You may have missed this New York Times story from the other
day. For several years, St. George’s University Medical School has been paying New York City’s
public hospitals to teach its third- and fourth-year students.
Now the school has established a scholarship fund that it will use to try to
entice its students to train as primary care physicians and work in the city hospital
system.
St. George’s also is offering the public hospitals more
money if they will allow more St. George’s students to do their clerkships at
those institutions.
So, you say, what’s the problem? It seems that New York City’s
medical schools are upset about all this.
Here’s an excerpt from the Times article: “The deal seemed
likely to increase friction with the New York City area’s medical schools,
which have already complained that St. George’s is squeezing out their own
students because it is willing to pay for clinical training. That training has
traditionally been perceived as part of the mission of teaching hospitals, to
be offered without charge.”
To clarify this. Medical schools like Cornell, Columbia, New
York University and Mount Sinai must farm students out to other hospitals
because their main medical school hospitals cannot provide enough clinical
material for the number of students they have in each class. These venerable schools,
with tuitions & fees of nearly $50,000/year, do not pay a single penny to
the affiliated hospitals or their teaching physicians. In fact, the hospitals
actually pay for the privilege. It’s about the prestige.
We are talking about 50% of a medical student’s tuition over
four years. Let’s do some math. Let’s say 150 students at $50,000/year. That’s $7,500,000/year
or $15,000,000 for the two years. That does not count the fees that the affiliated
hospitals pay the schools.
Note please that this situation is not limited to New York
City. To the best of my knowledge, almost all U.S. medical schools have similar
arrangements with affiliated hospitals.
A recent editorial in JAMA called for shortening the length
of medical school by a year. Somehow I don’t see that happening soon.
Question: Where does that tuition money go?
6 comments:
I am starting medical school at UCSD this fall and boy did this get me upset! I was accepted to Cornell and one of the reasons I turned them down was negative opinions about their clerkships! This just makes it worse. I would be very upset if as a M3 at Cornell I was losing clinical exposure to an IMG.
I didn't mean to upset you, but this is a reality.
Cornell is one of the schools that shares at least one affiliated hospital site with St. George's.
Faculty, staff, administration, administrative assistants, support staff, technology, physical building... etc. It's really expensive to run a medical school in the U.S...
Yes. I understand that, but the schools are receiving free teaching and support services from the affiliated hospitals, which do not see any of that money.
Most of the third- and fourth-year students are not on the med school campus or in its hospital.
It seems unfair to me.
My understanding is that medical schools cannot operate solely on medical student tuition -- even if we did the math of a total of 600 students at a time paying 50k/year that is 30 million per year from tuition. Considering that there are likely at least 50 faculty members at say 100k/year, that's already 5 million. Add some higher ups making more than let's say 200k/year, administrative assistants (there are *soooo* many of them now), building costs and I'd guess you're closing in on 10 million per year. Now, consider the fact that just about every major medical school has at least 1 shiny new building to boast "state-of-the-art" facilities + the newest technology and we're looking at 100s of millions... and that's where the rest of our money and generous donations can go.
This is all hypothetical, but that's my best guess.
Med schools have many sources of income of which tuition is a small part. To name a few: faculty practice, donations, endowments, revenue from clinics & hospitals, investments.
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