Avoid 'medical school creep'

Another year, another medical school?

South Carolina, a state that could be served ably by one appropriately funded medical college, now has three, and there are rumblings about training med students at yet a fourth campus.

Officials from Francis Marion University, McLeod Regional Medical Center and the Carolinas Hospital System in Florence are reported by SCnow.com to be mulling a plan to train third- and fourth-year medical students from the University of South Carolina College of Medicine.

Florence area officials are reported to say their region is a natural choice because it is the only one in the state without a medical school.

That is not a persuasive reason to spend more state money to hire additional teaching and supervisory staff, and possibly incur expenses for construction and equipment.

For years, the USC medical school has allowed third- and fourth-year students to take their training in Greenville as students of the Columbia school. About 60 students a year took advantage of the Greenville alternative.

But last year, in a planning process that school officials managed to keep largely out of public view, USC opened a full, four-year medical school in Greenville that is separate from the Columbia college. It has its own dean, its own curriculum and its own admissions process.

Florence leaders would like those 60 slots to come their way.

By referring to the Greenville program as an arm of the USC medical college, officials were able to avoid public scrutiny that comes with a new school.

The Florence plan, if it moves forward, would not be a new school. But the public should be made aware of what the expansion would cost, and should have opportunities to make their opinions known before a decision is made. A Francis Marion spokeswoman said that an outside consultant has been asked to provide a financial framework for the plan.

Students, who would work and study at Florence-area hospitals, would number 25 to begin with in 2014, and as many as 60 eventually.

Dr. Eddie Floyd, a Florence cardiologist and philanthropist, is shepherding the plan, which he said "will really enhance what we have to offer, both as a city and a medical community."

Realistically, however, medical school programs are costly -- far more so than other academic disciplines. And experts say there is a point of diminishing returns for medical education. There is already some question about whether the state's medical school graduates will be able to find enough residency programs with the new Greenville medical school adding to the candidates.

Also, a state with extremely limited financial resources, like South Carolina, does not need to be spreading its dollars so thin that existing programs -- like the nationally acclaimed Medical University of South Carolina in Charleston -- are weakened.

The S.C. Commission on Higher Education should be kept apprised of any plan to expand the USC medical school to Florence. It will need definitive information about costs and benefits. It will need to answer the question of whether the additional campus will help produce well-trained physicians (particularly those who will practice in underserved rural areas) or whether there is a more cost-efficient way to address the state's medical and academic needs.

And if the commission isn't able to do its job because of maneuvering by USC officials -- as happened in Greenville -- then the Legislature should step in and require the necessary accountability. Otherwise, South Carolina could eventually end up with four medical schools.