Part Three

UAMS Growing to Address Health Care Work Force Needs

As Arkansas’ only academic health sciences center, the University of Arkansas for Medical Sciences will continue to play a lead role in producing health care professionals for the state.

Increasing UAMS student enrollment will produce more health care professionals to meet the state’s needs. To increase enrollment, UAMS also will have to expand its facilities and recruit new faculty members.

Accommodating additional faculty and providing the needed space and clinical training sites to handle increased enrollment may require development of a UAMS satellite campus.

UAMS Produces Many of the State’s Health Care
Professionals

Historically, UAMS has produced the majority of Arkansas’ doctors, along with many of its nurses, pharmacists and other health care professionals. Nearly 80 percent of UAMS’ medical students stay in Arkansas after graduation as teachers, researchers or medical practitioners. By investing in development of programs and services, UAMS seeks to meet the increased demand for health care professionals.

The UAMS campus in Little Rock has grown from a small medical school with a charity hospital into an academic health center and research leader that today received more than $113 million annually in research grants and contracts. UAMS and its affiliates have an annual economic impact on Arkansas of more than $4.5 billion.

UAMS has developed world-class programs and centers of excellence than in the last three years have drawn patients from all 50 states and 52 foreign countries. UAMS also has attracted talented clinicians and researchers who provide quality patient care, instruct tomorrow’s health care professionals and conduct valuable research that can lead to new medical treatments.

UAMS has a history of meeting health care needs – providing both education and treatment – beyond its Little Rock campus. In 1973, the Arkansas Area Health Education Center (AHEC) program was established as a primary outreach effort for UAMS. (Chart 9)

Seven centers spread across the state serve as training sites for students in the fields of medicine, nursing, pharmacy and various allied health professions. The AHECs also host medical residents specializing in family medicine who continue their training by providing health care in those communities.

UAMS Plans for Enrollment Increases

To increase the number of health care professionals, UAMS is expanding enrollment in most of its programs. From 2000 to 2005, enrollment grew by 25 percent for a total enrollment of 2,328 students. (Chart 10)

During that time, the College of Nursing added 85 students for a total enrollment of 317. The College of Pharmacy added 48 for a total of 360. The Graduate School added 37 for a total of 395. The College of Medicine added 11 for a total of 581.

The 17 programs in the College of Health Related Professions – which includes respiratory care, radiologic technology and laboratory sciences – added 164 students for a total enrollment of 547.

The College of Public Health was started and reached an enrollment of 128 students.

Each of the colleges on the UAMS campus and the Graduate School examined enrollment issues in 2005. Each program in those schools was asked whether current enrollment was meeting state work force needs now and in 10 years.

As a result, the total UAMS enrollment is projected to grow by more than 500 students by 2010. This includes adding 119 more students in the College of Medicine, 105 more in the College of Pharmacy, 83 more in the College of Nursing, 80 more in Graduate School, 72 more in the College of Public Health and at least 53 in the varied programs of the College of Health Related Professions.

In the College of Medicine, though, the issue is not only graduating more medical students but creating more medical residencies to meet work force needs. A medical residency follows graduation from medical school and includes more specialized training in a hospital or health clinic. To be an orthopaedist, ophthalmologist, surgeon or obtain credentialing in any designated “specialty field,” requires between three and six years of additional training following medical school.

In 2005, UAMS had 692 residency slots available. UAMS has been approved for more residency slots – which it would allocate to needs in family medicine, internal medicine, obstetrics/gynecology and surgery – but there are not currently funds or enough clinical training sites to support those additional students. By 2010, UAMS has a goal of adding 58 new medical residents.

Most physicians stay within 200 miles of where they complete their residency. Increasing medical residencies at UAMS would increase the number of young doctors entering the profession in Arkansas – with the likelihood that many of those would remain in the state.

Increased Enrollment Requires More Faculty

Increased enrollment also requires having adequate facilities and faculty. Education is labor intensive.

The faculty-to-student ratio is a factor examined by the organizations that accredit academic programs. This ratio becomes even more of a factor in the required clinical rotations, where students receive hands-on experience in hospital and clinic settings with actual patients.

These students require close supervision to ensure they receive a complete educational experience and their patients receive the quality care they deserve. In some programs the ratio in the clinical setting is one faculty member to one or two students.

Some UAMS programs are currently at maximum enrollment and unable to take additional students because of faculty constraints. New faculty must be recruited to expand enrollment.

More Students Mean More Classrooms and Clinical Sites

Educating more students to meet work force needs will require more classroom space. Moreover, health care education also requires laboratories and clinical facilities where students receive experience developing their skills with the latest medical technology or treating patients.

New facilities will allow UAMS to expand many of its world-class patient care and research programs, which will attract new clinicians and researchers. In addition to their patient care duties or research, they will serve as UAMS faculty, passing on their knowledge and expertise to students.

UAMS is already addressing some facility needs with an ongoing $265 million expansion at its Little Rock campus. Included in this effort is a major hospital addition, the addition of a Psychiatric Research Institute, a new residence hall, a five-story addition to the Jones Eye Institute, an additional parking deck and additional utility services building.

Construction of the 500,000-square-foot hospital addition will begin in 2006 and be completed in 2008. The hospital will provide much-needed space for patient care and – as with the psychiatric facility and expanded eye institute – offer additional resources and clinical education opportunities that UAMS students need.

Simply expanding the UAMS campus, however, cannot provide space for graduating enough new health care professionals. Developing a satellite UAMS campus at another location is being considered.

A satellite campus in another part of Arkansas would allow UAMS to accept more students.

Factors that should be considered when deciding where to locate a satellite campus include the number of potential students in that area (by population growth) and the availability of hospitals and health care facilities. (Chart 11 and 12)

A second UAMS campus would need affiliate hospitals and clinics to provide clinical education for students, including new medial residents. Another consideration is whether the clinical affiliates have enough patients to provide a diverse range of medical conditions to observe and treat.

Paying for the Future

While increased enrollment will mean more funds from student tuition and fees, it is only a fraction of the costs of producing more health care professionals with the associated facility and faculty needs.

The ongoing $265 million campus expansion is being funded by a bond issue approved by the University of Arkansas Board of Trustees, as well as from campus revenue and philanthropic sources.

In its 2006 special session, the Arkansas General Assembly approved the issuance by UAMS of up to $40 million in bonds to partly fund a much-needed expansion of the Arkansas Cancer Research Center (ACRC). To complete funding of the ACRC addition, as well as needed expansions of the Reynolds Institute on Aging and the Outpatient Center, UAMS is looking to philanthropic sources.

Revenue from patient care at UAMS has grown substantially in recent years. In fiscal 2004-2005, hospital revenue neared $350 million. In the last three years more than $250 million in patient revenue came from patients outside Arkansas, demonstrating the value and quality of care given by UAMS.

Patient care accounts for more than half (66 percent) of annual UAMS revenue. It is perhaps a misconception that UAMS receives substantial state funding support. State appropriations account for just 11 percent of UAMS revenue, placing it third behind grants and contracts (15 percent). State funding, as a percentage of total UAMS revenue, has been declining since the mid 1980s, when it accounted for about 45 percent of the institution’s revenue. Student tuition and fees make up 2 percent of UAMS revenue, the smallest part, after contributions and other revenue sources.

UAMS is grateful for the support it receives. The institution seeks to remain a good steward of its resources and deliver on its responsibility to improve the overall quality of health care in Arkansas.

The education of new health care professionals is essential for UAMS to meet the health care work force needs of Arkansas. By remaining committed to its patient care, education, research and outreach missions, UAMS is focused on taking the necessary steps to meet that goal.