Proposed Montana medical schools raise questions about for-profit model
Two universities are looking to build medical schools in Montana. One is a non-profit university that is waiting for approval to start the accreditation process. A for-profit university has been given the green light to initiate this procedure.
MTPR’s Freddy Monares spoke to Victoria Knight, a reporter for Kaiser Health News, who recently published an article with NPR on the race to open a medical school in Big Sky State.
Freddy monares The two school models have raised questions about physician training, how it will be paid for, and whether a state like Montana can support either model for medical schools. Victoria is here to explain her story. Thanks for joining us today, Victoria.
Knight victoria Thank you very much for having me, Freddy.
Freddy monares Yes. Can you tell us a bit about the history of for-profit medical schools across the country?
Knight victoria So about a hundred years ago there was only a ton of medical schools in the United States. Basically, anyone who wanted to open medical school could do so at the time. After that happened for a little while, the Carnegie Foundation kind of did a report on how many doctors were providing poor quality medical care, and it got a bunch of states to decide, “We’re going to. implement accreditation standards, we ‘will standardize medical education. He basically banned these for-profit medical schools. It happened about 100 years ago. And then we didn’t see for-profit medical schools again until 2008. And that’s Rocky Vista University in Colorado.
Freddy monares Yes. From private, for-profit medical school that wants to establish itself here. Do we know who owns it?
Knight victoria So Rocky Vista is the name of the for-profit association that wants to open a satellite campus in Montana. Originally, when the campus opened in 2008, it was just an individual, essentially a wealthy investor who originally owned the school. But it was then sold a few years ago to a private equity firm. They refused to be part of the story. So beyond knowing that it’s a private equity firm, we really don’t know much else.
Freddy monares OKAY. Well, what’s at stake if the students don’t know who owns the school they’re going to?
Knight victoria Yes, you just don’t know who is behind it all, and on top of that there is just a real lack of transparency with finances. Most schools, private, if they are, even if they are private, if they are non-profit, most of them – or all really – will share financial reports on their websites showing how much money they earn from tuition, how much money they get from grants, how much money they get from their operating income, and then how much it costs to run the school. So with this for-profit model there is no financial reporting on the website like that. So that means students may be paying a lot of tuition fees, and it’s not clear exactly where that money is going. And so that’s it, that’s the problem, is that the students who go to these schools are really not going to know what the investors are, how much they profit from their going to these schools.
Freddy monares Yes. I was also wondering what ingredients does Montana have that make it appealing to these schools?
Knight victoria Yes, that’s a great question. I asked the schools, yes, why they chose Montana. I think part of the reason is because you don’t really have a medical school. I know there is a program with the University of Washington, a relationship where Montana students can attend medical school with the University of Washington. So there is this program that exists. But apart from that, there is no medical school in Montana. And also, at least what the schools have told me is that there is a real need for more doctors in the state of Montana and in this region of the west. There is this idea that if you go to school in a certain area, you might end up residing in the same area and then staying. And so I think these are the things. But I think it’s mostly that they see an opportunity to open a school when there really isn’t one.
Freddy monares Yeah, that’s interesting. I’m also wondering if any regional hospitals or medical providers have looked into what it might mean to have these new students trained in their backyards?
Knight victoria Yes, this is definitely something that some communities have weighed in. Are there concerns that the state of Montana could manage the opening of two medical schools? Part of that, opening a medical school, you have to be able, you know, the first two years you take courses, but then the next two years you take clinical training. So you go to doctors and, you know, do more practical things. So I think there’s a concern that if two new medical schools opened, both with, I think they both offered to have classes of about a hundred. If these are 200 new students each year, are there enough doctors in the community for them to take and complete the clinical training that they are required to take as part of their studies? And if not, does that mean they’re going to have to move out of state of Montana to do it instead, which defeats the goal of opening a school in Montana?
Freddy monares What Are Experts Saying About The Return of For-Profit Medical Schools?
Knight victoria Some say that any kind of for-profit institution is a really bad idea, and that’s because there really isn’t a lot of transparency with a for-profit model on where the funds go. There are others who say, “Well, these for-profit organizations have to go through the same accreditation process as the non-profit institutions. And so they can get through this process and their standards should be good enough to keep their doors open. It’s really a mixed bag, but come in. But yeah, it’s, yeah, it’s something to debate.
Freddy monares Does a for-profit model affect the loans students can get to help pay for their education?
Knight victoria Yes. When a new for-profit medical school opens, it begins the accreditation process, but it cannot be fully accredited until the first class of students graduate. So those students entering these new for-profit medical schools are not eligible – because the school is not fully accredited – they are not eligible for federal loans. This therefore means that they then have to take out private loans, which often have higher interest rates.
Freddy monares Yes, and obviously there are for-profit medical schools elsewhere in the country. I wonder if we know how graduates from these schools compare to graduates from nonprofit universities, and what do they think of their education afterwards?
Knight victoria So a lot of them are really new schools. So a lot of data is just not yet available on how these students might stack up against students in nonprofits. I spoke to a Rocky Vista alumnus. He graduated in 2015. He told me he really had no problem with it being a for-profit school. He appreciated that they seemed to take more non-traditional students. So he was an older student. And so he felt like the school was accepting, you know, more non-traditional people. But his only problem was that he had to take a lot of loans and he had to take one year of those private loans that I mentioned because the school was not fully accredited when he started attending it. So that was definitely a big concern for him.
Freddy monares Thanks for sharing your report with us, Victoria.
Knight victoria Thank you very much for inviting me, Freddy.
It was Kaiser Health News reporter Victoria Knight speaking to MTPR’s Freddy Monares about his report on a for-profit medical school coming to Montana. You can find his full report on our website.