replicate the student experience."

Ray Alden, UNLV provost, and Paul Ferguson, UNLV vice president of research and graduate studies, say they are excited about the proposal primarily because it seeks to resurrect the long strived for but never realized plan to build an academic medical center in the city.

The partnership would allow UNLV and UNR to coordinate all of their health sciences offerings together in one location to better meet the health needs of the state, UNLV Provost Ray Alden said,

The proposal would also allow both institutions to expand their biomedical facilities and faculty and bring in more research dollars, Alden said.

"We think this is a very important concept," Alden said. "Obviously it is something that will take some time to develop but I think it is something that can be done in real time considering the importance to the citizens of Nevada."

UNR officials said they too can see the potential of the proposed partnership but are significantly less "ambitious about what can be done in the short-term," McDonald said. UNR has already requested $12 million to $14 million in budget enhancements from the state that will be used to expand clinical offerings in Las Vegas and to improve biomedical facilities in Reno.

Rogers, who said he was still reviewing UNLV and UNR's responses, based his proposal on a memorandum of agreement recently signed by the University of Arizona in Tucson and Arizona State University in Tempe. Rogers has also been working on what he says will be a major private-public partnership to expand the medical school locally.

The Arizona agreement maintains the University of Arizona as the state's only medical school, but it allows students to take the basic science courses in both Tucson and Tempe. A planned academic medical center would further promote collaborative research between the two universities.

The majority of medical students in Arizona currently do their first two years of basic science work in Tucson and then move to the Phoenix area to do two years of clinical work.

All Nevada medical students do their initial coursework in Reno and then travel around the state for their clinical rotations, Dr. Jennifer Kimmel, assistant dean for medical education, said.

Students spend at least 14 weeks doing surgical and obstetric rotations in Las Vegas and one month in rural rotations, but may choose between Las Vegas, Reno and Elko for the rest of their clinical work, Kimmel said. About half of the students choose to work in Las Vegas.

Currently, UNLV's role in the medical school is limited to leasing space to a few researchers, McDonald said. The school of medicine's extensive clinical presence in Las Vegas is instead made possible through partnerships with the Clark County-run University Medical Center, the Veterans Affairs Medical Center and Sunrise Hospital and Medical Center.

McDonald said there is an immediate possibility for medical school staff in Las Vegas to work with UNLV professors on research efforts and for both universities to collaborate more on issues of public health.

Collaborations with UNLV's existing programs in physical therapy, radiology, dentistry, nursing and public health could also aid the medical school in its mission toward changing its "model of care" to a more team-orientated approach, McDonald said.

Under this new approach, the medical school would train doctors to be "quarterbacks for care," organizing the treatment of patients with chronic conditions with several other health providers, McDonald said. For a patient with diabetes, for instance, the main doctor would work with a nutritionist, ophthalmologist, podiatrist, endocrinologist, nurse and pharmacist to make sure the patient is getting coordinated care.

But McDonald also questioned whether UNLV currently has the biomedical capabilities to partner with the medical school, especially in order to offer some of the initial course work.

Ray and Ferguson, however, said UNLV has made significant strides in its development of biomedical research and improved partnerships will only increase those offerings. Both said that UNR's arguments against the plan, including the funding problems, are red herrings.

UNLV opened its 18-acre Shadow Lane campus this past year, which includes facilities for the dental school and biomedical research, and is working toward earning research extensive status, the highest ranking possible, by 2010, Alden said.

The university has brought in 13 National Institute of Health grants amounting to $3.4 million since 1999, Ferguson said.

In UNLV's response to Roger's proposal, officials also list its research and service programs in medical records, medical technology, cancer research and its new school of public health as offerings the institution could bring to the table.

"Between UNLV and UNR we have all the major divisions of health sciences ... all here in Nevada we just need to integrate it in an efficient way," Ferguson said.

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