UNIVERSITY OF HOUSTON
College of Medicine Report

November 2017

UNIVERSITY 01?

HOUSTON

University of Houston College of Medicine Report

INTRODUCTION
In Fall 2014, Chancellor Renu Khator announced that the University of Houston (UH) would explore pursuit of
a medical school adding to established UH healthcare-related programs already serving the Houston region
and the state of Texas. Dr. Khator stated in that address to the UH community her vision to establish “…down
the road, a primary care, community-based medical school.” In concurrence with a recommendation by the UH
Health Workgroup, she further vowed to “…not duplicate anything currently available in Houston, but to build
upon it and focus entirely on community-based research and training.”
In January 2015, the University of Houston retained Tripp Umbach1, in association with Dr. Jack Brose and Sharon
B. Zimmerman to determine the feasibility of various options for establishing a medical school and impact of
such a program on the community.
The Tripp Umbach consulting firm study was designed to allow the University of Houston to better understand
the need, the benefits and the economic impact of a four-year college of medicine. The study highlighted how
the health care industry is undergoing transformative change due to many factors and highlighted the current
healthcare environment.
These factors include unsustainable increases in costs, an aging patient and physician population, a primary care
provider shortage, and the need to shift from a medical education and health care delivery system focused on
providing episodic care to one designed to prevent and manage disease. The future of health care requires that
patients, providers, academic institutions, community organizations, and industry work together in innovative
ways to provide high-quality care with better outcomes at lower costs.
The study noted the shortage of physicians across the country. This problem is particularly acute in Texas, as
it lags well behind all but a handful of states in terms of physicians per capita and most critically, primary care
physicians. The state of Texas has 190.8 active patient care physicians per 100,000 population, compared to the
U.S. national average of 234.7, ranking 42nd out of 50 states on this ratio; Texas would need 11,838 additional
active patient care physicians to achieve the national average active patient care physician to population ratio
today. The state of Texas has 65.1 active patient care primary care physicians per 100,000 population, compared
to the U.S. national average of 82.5, ranking 47th out of 50 states on this ratio; Texas would need 4,686
additional active patient care primary care physicians to achieve the national average active patient care primary
care physician to population ratio today.2
Tripp Umbach is the national leader in conducting feasibility analysis and economic impact studies for existing academic medical campuses
as well as new or expanded medical schools.
1

² 2015 State Physician Workforce Data Book. AAMC Center for Workforce Studies. https://www.aamc.org/data/workforce/reports/442830/
statedataandreports.html. Accessed 1/5/17

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This specific need for primary care physicians permeates both rural and urban areas of Texas, including the
underserved areas of the Houston metro. A significant number of Texas counties continue to be classified as
Medically Underserved Areas (MUAs)/Populations (MUPs) and Primary Care Health Professional Shortage
Areas (HPSAs). Even large urban counties like Harris County, which is home to the Texas Medical Center, the
largest medical center in the world, continue to have geographic communities that are classified as medically
underserved and suffering from a shortage of primary care health professionals in their communities.
The following figures illustrate the geographical location of Medically Underserved Areas (MUAs) (top panel,
purple), Primary Care Health Professional Shortage Areas (HPSAs) (bottom panel, green) and their co-localization
(next page) in the Houston Metro area.

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Source: Health Resources & Services Administration (HRSA) Data Warehouse and Mapping Tool

This figure illustrates that the Health Resources & Services Administration (HRSA) has classified a large portion
of the Houston Metro within Beltway 8 as Medically Underserved Areas (MUAs). Virtually all of this area
geographically coincides with Primary Care Health Professional Shortage Areas (HPSAs). For example, there are
a total of 19 medically underserved areas (MUAs) located within the geographical area bounded by the red box
(above), with 5 distinct medically underserved populations (MUAs) being identified within the same geographical
region. In addition, the same geographical area currently has a total of 68 HPSAs, 39 of which have been
classified as High Needs areas.
Analysis of publicly available 2016 National Resident Matching Program (NRMP) data indicates that the shortage
of primary care residents currently practicing in Texas may only get worse, especially if the majority of future
Texas primary care physicians are expected to be graduates of Texas medical schools. For example, in 2016 only
20% approximately of all Texas medical school graduates selected residencies in primary care specialties.
Notably, there have been no new medical schools in Houston since 1972 despite significant population growth.
This need for primary care physicians permeates both rural and urban areas of Texas, including the underserved
areas of the Houston metropolis. The deficit is fueled by a growing and aging population, an aging physician
workforce, as well as increased access to healthcare as a result of the Affordable Care Act. For a variety of
reasons, the trend among medical students (both nationally and in Texas) is to pursue more lucrative specialties
than a primary care practice, thus exacerbating this shortage. The consulting firm study found that in part
because of its long history of involvement with programs related to health professions and health sciences, UH
recognizes this critical unmet need, and could address it through the creation of the new College of Medicine
embracing a community-based model and a primary care focus. The community-based College of Medicine
would feature an innovative curriculum focused on primary care, community and population health, behavioral
and mental health and the care of communities with significant health and healthcare disparities.
The study recognized that the Houston region is unique in its ability to address these challenges. The University
of Houston is a Carnegie-designated Tier One research institution, centered just a few miles from the Texas
Medical Center, the largest and most advanced health care system in the world. In addition, there are two
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other medical schools in the city and more throughout the state where collaboration and partnerships could
be established to meet the health care demands of the region and beyond. The University of Houston has an
enormous opportunity and potential to leverage these advantages, shaping the future of health care through the
development of a unique medical education enterprise.
The Chancellor accepted this study, to further explore the possibility of creating a new College of Medicine, and
UH hired Dr. Steve Spann as Planning Dean in September, 2015. In the fall of 2015, the Chancellor also established
a cross disciplinary Internal Advisory Committee (“Committee”) (Appendix A) to provide advice and to serve as
an institutional audience for the planning process. Dr. Spann’s role has been to work on a case document and
develop a business and finance plan, as well as a broad curricular framework for the College of Medicine. This
working group studied and visited multiple exemplary newly-formed College of Medicines across the country so
they could bring back knowledge and ideas for what could be the best design for a College of Medicine at UH.
In addition, this working group engaged the team of MGT of America Consulting, LLC (national higher education
consultants) and NBBJ (architects and planners) to assist them in developing the Business Plan (“Plan”) in June
2016. This Plan was a step in the process to develop a pro forma budget for the first 10 years of operation of the
school as required by the Liaison Committee on Medical Education (LCME) for preliminary accreditation.
In 2017, the Texas legislature asked the University of Houston to “conduct a study on the need for an additional
medical school in Houston that prepares students for primary care in urban and rural communities.” This action
has provided UH the opportunity to bring together all the work and studies to present what it believes is a solid
report on how a UH College of Medicine could provide needed primary care physicians to fill a real gap for the
State of Texas.
In evaluating the tremendous work of the Committee and Planning Dean, it is clear that they have provided a
proposal for a UH College of Medicine that would stay true to the UH mission.
The following summarizes a proposal for the UH College of Medicine.

MISSION
The UH College of Medicine will be accountable for improving the overall health and healthcare of the population
of not only Greater Houston but also other urban and rural areas of Texas that face significant doctor shortages by:
  Educating a diverse group of physicians who will provide compassionate, high-value (high quality at
reasonable cost) care to patients, families and communities, with a focus on primary care and other
needed physician specialties, such as psychiatry and general surgery.
  Conducting interdisciplinary research to find innovative solutions to problems in health and healthcare.
  Providing integrated, evidence-based, high-value care delivered to patients by inter-professional teams.
  Engaging, collaborating with, and empowering patient populations and community partners to improve
their health and healthcare.

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VISION
By 2030, the UH College of Medicine will be recognized nationally for:
  Educating physicians who have a deep understanding of the social determinants of health, health
disparities, and how to work with communities to improve their health and healthcare.
  Educating physicians who are experts in providing high-value healthcare, managing the health of patient
populations, and continuously improving healthcare delivery.
  Graduating physicians who choose to practice primary care and other needed physician specialties in
underserved (urban or rural) communities.
  Educating physicians who are underrepresented minorities in medicine, beginning with K-12 and college
pre-medical ethnically and socioeconomically diverse “pipeline” programs.
  Conducting high impact, interdisciplinary research that contributes to improving health and healthcare,
capitalizing on the breadth of talent and expertise present across our Tier One research university.
  Providing inter-professional team-based care to patients in surrounding underserved communities and
beyond that is integrated, evidence-based, safe, and of measurable high value.
  Engaging, collaborating with, and empowering patient populations and community partners to achieve
measurable improvements in health and healthcare.
  Contributing to measurable improvements in the health of the underserved populations in surrounding
geographic communities that are currently socioeconomically disadvantaged and have significant health
disparities.

GUIDING PRINCIPLES
Through the work of the Planning Dean and the Internal Advisory Committee, a value proposition for the new UH
College of Medicine emerged around three key guiding principles:
  The college will educate physicians who will deliver high-value (high quality at reasonable cost)
healthcare.
  The college will strive to educate physicians who will choose to practice primary care medicine, and
other needed medical specialties, such as psychiatry and general surgery.
  The college will educate physicians who will be experts in working with communities with significant
health disparities to improve the health of their populations.

COMMUNITY-BASED MODEL
The trend in medical education over the past several decades has been to train students in community settings
rather than university teaching hospitals. This approach exposes students to the full spectrum of health issues,
and is proving to be significantly more flexible and responsive than the traditional model focused entirely on a
single, insular academic medical center. A central premise is that new physicians should be trained in the types of
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environments in which they will practice. In addition to a superior learning environment, this emerging model for
medical education is much more efficient in terms of both capital and operating costs.
In response to the changes in healthcare delivery over the last few decades, innovative approaches to medical
education have been developed that are:
  Community-based – where the medical school uses existing community hospitals and clinics for clinical
training. The medical school’s clinical faculty are typically located there, along with community faculty.
The ownership of the hospital is not under the control of the school. Increasingly, community-based
medical education programs are using community physicians as faculty.
  Ambulatory – where the medical student and their mentors work in an outpatient environment. This
can include but is not limited to patients in the hospital who do not stay overnight, ambulatory clinics,
and doctor’s offices.
Today, new medical schools are successfully training students in diverse community settings, where most of the
patients reside. The students see patients all along the continuum of health to disease in doctors’ offices, clinics,
hospitals, and in all the settings where healthcare takes place. Research has shown that these students are much
more likely to practice in settings outside of academic health centers than students trained in the high-tech
settings of tertiary and quaternary care.
This new model, like the traditional model for delivery of undergraduate medical education (UME), must pass
through the rigorous five-step accreditation process established by the Liaison Committee on Medical Education
(LCME).

New Model of Medical Education
  New curriculum incorporating community based healthcare
  Patient-centered care teams involving first-year students
  Managing patient populations that are considered at risk

Key Outcomes:
  Higher quality care
  Personalized medicine
  Better care decisions
  Patient-empowered care
  More efficient health care delivery
  A pipeline of primary care physicians serving the rural and urban underserved of Texas
Throughout its 90 year history, the University of Houston has not only remained true to its mission, but also
expanded its mission over the years. The new College of Medicine would further the University of Houston
System’s mission of serving people through access, high-quality care, medical research and education.
The College of Medicine will also provide the University of Houston with the opportunity to be a leader in
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transforming medical education through a primary care curriculum that will provide inter-professional teambased clinical education, while also leveraging research opportunities for faculty and medical students at a
Carnegie-named Tier One, world-class research institution. The new College of Medicine will strengthen the
University of Houston’s ability to broaden its partnerships and advance the health of the population in the region,
the state and beyond.
It is anticipated that opportunities for interdisciplinary collaboration for existing UH faculty and staff and those
of the new College of Medicine will be available and encouraged. As noted in other medical schools, such
collaborations might include:
  Existing UH faculty participating in some teaching assignments within the College of Medicine, and
College of Medicine faculty who might have joint appointments within other University departments.
  College of Medicine faculty serving on graduate committees in other disciplines.
  Attracting new high-performing research faculty.
  Attracting interdisciplinary research contract and grant dollars, which may involve sharing of specialized
research facilities and equipment.
  Participating in interdisciplinary innovative activities which could benefit the University community, the
greater Houston region and the state of Texas.
Clinical partners are an essential component of a community-based model. The Greater Houston Area enjoys
the presence of several large and excellent health systems. Despite the current existence of two medical schools
in Houston, there is ample clinical teaching capacity within the current healthcare systems to accommodate
additional medical students and residents from a third medical school. A number of healthcare systems have
capacity and have expressed an openness to developing clinical affiliation agreements, including teaching
students at a new UH College of Medicine. (See also the discussion of Residency Partners.)
Through its partnerships, the University of Houston will follow national best practices in access to care, clinical
services for the underserved, and in the development of better preventive medicine protocols and population
health management capabilities.
The University of Houston will develop teaching methods based on a team-based fully integrated community
health care model with a medical school, community health clinics, and inter-disciplinary fully integrated
hospitals in a comprehensive university setting.
The UH College of Medicine along with its research partners, will be the springboard for future economic
development and research in the Houston area and the State of Texas.
As a major employer in the Houston community, it is critical that the University of Houston maintains its ability
to be a national leader in research, provide expanding opportunities to change lives while being a catalyst within
its own community.
The new College of Medicine is seen as important to the University’s ability to contribute to the economic
development of the region and state. The new College of Medicine will enhance the University’s ability to attract
and retain faculty, to secure and increase research funding and to conduct translational research that transforms
knowledge and creativity into economic growth for the state.
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The well-being and quality-of-life of the University will be improved through the development of the new College
of Medicine. A wider array of health services and future cutting-edge clinical trials will improve the health care
options of the University’s employees and the larger community.
Ultimately the new College of Medicine will allow the University of Houston to strengthen its competitive position
among its aspirational peers. In addition, the new College of Medicine will allow the University of Houston to
continue its commitment to diversity, to embracing change, and to being a strong community partner in serving
the region and impacting the world.
Increased partnership and collaborative opportunities will also allow for additional National Institutes of Health
funding potential for the University and the state overall. Ultimately, the new College of Medicine will provide an
opportunity to transform the state’s medical education system with its own unique focus and purpose.

CURRICULUM DEVELOPMENT
A broad curriculum framework for the UH College of Medicine was developed by the Internal Advisory
Committee with the Planning Dean. A set of differentiating features have been identified to guide that effort:
  Curriculum emphasis on community and population health, primary care, behavioral and mental health,
and preventive medicine.
  Highly integrated teaching of biomedical, clinical, behavioral and social, and health system and
population health sciences throughout the four-year curriculum.
  Emphasis on inter-professional education and training.
  Adaptive education approach.
  Longitudinal primary care experience across the four-year curriculum.
  Longitudinal integrated core clinical clerkship.
  Emphasis on learning about social determinants of health and health disparities.
  Participation in an inter-professional student team providing household-centered care to a family living
in an underserved community throughout the four years of the curriculum.
  Learning about engagement and partnership with communities to improve their health and healthcare
through service learning.
  Emphasis on learning the health system and population health sciences.
The UH College of Medicine curriculum will focus on the areas of Biomedical Sciences, Clinical Sciences,
Behavioral and Social Sciences, and Health System and Population Health Sciences, and the academic
departmental structure will reflect this, containing four departments with these respective names.
Because of the high prevalence of behavioral and mental health issues in the population and in patients cared for
by physicians in all specialties, there will be a strong curricular emphasis on behavioral and mental health. And
because of the significant need to increase the number of physicians practicing in rural Texas, the curriculum will
require every medical student to participate in a four week clinical learning experience in rural Texas.
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CURRICULUM LENGTH, TERMINAL DEGREE, AND EDUCATIONAL APPROACH
  A four-year, broad-based curriculum integrating the biomedical, clinical, behavioral and social, and
health system and population health sciences, emphasizing community and population health,
primary care, behavioral and mental health, and preventive medicine, leading to a Doctor of Medicine
(M.D.) degree.
  Students will have opportunities to gain additional expertise through concentrated study in a number
of areas such as primary care, community health, population health, global health, health informatics,
healthcare administration, health policy, and biomedical ethics; or obtain an additional master’s
degree in business, health informatics, public health or public policy, during a fifth year of education in
conjunction with other UH colleges or other institutions of higher learning in the Greater Houston area.
  Students will be encouraged to participate in research and scientific discovery, and opportunities will be
available within the medical school and across the broader university community.
  “Pipeline” programs will be developed with area middle schools, high schools, and colleges in order
to attract and admit minority students who are under-represented in medicine. A post-baccalaureate
program leading to a master’s degree in biomedical sciences will be developed on the foundation of the
UH Honors pre-medical program to assist students who may need additional academic preparation in
order to gain acceptance into medical school.
  The medical school’s educational approach will be adaptive to learner needs and learning styles, and the
curriculum will be adaptive to changes in the healthcare system and the medical profession.
  There will be a strong emphasis on inter-professional education and training, with the goal of educating
healthcare professionals who will be adept at working together in inter-professional teams. This will
include students from UH colleges of medicine, nursing, pharmacy, optometry, social work, education,
liberal arts and social sciences, and law. Joint educational activities will include didactic courses,
simulations, patient care in clinical settings and service learning opportunities involving community
engagement and partnership to improve the health of communities.
  Innovative and best practice teaching methods will be utilized, including problem-based, case-based,
and team-based learning, “flipped classroom,” clinical simulation including the use of standardized
patients, virtual reality, telemedicine, and service learning.

BIOMEDICAL SCIENCES CURRICULUM
  The teaching of the biomedical sciences will be concentrated in the first 19 months of the curriculum,
but biomedical sciences concepts will be reinforced and amplified during the remaining months of the
curriculum that are more clinically focused.
  The biomedical sciences will be taught within the context of their relevance to clinical practice; utilizing
clinical correlations and clinical problem solving through problem-, case-, and team-based learning
exercises. Clinician faculty will join biomedical sciences faculty as co-teachers in this part of curriculum.
  The biomedical sciences will be taught using an integrated body system approach, as opposed to a
discipline-based approach. An initial Scientific Foundations of Medicine course (molecular and cell
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biology, metabolic pathways, genomics, pharmacokinetics, and pathobiology) will be followed by an
Integrated Medical Sciences course with system-specific blocks (musculoskeletal/skin, hematopoietic,
cardiovascular, pulmonary, renal/genitourinary, gastrointestinal and nutrition, endocrine/metabolic/
reproductive, and brain and behavior). The timing of clinical skills teaching will be coordinated with the
body systems teaching in the biomedical sciences curriculum.

CLINICAL SCIENCES CURRICULUM
  The teaching of clinical sciences will begin on “day one” of the curriculum; students will be exposed to
the care of patients in the community-based primary care setting as part of the clinical skills course and
longitudinal primary care clerkship experience.
  The clinical sciences curriculum will utilize clinical simulation and standardized patients to teach
fundamental principles of clinical care.
  The biomedical sciences will be taught within the context of their application to clinical medicine, with
significant utilization of clinical correlations and clinical problem solving exercises, including a review of
the scientific evidence in current biomedical literature.
  In lieu of a traditional block core clinical clerkship approach to teaching the clinical sciences, the
curriculum will combine a longitudinal integrated core clinical clerkship with short hospital-based clinical
rotations in internal medicine, surgery, obstetrics, and neonatology, and a required 4-week clerkship in
rural health. The longitudinal integrated clinical clerkship will involve spending time each week with an
internist, pediatrician, gynecologist, surgeon, psychiatrist, and family physician over a prolonged period
of time (six months), mostly in outpatient settings.
  Each student will be assigned to a primary care practice throughout the four-year curriculum in order
to gain longitudinal primary care experiences involving continuity of care of a panel of patients. In
traditional medical schools, exposure to primary care settings is limited to a more condensed period
that tends to result in fewer students choosing to practice in primary care.
  The final year of the curriculum will include some required inpatient clinical rotations (critical care,
acting internship) along with clinical electives across a broad range of specialties/subspecialties.

Behavioral and Social Sciences Curriculum
  The teaching of the behavioral and social sciences will happen across all four years of the curriculum,
and will be integrated with the teaching of the other sciences.
  Teaching methods will include didactic lectures; problem-, case-, and team-based learning exercises;
case studies; team-based projects; and cooperative service learning opportunities. Some of the learning
will occur in inter-professional education settings.
  Students will learn about the social determinants of health and health disparities in multiple settings.
  Students will participate in an inter-professional team providing family care an underserved community
throughout the four years of the curriculum.
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  Students will learn about engaging and partnering with communities to improve their health and
healthcare through inter-professional service learning experiences.
  Curricular content will include physician-patient communication, relationship-based care, the art of
healing, cross-cultural care and cultural fluency, motivational interviewing, behavioral treatments for
lifestyle modification, and the management of patients with addictions.

HEALTH SYSTEM AND POPULATION HEALTH SCIENCES CURRICULUM
  The health system and population health sciences (epidemiology, biostatistics, research design including
clinical trials, evidence-based medicine, clinical decision-making, health informatics, population health,
quality improvement and patient-safety, health economics, health systems and policy, biomedical ethics,
team-based care, and leadership) will be fundamental components of the curriculum and will be taught
across the four years in an integrated fashion with other sciences.
  Teaching methods will include didactic lectures; problem-, case-, and team-based learning exercises;
case studies; team-based projects; and cooperative service learning opportunities. Some of the learning
will occur in inter-professional education settings.

ANNUAL BUDGET PROJECTIONS
The initial class of 30 students is projected to enter in Fall 2020, and the size of the entering class will increase to
60 students in Fall 2022. A full entering class of 120 students will start in Fall 2024, and the school will reach its
full complement of 480 total students by Fall 2027 (Appendices D-1 and D-2).
The pro forma budget (Appendix B-1) is tailored to the stated vision and mission for a community-based medical
school with a focus on primary care. Recently accredited medical schools with similar missions, as well as other
UH professional schools, were used as benchmarks in the development of the pro forma budget. Benchmark data
informed planning assumptions about required numbers of faculty and staff, competitive salary rates, and typical
costs for fringe benefits and operating expenses.
Once the new College of Medicine reaches its planned enrollment of 480 students, it is expected to have 153
faculty and staff, and annual projected operating expenditures of approximately $33.3 million (expressed in 2016
dollars). Total expenditures are projected to be much lower in early years, with $23.1 million for the three years of
planning and $19.8 million for the first year of instruction.
The College of Medicine is expected to depend on multiple sources of revenue to fund its operations during its
first 9 years of student enrollment. State appropriations are projected to cover about 55% of expected spending
at full enrollment. Medical student tuition is projected to cover an additional 31% of costs. Additional sources of
revenue include sponsored research grants, medical practice, patient income, and philanthropy. Our budgeting
plan for the start-up years has approximately one third from legislative appropriations starting in FY 2020, one
third from philanthropy, and one third from incremental increases to our intellectual property revenue over and
above current levels. The College of Medicine will be on a separate cost center with its own transparent revenues
and expenditures.

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FACILITY NEEDS AND CAPITAL COST ESTIMATES
The new UH College of Medicine will require a significant amount of space in which to operate on the campus as
it grows to full enrollment. Given the length of time it takes for capital budget requests, approvals, design and
construction of a new facility, temporary space must be identified for the new college. University officials have
identified space on several floors in the new Health and Biomedical Sciences Building Phase II (HBSB-2) currently
nearing completion. After careful examination of College of Medicine interim space needs a “test fit” of the
identified space (floors 8 and 9), the consulting architectural team concluded that the available space in HBSB2 could meet the clinical instructional and administrative needs for a limited time period, with additional office
space available on the 6th floor. HBSB-2 could serve as a temporary home to the College of Medicine for three
planning years and the first two years of initial enrollment. Such an arrangement would provide the necessary
facilities and resources for attaining preliminary LCME accreditation. The temporary facility would house a small
number of students (anticipated maximum of 60), as well as administrators, faculty, and staff while the College of
Medicine grows. Interim space needs to service the temporary College of Medicine facility are based on faculty,
staff, and student projections. Assuming enrollment build out as outlined over a 10-year period beginning with
the charter class of 30 students in Fall 2020, a new permanent facility would need to be available by Fall 2022.
The total project costs (current dollars) for developing College of Medicine space in HBSB-2 is dependent upon
the end stage of build-out resulting from the current construction effort.
  An estimated project cost of $13.1 million will be required to build out the two floors of HBSB-2 to meet
the College of Medicine needs.
  The permanent College of Medicine facility will be built on campus, similar in scope/cost of HBSB-2,
but adjusted to the smaller project size. An on-campus utilities facility with existing parking (no cost
for added parking) is included in the Capital Cost Analysis. Total Project Costs are estimated to be $80
million (current dollars).

RESIDENCY PARTNER
This last legislative session, the Texas Legislature passed SB 1066 which requires in part that an institution of
higher education in their preliminary planning for a new doctor of medicine degree shall include a plan for an
increase in first-year residency positions for the graduate medical education program to be offered in connection
with the new degree program. The increase must be sufficient to reasonably accommodate the anticipated
graduates with a doctor of medicine degree that will come from the new program so that there will be adequate
opportunity for those graduates to remain in the state for the clinical portion of their education. This requirement
has been part of the efforts of our Planning Dean who has negotiated an arrangement with Hospital Corporation
of America (HCA) Gulf Coast Division. In this arrangement, UH will serve as the academic affiliate partner in
the development of 8 new residency programs including 103 new first year residency positions to be in place
by 2020, containing 309 total residents by 2024, with projections of further growth in the numbers of first year
and total residency positions to follow in ensuing years. Our plan includes adding additional residencies as the
opening of the College of Medicine draws nearer.

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ECONOMIC IMPACT
As part of the feasibility study, the consulting team completed an analysis to estimate the projected economic
impact of a new University of Houston College of Medicine. The analysis was conducted using a national
database of the economic impact of all U.S. allopathic medical schools (2012), developed by Tripp Umbach on
behalf of the Association of American Medical colleges (AAMC).
Based upon analysis of the impacts of established medical schools located in markets in which there is another
larger medical school (Los Angeles, Washington D.C., Chicago, Boston, New York City, and Philadelphia), it
is estimated that the total economic impact of the new College of Medicine enterprise will exceed $1 billion
annually by 2050 when the college is at full maturity (Appendix C-1). The new college is expected to sustain more
than 6,410 jobs statewide by 2050 (Appendix C-2). This impact will stem from the spending by the College of
Medicine and its partners on capital improvements, goods and services, the spending of staff and faculty, the
spending of medical trainees, and the spending (external to the institution) of visitors to the proposed school.
This impact is conservative in its projected spending related to capital expenditures needed to operate a medical
school, such as equipment, clinical supplies, and non-salary related expenditures for the medical school. In
addition, it is anticipated that the health research impact will increase from $25 million in 2016, to $125 million by
2050, a 400% increase. (Appendix C-3)
In addition, the economic benefits generated by the development of a new College of Medicine extend beyond
the direct impact of its operations. The number of benefits generated in the region as a result of the College
of Medicine will include newly constructed neighborhoods and schools to support the anticipated increase in
families relocating to the region, and communities championing the expansion of dedicated education, and
greater choices for entertainment. In addition to the construction of new homes and schools to support projected
population increases, the need for new retail, banking, and commercial opportunities will serve as additional
economic benefits for the region.
The new College of Medicine and its partnerships with other organizations throughout Texas will be the
springboard for future economic development in Houston and the state. These partnerships have the opportunity
to launch new industries and add value to existing industries, creating new high-paying jobs in health care,
higher education, and related industries.

WORK PLAN
The current work plan outlines the activities that need to occur to begin the recruitment of inaugural class by
2019 and admit first class by 2010 (Appendix E-1).

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APPENDICES
A — Internal Advisory Committee
B — Business Plan/Budget
C — Economic Impact
D — Timelines
E — Current Work Plan
F — Medical Education Committee

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Appendix A

INTERNAL ADVISORY COMMITTEE
CHAIR:
Stephen J. Spann, M.D., M.B.A. - Planning Dean, University of Houston College of Medicine

MEMBERS:
Muayyad Al-Ubaidi, Ph.D. - Professor, Biomedical Engineering, Cullen College of Engineering
Stuart E. Dryer, Ph.D. - John and Rebecca Moores Professor, Department of Biology and Biochemistry, College of
Natural Sciences and Mathematics
Jack M. Fletcher, Ph.D. - Hugh Roy and Lillie Cranz Cullen Distinguished Professor of Psychology and Chair,
Department of Psychology
Lynn M. Maher, Ph.D., CCC-SLP - Professor and Chair, Department of Communication Sciences and Disorders
William Monroe, Ph.D. - Professor of English, O’Connor Abendshein Professor, and Dean, The Honors College
Dan O’Connor, Ph.D. - Associate Professor of Health and Human Performance
F. Lamar Pritchard, Ph.D. - Dean, College of Pharmacy
Jessica Roberts, J.D. - Director, Health Law and Policy Institute, and Associate Professor of Law
Earl L. Smith III, O.D., Ph.D. - Greeman-Petty Professor and Dean, College of Optometry
Nathan G. Smith, Ph.D. - Associate Professor of Psychological Health and Learning Sciences, Counseling
Psychology Program, College of Education
Kathryn Tart, Ed.D., M.S.N., R.N. - Professor and Founding Dean, College of Nursing
Luis Torres, Ph.D. - Associate Professor and Associate Dean for Research and Strategic Partnerships, Graduate
College of Social Work
George Zouridakis, Ph.D. - Professor and Associate Dean for Research and Graduate Studies, College of
Technology

A-1

 University of Houston College of Medicine Report – November 2017

BUSINESS PLAN/BUDGET
Organizational Unit

Year 1
2016-17

Year 2
2017-18

Year 3
2018-19

Year 4
2019-20

Year 5
2020-21

Year 6
2021-22

Year 7
2022-23

Year 8
2023-24

Year 9
2024-25

Year 10
2025-26

Year 11
2026-27

Year 12
2027-28

Year 13
2028-29

Projected Expenditures

Fall 2016

Fall 2017

Fall 2018

Fall 2019

Fall 2020

Fall 2021

Fall 2022

Fall 2023

Fall 2024

Fall 2025

Fall 2026

Fall 2027

Fall 2028

Biomedical Sciences

0

0

353,808

2,830,467

3,891,892

4,245,700

4,953,317

5,307,125

Clinical Sciences

0

0

626,970

3,761,821

4,388,792

5,015,762

6,269,702

Behavioral & Social Sciences

0

0

306,105

612,211

918,316

1,224,422

Health Systems & Populations Sciences

0

0

324,504

973,511

1,947,023

300,000

1,192,750

5,035,750

7,073,000

8,703,000

300,000

1,192,750

6,647,138

15,251,010 19,849,022 21,460,410 24,052,577 25,660,325 28,223,187

Faculty, Executive & Professional FTE

0.00

2.50

11.17

29.33

38.67

40.67

47.33

50.33

56.00

61.00

63.00

65.00

65.00

Support Staff FTE

0.00

2.50

16.00

41.75

54.00

57.75

65.25

69.00

76.50

82.75

85.25

87.75

87.75

Total, Full-Time-Equivalent Positions

0.00

5.00

27.17

71.08

92.67

98.42

112.58

119.33

132.50

143.75

148.25

152.75

152.75

Student Tuition @ $21,431 per student

0

0

0

0

642,930

1,285,860

2,571,720

3,857,580

5,786,370

7,715,160

Sponsored Research Salary Support

0

0

0

221,903

443,806

489,593

577,651

577,651

711,496

711,496

711,496

711,496

Practice Plan Salary Support

0

152,750

389,448

809,189

893,137

977,085

1,144,981

1,312,877

1,480,773

1,732,617

1,900,514

2,068,410

State Appropriations - Formula
Funding @ $38,276 per student

0

0

0

0

0

0

4,593,120

Philanthropy

0

0

3,636,364

3,636,364

3,636,364

3,636,364

3,636,364

State Appropriations Start Up Funding

0

0

College Administration
Total, College of Medicine

Total

6,368,550

6,368,550

6,368,550

6,368,550

52,717,443

7,523,643

8,777,583 10,658,494

11,912,434

13,166,375

13,166,375

85,267,950

1,530,527

1,530,527

1,836,632

1,836,632

1,836,632

1,836,632

1,836,632

15,305,270

2,271,527

2,596,031

2,596,031

3,245,038

3,245,038

3,245,038

3,245,038

3,245,038

26,933,817

8,703,000

8,703,000

8,703,000

8,703,000

8,703,000

8,703,000

8,703,000

8,703,000

91,928,500

30,811,715 32,065,655 33,319,595 33,319,595

272,152,980

5,660,934

Projected Staffing Levels

Projected Revenue

300,000 1,040,000

19%

711,496

5,868,082

2%

2,068,410

14,930,190

5%

6,889,680 10,334,520

13,779,360 16,075,920 18,372,480 18,372,480

88,417,560

32%

3,636,364

3,636,364

3,636,364

40,000,000

15%

0 4,000,000 4,000,000 4,000,000 4,000,000 4,000,000 4,000,000 4,000,000 4,000,000 4,000,000 4,000,000

40,000,000

15%

31,502,748

12%

2,621,326

6,583,555 10,232,787 11,071,509

7,528,741

5,386,174

3,636,364

2,273,664

3,636,364

3,636,364

-763,282 -3,259,658 -5,756,034 -5,756,034

B-1

272,152,980

Appendix B

Required Additional Funding

51,434,400

9,001,020 10,286,880 10,286,880

 University of Houston College of Medicine Report – November 2017

Appendix C

ECONOMIC IMPACT

$1 Billion

$410 Million

T

C
E
L
OTA

IC
M
O
ON

CT
A
P
IM

0

2025

2050

.
Impacts do not include significant economic and employment impacts that will
result from the construction of facilities related to the new college of medicine.
Source: TrippUmbach: Evaluating the feasibility of a new college of medicine at the University of Houston

C-1

 University of Houston College of Medicine Report – November 2017

Appendix C

EMPLOYMENT IMPACT

6,410
T
C
A
MP

142%

I
T
N
ME

Y

2,653

L
A
T
TO

O
L
P
EM

C-2

 University of Houston College of Medicine Report – November 2017

Appendix C

UH HEALTH RESEARCH IMPACT

$150 M

$125M

400%

$70M

$25M

increase

$25M

0

2016

2025

2040

2050

C-3

 University of Houston College of Medicine Report – November 2017

Appendix D

2029-2030

2028-2029

2027-2028

2026-2027

2025-2026

2024-2025

1 2 3 4 1 2 3 4

2023-2024

Major Milestones

Quarter

2022-2023

Quarter

2021-2022

2018-2019 2019-2020

2020-2021

TIMELINE FOR DEVELOPMENT
CURRENT UNTIL FIRST FULL CLASS GRADUATION

Preliminary accreditation granted
Admissions activities
Enroll charter class of 30 students
Enroll 2nd entering class
Enroll 3rd entering class
Enroll 4th entering class

30
30
60
60
120

Enroll 5th entering class

120

Enroll 6th entering class

120

Enroll 1st complete class
Graduate initial class of 30

30

120
30

Graduate class of 60

120
60

120
60

Graduate 1st full class of 120

120

D-1

 University of Houston College of Medicine Report – November 2017

Appendix D

TIMELINE FOR PHASE-IN OF ENROLLMENT

Program
Year
First Year
Students
Second Year
Students
Third Year
Students
Fourth Year
Students
Total

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10
2020-21 2021-22 2022-23 2023-24 2024-25 2025-26 2026-27 2027-28 2028-29 2029-30
30

30

30

60

60

120

120

120

120

120

120

30

30

60

60

120

120

120

120

120

30

30

60

60

120

120

120

120

30

30

60

60

120

120

120

180

270

360

420

480

480

480

60

120

D-2

 University of Houston College of Medicine Report – November 2017

Appendix D

TIMELINE FOR DEVELOPMENT
CURRENT UNTIL CHARTER CLASS GRADUATION
ACADEMIC YEAR
Major Milestones

20172018

20182019

20192020

20202021

20212022

20222023

20232024

Quarter

Quarter

Quarter

Quarter

Quarter

Quarter

Quarter

1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
ACHIEVE APPLICANT STATUS
Obtain board/state approvals and funding commitments
Make initial contact with LCME
Submit LCME application letter; pay $25K fee

ACHIEVE CANDIDATE STATUS
Prepare and submit Preliminary DCI and Self-Study
LCME staff determines readiness for site visit
Receive candidate status

ACHIEVE PRELIMINARY ACCREDITATION
Work with LCME to schedule site visit
Site visit conducted by LCME team
LCME reviews survey report
Receive preliminary accreditation

COMMENCE RECRUITMENT AND ADMISSION OF CHARTER CLASS
Register with AMCAS
Develop admissions procedures and descriptive materials
Begin to receive applications
Review applicants
Interview applicants
Admit charter class
Welcome charter class to 1st day of instruction (30 students)

GRADUATE CHARTER CLASS
Implement 1st year of curriculum with charter class
Implement 2nd year of curriculum, welcome 2nd class
Receive provisional accreditation
Implement 3rd year of curriculum, welcome expanded 3rd
class
Implement 4th year of curriculum, welcome 4th class
Receive full accreditation
Conduct graduation ceremony for charter class

D-3

 University of Houston College of Medicine Report – November 2017

Appendix E

CURRENT WORK PLAN
Year

Date

Event

Purpose/Notes

2017

September/October

Negotiate LOI with hospital partner, Hospital Corporation of
America (HCA)

Establishment of multiple residency slots for potential medical students

2017

Fall

Consider relationship with FQHC for clinical care

Community health initiative, behavioral health, research and student
opportunities

2017

September 28th

Presentation to Faculty Senate

Information and status update

2017

October 2nd

Presentation to Faculty Senate

Information and status update

2017

Fall

DCI committees formed

Initiation of LCME accreditation preliminary activities 4 Faculty
Committees

2017

October 4th Breakfast

Presentation to LCME DCI Committee

Information and status update

2017

October 4th Lunch

Presentation to Faculty

Information and status update

2017

October 9th Lunch

Presentation to Faculty

Information and status update

2017

November 7th

Final Feasibility Report

For Board of Regents (BOR)

2017

November 7th

Presentation to Graduate & Professional Studies Program
Evaluation Committee

For approval of new M.D. degree (prior to Texas Higher Education
Coordinating Board (THECB))

2017

November 16th

Presentation to Board of Regents

Presentation of feasibility study report requested by legislature and
approval sought for establishment of the College of Medicine (no other
approval required from the state)

2017

November

Finalize agreement with hospital partner, HCA

Residency slots, etc.

2017

November

Search for leadership positions begins

Founding Dean
Chief Business Officer
Associate Dean for Medical Education
Associate Dean of Student Affairs
Associate Dean of Community Health

2017

November-December

College of Medicine Strategic Planning Retreat

LCME accreditation planning processes

2018

February 6

Graduate & Professional Studies (GPSC) Full Body Review

2018

February 22nd

BOR meeting

Approval of M.D. degree

2018

February

Presentation to Texas Higher Education Coordinating Board

Approval for new degree from THECB

2018

March

THECB Committee on Academic and Workforce Success
(CAWS) makes recommendation

2018

May

Leadership team in place or about to be in place

2018

June

Seek approval of M.D. degree from SACS

2018

June/July

Consultative visit from LCME

2018

Summer/Fall

Response from THECB regarding approval of M.D. degree

2018

August

Search begins for additional positions

Associate Dean of Faculty Affairs
Associate Dean of Research

2018

August

Initiate LCME application: Submit DCI/Self-Study

Accreditation process

2018

October

LCME approves Preliminary visit

2019

January

Legislative session begins

2019

February/March 2019

LCME Preliminary Site visit

2019

May

Legislative session ends

State Funding Approval

2019

June

LCME Reviews Site Team Report

Preliminary Accreditation Awarded

2019-20 June -- May

Recruitment of inaugural class

2020

Admit first class

July-August

Chair, Basic Sciences
Chair, Clinical Sciences
Chair, Health System and
Population Health Sciences
Chair, Behavioral and Social
Sciences

Assistant Dean for Curriculum
Additional faculty

Support for College of Medicine initiative

E-1

 University of Houston College of Medicine Report – November 2017

Appendix F

MEDICAL EDUCATION COMMITTEE
CO-CHAIRS:
Paula Myrick Short, Senior Vice Chancellor for Academic Affairs, UH System, Senior Vice President for Academic Affairs
and Provost, UH
Stephen J. Spann, Planning Dean, University of Houston College of Medicine
MEMBERS:
Muayyad Al-Ubaidi, Professor, Department of Biomedical Engineering, Cullen College of Engineering
Elizabeth Anderson-Fletcher, Associate Professor, Supply Chain Management, Department of Decision and Information
Sciences, C. T. Bauer College of Business
Raymond Bartlett, Senior Associate Vice Chancellor and Senior Associate Vice President for Finance, Division of
Administration and Finance
Mark Clarke, Associate Provost for Faculty Development and Faculty Affairs, Division of Academic Affairs
Elizabeth Coyle, Associate Dean for Academic Affairs, Clinical Professor, Department of Pharmacy Practice and
Translational Research, College of Pharmacy
Linda Davis, Director, Educational Technology, College of Liberal Arts and Social Sciences
Stuart E. Dryer, John and Rebecca Moores Professor, Department of Biology and Biochemistry, College of Natural Sciences
and Mathematics
Jack M. Fletcher, Hugh Roy and Lillie Cranz Cullen Distinguished Professor, Chair, Department of Psychology, College of
Liberal Arts and Social Sciences
Dennis Fouty, Associate Vice Chancellor and CIO - University of Houston System; Associate Vice President and CIO University of Houston, Division of Administration and Finance
Lisa German, Dean of Libraries and Elizabeth D. Rockwell Chair at the University of Houston Libraries
Scott Gilbertson, MD Anderson Professor, Department of Chemistry, College of Natural Sciences and Mathematics
Erika Henderson, Assistant Provost, Faculty Recruitment, Retention, Equity and Diversity, Division of Academic Affairs
Nick Holdeman, Professor and Associate Dean, Clinical Education, College of Optometry
Bruce Jones, Vice Provost for Academic Programs, Office of the Provost
Jami Kovach, Associate Professor, Department of Information and Logistics Technology, College of Technology
Mimi Lee, Professor, Department of Curriculum and Instruction, College of Education
Sandra Lee, RN-BSN Track Manager and Assistant Clinical Professor, College of Nursing
Lynn Maher, Professor and Chair, Department of Communication Sciences and Disorders, College of Liberal Arts and
Social Sciences
F-1

 University of Houston College of Medicine Report – November 2017

Appendix F

MEDICAL EDUCATION COMMITTEE (CONTINUED)
Daniel M. Maxwell, Associate Vice Chancellor and Associate Vice President for Student Affairs, Division of
Student Affairs
William Monroe, Dean, Honors College, Professor, Department of English, College of Liberal Arts and Social Sciences
Ricardo Nuila, Assistant Professor, Instructor, Honors College, Assistant Professor, Baylor College of Medicine
Daniel O’Connor, Professor and Chair, Department of Health and Human Performance, College of Liberal Arts and
Social Sciences
David Oliver, Associate Vice Chancellor and Associate Vice President, Facilities and Construction Management, Division of
Administration and Finance
Daniel Price, Clinical Assistant Professor, Honors College
F. Lamar Pritchard, Dean, College of Pharmacy, Professor of Pharmaceutical Health Outcomes and Policy
Miguel Ramos, Director, Institutional Effectiveness, Assessment and Accreditation, Institutional Planning and Analysis,
Division of Academic Affairs
Kathleen Reeve, Associate Dean, Director, Master of Science in Nursing Program, Clinical Professor, College of Nursing
Jessica Roberts, Associate Professor, George Butler Research Professor of Law, Director, Health Law and Policy Institute,
Law Center
McClain Sampson, Assistant Professor, Graduate College of Social Work
Amy K. Sater, Professor and Chair, Department of Biology and Biochemistry, College of Natural Sciences
and Mathematics
Jonathan P. Schwartz, Professor and Associate Dean of Graduate Studies, College of Education
Nathan Smith, Associate Professor, Department of Psychological Health and Learning Sciences, College of Education
Earl L Smith III, Greenman-Petty Professor and Dean, College of Optometry
Kathryn Tart, Professor and Dean, College of Nursing
Vanessa Tilney, Executive Director and Chief Physician, Student Health Center, Division of Student Affairs and
Enrollment Services
Luis Torres, Associate Professor, Graduate College of Social Work, Associate Director, UH Center for Drug and Social Policy
Research
Richard Walker, Vice Chancellor and Vice President for Student Affairs and Enrollment Services, Division of
Student Affairs
Dan Wells, Professor and Dean, College of Natural Sciences and Mathematics
George Zouridakis, Professor and Associate Dean for Research and Graduate Studies, College of Technology
F-2