A new report has concluded that establishing a medical school at the University of Maine is not financially viable at present, despite a growing shortage of primary care physicians across the state. The study, commissioned by the university, cites a staggering $250 million in startup costs and an additional $22.5 million in annual state funding needed for operations, effectively halting the project for the near future.
The findings highlight a critical challenge for Maine's healthcare system, which is projected to need 120 new primary care doctors by 2030. The report suggests alternative strategies to address the workforce gap, focusing on expanding existing training programs rather than building a new institution from the ground up.
Key Takeaways
- A new medical school at the University of Maine would cost over $250 million to build and require $22.5 million in annual state funding.
- The plan is deemed not currently feasible due to the substantial and sustained financial investment required.
- Maine is facing a significant physician shortage, with a projected need for 120 additional primary care doctors by 2030.
- The report recommends expanding existing medical residency and clerkship programs as a more immediate solution.
- Experts point to a lack of residency slots, not medical school graduates, as the primary bottleneck in retaining doctors in Maine.
A Costly Proposal Amid a Growing Crisis
The comprehensive 109-page report, prepared by consulting firm Tripp Umbach, was presented to the state legislature's education committee on Monday. The firm was paid $100,000 for the study, which was funded by state lawmakers in 2023 to explore solutions for Maine's healthcare workforce challenges.
According to the analysis, the financial burden of a new medical school is too great for a rural state with already strained hospital systems. The report stated that such a project would "require substantial and sustained financial investment from the state, well beyond the scale typically feasible." These costs would be in addition to the university system's existing state appropriations for operations and research.
Doctor Deficit by the Numbers
- 710: Number of family physicians in Maine in 2019.
- 630: Number of family physicians in Maine in 2024.
- 120: Additional primary care doctors needed by 2030.
Data from the U.S. Bureau of Labor Statistics and the Tripp Umbach report illustrate a clear downward trend in available physicians as demand from an aging population rises.
Joan Ferrini-Mundy, President of the University of Maine, acknowledged the report's conclusion but framed it as a call to action. She emphasized the university's role in addressing the statewide challenge.
"The state of Maine has to solve this problem of the physician shortages. I see this as a call to arms to do our part in what is a statewide challenge."Joan Ferrini-Mundy, University of Maine President
The report outlines a five-year plan for the university to strengthen its health and biomedical infrastructure, which could position the state to reconsider a new medical doctor program in the future.
The Real Bottleneck: Post-Graduate Training
While the idea of a new medical school is on hold, healthcare leaders argue that the more pressing issue is the lack of post-graduation training opportunities. The report's top recommendation is to expand Maine's existing system for training doctors, which includes programs at the University of New England (UNE) and a collaboration between MaineHealth and Tufts University.
James Herbert, President of the University of New England, explained that the primary obstacle to retaining physicians is not a shortage of medical students, but a deficit of residency and clerkship programs.
"Every year we have students who graduate, and want to do their residency in Maine, but they have to leave the state to do their residency," Herbert stated. "They want to stay in Maine, but they can’t, and they are effectively being exported to other states."
Understanding Medical Training Stages
Clerkships: Hands-on training for third- and fourth-year medical students within hospitals and clinics.
Residency: A required 3-year (or longer) on-the-job training period for doctors after they have earned their medical degree. Doctors often establish their careers in the region where they complete their residency.
Expanding Residency Programs a Top Priority
The data strongly supports the focus on residency expansion. Doctors frequently start their professional careers near their residency training locations. The Tripp Umbach report found that to reach the national average, Maine would need to nearly double its residency program capacity from 333 to 660 slots.
Herbert suggested that state investment could help reduce the cost for hospitals to host these training programs. Additionally, financial incentives tied to scholarships could persuade more medical graduates to complete their residencies within Maine.
Existing institutions are already working to increase capacity. UNE recently expanded its physician graduating class from 165 to 200 students. The MaineHealth/Tufts University program now graduates 41 doctors per year, an increase of more than 10 compared to a few years ago.
Legislative and Health System Response
State lawmakers and healthcare providers are now grappling with the report's findings. State Sen. Joe Baldacci, who sponsored the legislation for the study, emphasized the urgency of the situation, particularly in rural and northern parts of the state.
"I’m pleased they recognized the urgent need for expanded medical training in Maine," Baldacci said.
MaineHealth, one of the state's largest healthcare systems, expressed its commitment to finding solutions. Dr. Linda Chaudron, the system's vice president of medical education, said in a statement that MaineHealth is "fully committed to supporting expansion of medical education in Maine and welcomes any opportunity to work with the state on this issue."
The office of Gov. Janet Mills also released a statement acknowledging the importance of increasing the number of doctors serving Maine communities.
Exploring All Avenues for Primary Care
Beyond training more M.D.s, the report and university officials suggest bolstering the ranks of other primary care providers. Ferrini-Mundy noted the importance of increasing the number of nurse practitioners, who can provide essential primary care services.
Several branches of the University of Maine system, including campuses in Orono, Fort Kent, and Southern Maine, already offer nurse practitioner programs. Expanding these programs could offer a more immediate and cost-effective way to improve healthcare access while the state develops a long-term strategy for its physician workforce.
As Maine confronts the dual challenges of an aging population and a shrinking pool of doctors, the focus now shifts from building new facilities to strategically investing in the training infrastructure that keeps medical talent in the state.