Vital Signs - September 2000

The Business of Medical Education in Nevada

Medical School Dean Outlines Challenges

by Kathleen Foley

Robert H. Miller, MD, MBA, has just completed his first year as dean of the University of Nevada School of Medicine. The 53-year-old Louisiana native is uniquely suited to the position – in addition to his medical training as a specialist in head and neck cancer surgery, he holds a masters degree in Business Administration. Miller said his biggest challenge has been building an administrative infrastructure. The medical school didn’t even have a chief financial officer to manage its $70 million budget until August of this year. Finances, and concerns about improving the school’s bottom line, have also been top priorities.

The University of Nevada established a two-year medical school at its Reno campus in 1969, with students traveling out-of-state to complete their last two years of education. The medical school became a four-year program in 1979. The following year it was expanded to Las Vegas, where it now has several facilities, chiefly in rented space. Intentionally small and selective, the school accepts a total of only 52 applicants. Medical students are typically from Nevada, although two or three students a year come from western states such as Idaho and Wyoming which do not have medical schools. Miller said the administration hopes the out-of-state students will make contacts here and decide to stay in Nevada to practice medicine.

Although more than 40 percent of medical students are female, finding minority applicants is a challenge, according to Miller. Last year’s class did not contain any minorities. "The competition nationwide for qualified minority students is incredible," he stated. "We are not in a position to be able to offer them full four-year scholarships, which puts us at a disadvantage relative to other schools. Helping qualified applicants of all races who can’t afford tuition is a challenge. Building up a scholarship fund for four-year medical students is definitely on my short list of important projects." Miller reported that 70% of all students graduate with some kind of medical school debt, with the average per student exceeding $80,000.

Managing a relatively young medical school with two campuses and two faculty groups, separated by 450 miles, presents its own set of challenges. Bringing Reno and Las Vegas faculty members together is one of the dean’s priorities. "One key to improving relationships between the two groups is to improve communications," he said. Frequent teleconferences help foster a sense of community, and Miller divides his time between the two locations, spending each Monday and Tuesday in Reno and the rest of the week in Las Vegas.

The dean decided to use Las Vegas as his principal base of operations in order to focus his efforts on projects in the southern part of the state. He plans to establish an academic medical center in southern Nevada modeled on the Texas Medical Center in Houston, which he said adds more than $10 billion annually to the Texas economy. The medical center could contain a pharmacy school, a dental school, a library and a cancer center, in addition to research and laboratory facilities.

One of the advantages of the academic medical center would be in encouraging biotechnology companies to locate in southern Nevada. Basic research facilities at the medical school would make the area attractive to them, and biotechnology companies could in turn provide a valuable funding source for the university. Researchers at the northern campus currently bring in more than $300,000 in external grants per year, many of them from the federal government. University researchers have achieved major breakthroughs in fetal cell transplantation, information on the Hanta virus and the discovery of chloride channels within the cells of the heart.

"Our first goal is to establish a location for the medical center," according to Miller. "We are partnering with UNLV, the City of Las Vegas and Nevada Development Authority and conducting monthly planning meetings, but we haven’t decided on a site yet. The city has donated ten acres on Tenaya Avenue in the northwest medical corridor, but we also have 12 acres at UNLV. Because they are on opposite ends of town, commuting between them would be inconvenient." After a site is chosen, Miller’s next priority will be to arrange funding for the project. "We envision most of the funding would come from private sources," said Miller. "After we obtain funding, we should be operational in two or three years."

Kathleen Foley
Kathleen Foley is a freelance writer based in Southern Nevada.