Funding the Future

Issue 27 | May 2017

Funding the FutureAs a major teaching center, Baylor Scott & White offers GME training to hundreds of residents and fellows at hospitals throughout Central Texas. Advanced education in medicine continues the vital training of medical students who have completed the four-year medical school degree and helps them prepare for clinical practice.

“It’s essentially on-the-job training. We consider it an honor to help prepare students to practice medicine,” says Christian Cable, MD, an oncologist with Baylor Scott & White Health, medical director of Scott & White’s GME program, and chairman of the GME Committee.

Dr. Cable says the GME program at Baylor Scott & White benefits not only the system and its patients but also the state of Texas by adding to the number of physicians living and working in the state. Statistics show most residents and fellows remain in the state where they received their training. Furthermore, 20 percent of the Baylor Scott & White GME graduates take jobs in the Baylor Scott & White system. “We have a wonderful pool of young physicians to recruit from,” Dr. Cable says.

Funding the Future

Growth and a funding gap

But funding medical school graduates’ training at Baylor Scott & White Health poses challenges because residents and fellows do not pay tuition. Instead, they receive salaries to work alongside Baylor Scott & White teaching physicians, who are affiliated with the Texas A&M Health Science Center College of Medicine, to learn their medical specialties. Depending on their chosen specialty, graduates’ training takes three to seven years. The cost of GME training is expensive and is further challenged by limits to public funding established two decades ago.

As part of the Balanced Budget Act of 1997, a cap was imposed on the Medicare funds that could be used to meet the costs of graduate medical education programs. The cap froze the number of GME positions per training center, based on 1996 population statistics. In the 20 years since, the population along the Interstate-35 corridor has grown tremendously and so have the operations of Baylor Scott  & White Health in Central Texas. “All of this has led to us growing our clinical enterprise, including residencies and fellowships, proportionately,” says Dr. Cable. The Temple hospital now hosts 490 residents and fellows in 40 GME programs. Of that number, about 200 of the positions are “above the cap” and thus not funded by Medicare. That extra cost, $3.5 million annually, comes out of the healthcare system’s annual operations budget.

“We have tried to be very good stewards of our funding,” Dr. Cable says. “We work to be as cost effective as possible while providing the highest level of training to our students.”

Fred Slicker Training Texas Physicians Fund

Fred Slicker and Kipp Slicker, DONevertheless, Dr. Cable believed another source of funding was necessary to sustain the GME program. “In the future, Medicare will likely be less involved with the training of physicians,” he says. Earlier this year, a new fund was established in memory of the father of a 2016 graduate who had completed a three-year internal medicine residency at Baylor Scott & White, followed by three years in cardiology, and one year in interventional cardiology. Kipp Slicker, DO, was one of Dr. Cable’s recruits eight years ago from the Oklahoma State University College of Osteopathic Medicine in Tulsa. During the last few months of his residency in internal medicine, Dr. Slicker’s father Fred was diagnosed with, and later died from, multiple myeloma, a cancer of the blood. In January, the GME committee at Baylor Scott & White established the Fred Slicker Training Texas Physicians Fund to honor Dr. Slicker’s father and start building a philanthropic stream to fund the GME program.

Fred Slicker had received radiation treatment in Tulsa but needed a stem cell transplant, which was not available in Oklahoma. Dr. Slicker knew that Dr. Cable performed autologous stem cell transplants to treat myeloma, and soon his father journeyed to Temple to become Dr. Cable’s patient. Dr. Slicker says the development altered his outlook on the education he was receiving. “It becomes even more real to you when your mentor is taking care of your family,” he says.

Mr. Slicker received a stem cell transplant, and his condition improved. He lived another four years, surpassing his original prognosis of two years at most, and was able to see his son graduate in June 2016 before finally succumbing to the disease in October. “I know he lived longer and had a better quality of life because Dr. Cable and his team were taking care of him,” Dr. Slicker says. That team included residents and fellows Dr. Slicker knew from the GME program.

Dr. Slicker says his father strongly supported his medical education. “He was so proud of my accomplishments,” he says. Thinking about how his father would react to having a fund to benefit GME named after him, Dr. Slicker says, “I think that he’d be embarrassed by it, but I know that its purpose is what he was all about. I just wish I could tell him about it.”

Dr. Slicker was one of the first donors to the fund named in his father’s memory. “I just want something to keep the GME program at Baylor Scott & White going on in perpetuity,” he says. “The community of it all is what really attracted me to the program originally,” says Dr. Slicker, who now practices cardiology at the Harbin Clinic in Rome, Georgia.

“The fund is the beginning of something we hope will be a good tradition,” says Dr. Cable. To contribute to the Fred Slicker Training Texas Physicians Fund, please contact Lori Luppino at 254-899-3771.

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