Maritza Garza never wavered in her desire to come back home.
As a youth, the 32-year-old had already mapped out her plan to pursue a career in medicine. Her parents still have keepsakes from the first grade, when she stated her intent to be a doctor. She followed through with that goal by attending summer biology camps and volunteering in high school at local hospitals.
With limited higher education opportunities available locally, however, Garza’s path from McAllen Memorial High School eventually carried her out of the Rio Grande Valley — first to a biology degree at St. Mary’s University in San Antonio and then, after a brief break, onto medical school at the University of Texas Health Science Center at San Antonio.
But when Garza was surveying her next step after finishing up at San Antonio, she and her husband, a nurse, settled on a return to the Valley.
And when Garza finishes the third year of her family medicine residency program next summer, she intends to remain close to home.
“What I had always wanted to do was go out, get educated, get my medical degree and then come back,” Garza said during a brief break at her shift at McAllen Medical Center, where she was waiting to deliver a baby after a long day spent at the residency program’s clinic. “Our goal was to do that and see what opportunities were there.”
If one word could sum up the value that the Valley’s first medical school will bring when it opens its doors in the fall of 2016, it’s opportunity. For good reason, the medical school has been lauded for its potential to transform the Valley’s economy by creating high-paying jobs, attracting new industry and drawing in research funding.
But strip away those benefits and you’re left with the medical school’s core mission: Educating the next generation of health care professionals. In a place like the Valley, which lags far behind the state and national average for physicians per capita, the net benefit of the medical school’s impact on healthcare here is nearly unquantifiable.
“If you look at the number of physicians per 100,000 lives, we have to catch up in the Valley, but it’s difficult to catch up (with population growth in South Texas and the difficulty of recruiting doctors),” said Dr. Francisco Gonzalez-Scarano, the dean of the Health Science Center’s school of medicine. “To me, the principal reason for building a school in the Valley is the enormous social value it will have in elevating the quality of care and bringing new physicians to that area.”
A CRITICAL SHORTAGE
The practical effect of a medical school is visible each summer in San Antonio.
In July, more than 200 entering medical students of the Class of 2017 attended the Health Science Center’s White Coat Ceremony, where medical school faculty cloaked their profession’s signature garb on each incoming student. The ceremony, mirrored at most other schools, signifies the students’ official introduction into medical school and a career in medicine, but it’s also a clear picture of the next generation of physicians who will fill a critical need in their communities.
There are only 165 doctors for every 100,000 residents in Texas, much less than the national average of 240 doctors per 100,000 residents, according to the Association of American Medical Colleges. But in a dozen South Texas counties that include the Valley, the ratio falls to 124 doctors for every 100,000 residents – and it’s even worse in rural areas.
With an average physician age of 57, decades above the median age for the overall population, the need for physicians in the Valley will only grow.
The shortage of doctors means long hours in the waiting room at busy clinics, less quality time available with the doctor in the examining room and emergency rooms packed with patients who couldn’t find a physician elsewhere.
The Valley’s healthcare community has spent years trying to beef up its numbers of doctors through recruiting and incentive programs. At the University of Texas-Pan American, the institution has done its part by establishing pipeline programs that take students and place them in medical schools in San Antonio, Houston and Waco.
The programs help Valley students — many of whom are the first in their families to go to college — by putting them on a straight path toward medical school, and the university has joined the UT System’s efforts to integrate curriculum for undergraduate and medical degrees, getting future physicians out of school quicker and reducing the burdensome debt they encounter, said UTPA President Robert Nelsen. But Nelsen concedes that the problem with the pipeline programs from the Valley’s perspective is that the students have to go elsewhere to complete them.
Most won’t return.
“With the new university and medical school, the important thing is the opportunity it’s going to give our kids and keep people in the Valley,” Nelsen said.
While the medical school was a needed component to address the Valley’s physician shortage, it’s not the only one. Graduate medical education programs, or residencies, are perhaps even more important to boosting the Valley’s ratio of physicians.
About 80 percent of students stay in the communities where they have their terminal residency program, leaving only about 20 percent that can be recruited from elsewhere.
By establishing a medical school and corresponding residency slots, the Valley stands a better chance of keeping physicians after they’re educated, said James Humphreys, a San Antonio pathologist who is vice president of the Bexar County Medical Society. A Port Aransas native who attended Baylor University, Humphreys made his way to San Antonio for a residency program, made contacts and stayed there.
Humphreys and other doctors have pressed the state to expand funding for residency programs or risk losing educated doctors to other states. Beginning next year, there will be more students graduating from medical school in Texas than there are available residency slots.
“Having residency slots there (in the Valley) will be tremendously helpful in attracting some doctors down there and retaining them once they go through the training program,” Humphreys said. “The Valley has been growing in population, and it will provide an incentive for them to stick around.”
The numbers already bear that.
Roughly 100 Health Science Center students currently receive the final part of their medical education at the Regional Academic Health Science Centers in Harlingen and Edinburg, according to the UT System. About 30 to 35 students choose to study and work at hospitals through the residency programs currently available at Valley Baptist and McAllen Medical Center and, upon graduation, about 66 percent of the residents remain in the Valley to practice medicine.
The UT System plans to increase graduate medical residents to 150 per year and place them in hospitals in Brownsville, Edinburg and McAllen. Doctors Hospital at Renaissance has committed to establishing about 50 of those residency slots in family medicine, general surgery, internal medicine and obstetrics and gynecology.
The two-fold approach to medical education creates a new pipeline that should bring the Valley closer to state and national averages for physicians per capita, said Hidalgo County health director Eddie Olivarez. But it also promises to inspire a generation of new physicians who now no longer see medical school as out-of-reach because of the exposure they have to the resources in their own area.
“One of the most important things it will bring over a generation is exposure to the very young students in our communities that they can be a doctor, biomedical engineer or a physician’s assistant or nurse,” Olivarez said. “The belief they can pursue medical education in their own community adds value.”
CLOSER TO HOME
For Ricardo Sobrevilla, the path to medical school also took him out of the Valley.
After graduating from Med High in Mercedes, Sobrevilla attended and completed medical school in Mexico. He passed his board exams in the U.S. and then interviewed at about a dozen residency programs before selecting the one in McAllen that was closest to home.
Now a hospitalist with a group at McAllen Medical Center, the 33-year-old Sobrevilla said the Valley’s family atmosphere could help it retain and recruit future physicians to stem its shortage.
“If we can recruit them here for a residency program, they can see that the Valley is a good place to live and raise their families,” he said. “If they train here, they’ll probably stay here.”
Family is, in part, what brought Garza home. With Garza and her husband both at the start of busy careers in medicine, they knew they could lean on their families as needed. But Garza also saw the Valley — with its unique culture and challenging health care needs — as a dynamic place to practice medicine.
When state lawmakers approved the legislation that set out a definite timeline for the Valley’s medical school, Garza’s husband asked whether she would have stayed here. While she couldn’t say for sure, she knew it would be nice to have it as an option.
“For those that can’t leave for some reason or another,” she said, “they have that opportunity in their own backyard to do it.”