Plan aims to put more doctors in SD small towns

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SIOUX FALLS (AP) — Officials hope a plan to boost the annual state medical school budget more than $1 million will attract more doctors in rural South Dakota.

Gov. Dennis Daugaard proposed the additional money this month. The media reports that the Legislature is slated to look at the request in January.

"I see this as an important step forward," said Dr. Rodney Parry, retiring dean of the Sanford School of Medicine of the University of South Dakota.

Parry said two changes would result. An incoming class at the medical school now has slots for 52 students a year for the MD program. That number would increase to 56. The school also would set up a rural track as a training option to immerse participating students in small-town culture. The changes could take effect in 2013.

The medical school budget is about $40 million a year, said Julie Kriech, director of finance for health affairs at USD. Tuition and fees cover much of that, but $10.7 million comes from the general fund that lawmakers control. Daugaard's request would push that close to $12 million.

Prospective doctors in South Dakota now earn a four-year bachelor's degree, then study four years in medical school before what's usually at least three more years in residency and fellowship programs. The medical school portion typically includes two years at the Vermillion campus, with about four weeks at the end of the second year in a small South Dakota community. The third year is in hospitals in Yankton, Rapid City and Sioux Falls, with the fourth year an elective.

The change Parry foresees would devote the entire third year of medical school to training in a rural area. The student would not have to commit to returning there after graduating, but Parry hopes that might be the result.

Where medical students complete their residencies after finishing medical school is a common predictor of where they will end up working. Parry thinks the third year of medical school also is a predictor.

"Toward the end of the third year they make a decision on a career pathway," he said. "What we're hoping is they'll want to practice in a smaller community. We're trying to look for ways for students to be more confident they can serve in small communities."

Parry would not say which communities would be in line to host a rural track in South Dakota. That decision might wait for his successor, Dr. Mary Nettleman, who will arrive in April from Michigan State University to become South Dakota's new medical dean.

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