By Joey Gomez
As a 12 year old, Julio Ramos was suddenly thrust into a very adult world that would alter his future forever. Given the responsibility of caring for his mother, who was stricken with breast cancer and who required constant medical attention, Ramos said his stance as the middle child of the family often meant staying at home while his father and brother worked. At that time, his sister was still too young to contribute, so the task to take care of his mother fell on him.
As his mother’s caretaker at home, Ramos was simultaneously able to make straight A’s in school. And there was one experience that would influence his decision to pursue a medical career.
“There was one instance I remember clearly. She needed to clean her wound, and she asked me to help her. She was my mother, so of course I had to help her,” said Ramos, who is now 19. “I remember her lying in bed, and she asked me to clean her wound, and I remember seeing the big scar on her chest. That was the experience that resonated most with me. That is what got me thinking about the process people go through to become doctors.”
“That introduced me to the medical field,” Ramos said. At 12, he said he wasn’t confused about his future. He knew that he wanted to be a doctor, even at a time when many kids were still trying to figure out what they want to do, he said. “By that time, I already had a feeling that I wanted to go into the medical field.”
From there, Ramos said he took the steps necessary to begin his education toward a future medical degree. He learned about Brownsville ISD’s groundbreaking “school within a school” Magnet Program. Homer Hanna High School, which is the home of BISD’s Tech Med Magnet Program for Medical and Health Professions, set him up for success in college.
Currently, as a sophomore at UTB, Ramos has an assured place at the University of Texas-Health Science Center in Houston when he graduates. He said he eventually wants to study reconstructive surgery in order to treat victims of burns and accidents.
“My family is very low income. Nine of us live in one house. Only three people work: my sister-in-law, my brother, and my dad. That is the only income that takes care of the whole house, so that is why I decided to come here (UTB),” Ramos said. “If all goes well with my MCAT (exam), which I take in April, along with the regular 15 hours I am taking as an undergrad, I will be granted acceptance to medical school, and I would start by August 2014.”
Ramos’s story is common among Valley students who have similar talents, but who are searching for a vehicle to help them reach their goals.
“I feel there is a stigma in the Valley that tends to say that education isn’t as important,” Ramos said. “I feel students here, when they realize that medical school is a possibility, will feel better when they realize they don’t have to travel far. Hispanics are very family-oriented, so I think it’s the perfect opportunity for Valley kids who want to go to medical school.”
They may get their chance.
Photo by Adrian Castillo
A New University and a New Future
University of Texas System regents have unanimously approved an initiative to authorize its Chancellor, Francisco G. Cigarroa, to work with the Texas Legislature to establish a new university that combines the University of Texas at Brownsville with the University of Texas-Pan American and create a future South Texas School of Medicine.
The plan would result in a single institution that spans the entire Rio Grande Valley, with a presence in each of the major metropolitan areas of Brownsville, Edinburg, Harlingen, and McAllen.
As the crown jewel embedded within that approval, the decision was made to allocate $100 million over the next 10 years to accelerate the pace of transitioning the Regional Academic Health Center in Harlingen into a future school of medicine.
Now everyone from school leaders, experts in business, lawmakers, doctors, students, and faculty say the implications are endless for establishing a future medical school in South Texas attended by local students who are driven by culture and motivated, above all else, by family.
Most students have had a direct experience with some of the most prevalent conditions facing communities in the region. What is at stake is the future of medicine in the Rio Grande Valley, according to faculty and medical professionals.
“The medical school in the Valley is going to be a source of primary care doctors for the Valley, which is desperately needed,” said Dr. Lorenzo Pelly. A well-known and respected physician in Brownsville for more than 30 years, Dr. Pelly was Valley Baptist Medical Center-Brownsville’s Physician of the Year in 2012.
As a former assistant professor of medicine at UT Health Science Center-San Antonio Regional Academic Health Center, Pelly says a trend at the RAHC included students who arrived to do their training, but then left for sub-specialty training. However, many have come back to the area where they studied, Pelly said.
“It is well known that when you have a medical school, many of the graduates stay in the area of the medical school,” Pelly said. “That is going to be of enormous importance for the Rio Grande Valley. It’s also well known that a medical school is a magnet for businesses. The economic gains from having a medical school are also very substantial.”
The State of Texas has 200 physicians for every 100,000 people. The Rio Grande Valley has 100 physicians for every 100,000 people. With the new medical school, every 10 years, we will be able to place an additional 350 to 400 physicians in the Valley, according to estimates by the UT-System.
Residents tend to stay where they were trained at a rate of about 70 percent nationwide. In the Valley, that will be about 65 to 66 percent, the UT-System predicts.
“When we increase the number of residents in the Valley, we will thus increase doctors in the Valley and improve the health of the Valley,” said UT Regents Chairman Gene Powell. “This is an opportunity to create a new emerging research university that has the potential to become a Tier One university in the next decade. It creates incredible opportunities to capitalize on the bicultural heritage of the Rio Grande Valley and build a university for the Americas.”
The reasons for merging into one university are many, and are especially significant when it comes to drawing from funding sources previously not available to local institutions.
UT Brownsville and UT Pan American are currently not eligible for revenue from the Permanent University Fund, a public endowment created by the Texas Constitution. A new university would be eligible for PUF funding, considered by most to be a potential catalyst for building a research university and a school of medicine.
As an emerging research university, the new institution would also be eligible for more funding sources, such as the National Research University Fund, the Texas Research Incentive Plan, and matching UT System money.
The new university’s overall size and portfolio would be similar to other existing UT emerging research universities, with a student population of 28,000, research expenditures of $11 million, an endowment of $70.5 million, and a total operating budget of $419 million.
It would also be one of largest Hispanic-serving institutions in the nation, both for total Hispanics enrolled and the number of bachelor’s degrees awarded, according to the UT-System.
“With medical residents working in hospitals in Brownsville, Harlingen, McAllen, and Edinburg, the strength of the new university and school of medicine will attract new faculty, research funding, and new economic development,” Powell said. “The new university will stand on the shoulders of three great institutions that have done so much for the region over the past 75 years.”
Under this plan, Valley medical students will be accepted through an independent admissions process, spend their first two years in San Antonio, and then finish school at academic centers in Edinburg and Harlingen. A stand-alone medical school would be phased in over a period of several years as the school finishes its accreditation process.
UT System’s $10 million annual appropriation will be used towards the recruitment of the school’s first dean, as well as faculty who can work in San Antonio and the Valley. Work is also currently ongoing with local hospitals as the UT System is seeking commitments from Valley hospitals for up to 150 residency slots to retain doctors when they finish medical school in the region.
“We anticipated that there eventually will be a medical school, and it seems to be moving much faster than we thought,” said Dr. Micheal Lehker, who is the Chair of UTB’s Department of Bio Medicine and Associate Dean of the College of Biomedical Sciences and Health Professions.
“Because it is built around medical school education or grad school education, I think we already have everything in place to make our students very attractive,” Dr. Lehker said. “The overall impact that I really see is that this might alleviate the healthcare shortages that we have, especially with our physicians. If the physicians train here, they will usually stay here. So, we hope it will mean an influx of physicians that we need to take care of the health of the Valley population. In terms of our program, I think it will be a great alignment with an undergraduate institution and a medical school. Our program, and the Department of Bio Medicine, really prepares students to be really good at competing for slots in medical school. If those students don’t have to leave the Valley, I think it makes it that much more attractive.”
Tracing the Proposed University’s Roots through the History of the RAHC
State Senator Eddie Lucio, D-Brownsville, carried legislation (SB-98) in the Texas Senate during the 2009 Legislative Session to establish a medical school in the Rio Grande Valley. His son, Representative Eddie Lucio III, D-San Benito, carried the legislation through the House.
Representative Lucio’s legislation authorized the creation of the University of Texas Health Science Center-South Texas.
Earlier, the 75th Texas Legislature enacted Senate Bill 606, which authorized The University of Texas System to establish and operate a Regional Academic Health Center (RAHC) to serve the four counties of the Lower Rio Grande Valley. The Legislature appropriated $30 million of Tuition Revenue Bond Proceeds for construction of the RAHC facilities.
At its November 1998 meeting, the U.T. System Board of Regents established a Lower Rio Grande Valley-wide RAHC, comprised of three major divisions – the Medical Education Division, the Medical Research Division, and the Public Health Division.
At the time, sites in Brownsville, Edinburg, Harlingen, and McAllen were selected for the location of these various divisions of the RAHC. Medical education divisions were designated for Harlingen and McAllen. The medical research division was designated for Edinburg, and the public health division was designated for Brownsville.
Additionally, the Board of Regents designated The University of Texas Health Science Center at San Antonio (UTHSCSA) to oversee and operate the Medical Education and Medical Research Divisions. The Public Health Division was designated as a branch of The University of Texas Health Science Center at Houston’s School of Public Health.
Harlingen was selected through the RFP process as the site for the Medical Education Division, which includes a facility for undergraduate and graduate medical education programs. This facility houses the educational programs and support for 24 third-year and 24 fourth-year UTHSCSA medical students, as well as the UTHSCSA residency in Internal Medicine under the sponsorship of Valley Baptist Medical Center (VBMC).
The facility for the Harlingen Medical Education Division (H-RAHC) was constructed using $25 million of the $30 million of Tuition Revenue Bond Proceeds appropriated by the Legislature for the RAHC. In December 2007, the second facility was dedicated at the Harlingen RAHC campus – the Academic and Clinical Research building. This facility houses the RAHC clinical research center and also the South Texas VA Health Care Center.
The UT Board of Regents designed $20M from the Permanent University Fund (PUF) for the construction of the initial medical research facility of the Medical Research Division (E-RAHC). This research campus of the RAHC is located in Edinburg, adjacent to The University of Texas-Pan American, and serves the four counties of the Lower Rio Grande Valley.
The flagship RAHC building was constructed on an 18.609-acre tract of land donated and deed to the UT-System by VBMC. An additional 7.6 acre tract was donated by VBMC for future use by the RAHC. Funds for the purchase of the twelve acre tract where the first phase of the Medical Research Division were gifted to the U.T. System by the City of Edinburg.
University Clears a Hurdle in Current Legislative Session
Legislation that calls for the creation of the upcoming university and medical school was officially filed by Valley lawmakers on February 4. The Senate bill for the UT university-medical school legislation (SB 24) has been filed by Senators Juan “Chuy” Hinojosa, D-McAllen, and Eddie Lucio, D-Brownsville, and assisted by Senator Judith Zaffirini, D-Laredo.
The House bill for the UT university-medical school legislation, known as HB 1000, is being carried by Representative René Oliveira, D-Brownsville, Dean of the Valley legislative delegation. The House bill’s joint authors are Representative Dan Branch, R-Highland Park, who chairs the House Committee on Higher Education, Representative R.D. ‘Bobby’ Guerra, D-McAllen, Representative Terry Canales, D-Edinburg, and Representative Oscar Longoria, D-La Joya.
Senator Lucio agreed with reporters who asked if the proposed legislation will define his legacy after nearly 30 decades in Austin.
“This has to sit on the very top, because this will lead to the quality of life that I have been looking for, for a long time under one issue,” Lucio said. “I have worked on issues that deal with housing, healthcare, education (public and higher), and criminal justice.”
“My legislative tenure has included all kinds of issues, but never has there been one that I can identify that would have such an incredible impact, because the basis of success for our young people seeking higher education is based on the level of education that will be achieved in this new university,” Lucio said.
Cigarroa, who earlier gave a presentation to the board outlining the request to move forward, said there are challenges and opportunities in the Rio Grande Valley. Taking advantage of UT campuses with a bi-national presence on the border of Mexico in one of the fastest-growing regions in Texas has been part of his vision since becoming chancellor in 2009.
“We have to think globally, not regionally,” Cigarroa said. “We have an opportunity to make the Rio Grande Valley a center for bicultural programs in economics, business, medicine, biomedical sciences, energy, environmental studies, Latin American studies, and a host of other areas.
“If we focus our attention on this crucial region of Texas, we can create new jobs, attract new federal and private funding, launch new facilities construction and, most importantly, provide higher education and training – and a stronger future – for this generation and generations to come.”
Following public testimony in February, which included a united front and appearance by the Rio Grande Valley legislative delegation, HB 1000 will be set for a final committee vote possibly by this month.
“As a legislative delegation, we are optimistic about and really looked forward to today’s hearing. We showed that we have put aside parochial interests to do what is best for everyone in the Rio Grande Valley,” said Oliveira. “The bipartisan support we have received from Chairman Branch and Governor Perry has been extremely helpful. Legislators are realizing that this bill isn’t about the future of the Valley, but rather the future of the state.”
Oliveira said Representative Armando Martínez’s seat on the House Higher Education Committee is a great asset for the interests of deep South Texas.
Oliveira emphasized the importance of HB 1000 to the entire state.
“The Valley is one of the fastest growing areas of the state, and a key population center for the fastest growing demographic, Hispanics, in the state. This bill will provide a much greater opportunity for the people who will be the future workforce of Texas,” Oliveira said. “More and more lawmakers realize that when we improve the Valley, we improve the entire state. The economic and social future of Texas will largely be determined by what happens in the Valley over the next decade or so. If Texas is to prosper, then the Valley must prosper.”
According to the bill analysis of HB 1000, other aspects of the legislation include:
• The bill allows the new university to participate in the Permanent University Fund if the act receives a vote of two-thirds of the membership of each house of the Legislature. Currently, UTB and UTPA are eligible for the Higher Education Fund.
• The bill provides for the abolition of UTB and UTPA at a date to be determined by the UT System Board of Regents. The bill requires the Board to set up an advisory group to assist in the designing, organizing, and implementing a medical school to serve the Rio Grande Valley. Recommendations to the Board would include the best locations for the medical school administration and operations.
• It is assumed that in the first year the medical school is operational, it would enroll 50 medical students. Using a formula base value of $8.874 and a weight of 4.753, it is estimated that the All Funds formula cost for these students would be $2.1 million. It is assumed that the formula statutory tuition income for those students would be $175,048, and that the General Revenue formula cost would be approximately $1.9 million.
It is assumed that 50 students would enter the school each year until enrollment reached 200. The formula costs associated with 200 students would be $7.7 million in General Revenue, and the anticipated statutory tuition would be $700,193.
• It is assumed that any remaining costs, including faculty and construction costs associated with the new medical school, would be covered by existing institutional resources or constitutional funds allocated for that purpose. It is also assumed that participation in the Permanent University Fund instead of the Higher Education Fund would not result in any additional costs or savings to the two funds. Any costs associated with the advisory group would be absorbed within current resources.
‘My Babies Will Go to this Medical School’
Gathering feedback from students and the community, leaders of institutions say the proposed university and medical school will transform the Valley forever.
“I have already heard from mothers, and one told me that she has a two year old and a four month old. She said that after hearing this announcement, she felt both of them will go to that medical school,” said UTB President, Dr. Juliet Garcia. “It just changes the whole expectation of what’s possible for her own children.”
“It’s going to literally transform the Valley in many significant ways. The first way is that it will create a template for all of us to work together and thing regionally,” Garcia said. “People from all over the world already think we are one place. We are the only ones who sometimes forget that. The synergy that is going to come from this is going to be very powerful. Immediately, all the degrees that are available at UTPA will be available at UTB, and vice versa, so without spending more money, you have taken the same resources and exploded their impact.”