Saturday was a big day for a newly-minted El Paso family. Mother Dayla, dad Jesse and Baby Isabel headed home after staying in hospital for almost 3 months after her birth.
As one would imagine, both Dayla and Jesse were ecstatic; however it was a long road to Saturday.
Isabel was born 2 months premature – due to a condition known as ‘hydrops’ – which means she had excessive amount of water around her vital organs, which is life-threatening even before the baby is born.
Physicians at Texas Tech University and El Paso Children’s Hospital had counselled Dayla prior to delivery about her baby’s severe condition and possibility that the baby may not survive after birth.
Shortly after birth, Isabel suffered respiratory failure and was put on machines to help her breathe. Also, tubes were placed in her both the lungs to drain extra fluid.
3 days after her birth, Isabel was also found to have arteriovenous malformation in the left hand.
Arteriovenous malformation is an abnormal connection between the blood vessels. This abnormality was causing extra blood to return to heart and eventually making fluid leak into her lungs and other organs. It was also making heart function very difficult.
A team of physicians at El Paso Children’s Hospital, which included Dr. Ajay Singh (Neonatologist), Dr. Sudheer Gorla (Pediatric Cardiologist), and Dr. Chetan Moorthy (Pediatric Interventional Radiologist) convened and decided that the only viable option for Isabel was to undergo a risky, but lifesaving procedure known as intravascular coiling.
As a part of this procedure, metallic coils were placed in Isabel’s left had to close off the abnormal blood vessels. After detail discussion with the family, the team of doctors decided to proceed with this high-risk procedure and were successful.
Following this procedure, Isabel required close intense monitoring neonatal intensive care unit. Finally, after 3-months of devoted, hard work by the medical team, she recovered and was discharged home with her family.
Dr. Gorla, the cardiologist involved in Isabel’s care, feels that the team was fortunate to diagnose this abnormality soon after birth. If this malformation had remained undiagnosed for long time, the results could have been deadly.
Dr. Moorthy describes this as one of the most challenging procedures that he has done in his career. According to him, Isabel will need close follow up and subsequent procedures when she is older.
Reasons for most cases of this unique disease (hydrops) remain unknown even after extensive work up, says Dr. Singh. The team’s systematic clinical approach led them to the timely diagnosis and intervention.
While Isabel had a rough start and hospital stay which was filled with ups and downs, her parents and her care team never gave up the fight.
In words of Isabel’s mother: “the whole process has been a miracle, nobody would even know looking at her now, what she went through after birth and the only reason she made it was because she was in El Paso Children’s Hospital”.
CANYON — Veterinarian Gregg Veneklasen loves what he calls “this part of the world.” He loves the natural beauty of the Palo Duro Canyon, the second-largest canyon in the country, only minutes from his home. He loves the peaceful vistas stretching across heartland plains. He loves the temperate weather, the friendly people and the animals he works with in his horse clinic near downtown.
But few young people want to move to rural areas like Canyon to practice veterinary medicine, and Veneklasen can’t blame them.
“If you’re a young guy, what in the hell would you want to live in Sunray, Texas, for? Insane,” Veneklasen said, referring to another Texas Panhandle city. “And raise a family? More insanity.”
Rural areas around the state are facing shortages of veterinarians as fewer young graduates want to practice away from urban amenities. In places like the Texas Panhandle — an agricultural focal point for the country — not having enough vets can pose serious consequences to livestock and food production. Texas livestock include over 1 million hogs, nearly a million sheep and over 12 million cattle. In 2016, there were only about 180 vets working on livestock in rural Texas areas.
Texas Tech University hopes to remedy that problem by opening its own veterinary school in Amarillo in the middle of the Panhandle. It would be the second veterinary school in the state. But Texas A&M University, which operates the only veterinary school in Texas, in College Station, and already sends veterinary students to study minutes away from where Tech hopes to build its new program, is less than enthused.
“It is completely redundant,” Eleanor Green, dean of the Texas A&M College of Veterinary Medicine, said about Tech’s proposed vet school. “There’s nothing they’re talking about doing that we don’t already do.”
Tech announced its desire to build a vet school in 2015, expecting to open in 2019, but the idea of a Tech vet school goes back to the 1970s. The plans got off to a sputtering start: the university shelved its proposals to prioritize medical school expansion. Tech announced it was pausing the latest plan in late 2016, but was granted $4.1 million from the Legislature in 2017 to restart the initiative. If all goes according to plan, the first class of Tech vet school students will begin in fall 2021.
A&M, whose program is ranked among the best in the world, has protested the newest proposals, saying Tech’s plans would be an inefficient use of state funds. But Tech said its program would complement A&M and fill a need that no one institution could.
One of the driving tenets of Tech’s new vet school is its non-traditional education model, said Guy Loneragan, a veterinarian and Tech professor who has developed much of the curriculum for the new school. Based on a teaching model developed at the University of Calgary, Tech’s program would send students out to do residency-like learning in participating clinics across rural areas.
Doing so, Loneragan said, would give students more exposure to rural practices as opposed to keeping students in a teaching hospital on campus far from the communities that are facing vetshortages. It would also spare the cost of constructing an expensive teaching hospital, he added.
A&M’s vet school plans to expand its freshman class size from 132 to 162 by next fall, which would be the largest veterinary class size in the United States or Canada, according a 2017 report commissioned by Tech. The report said expanding class size more would risk the quality of education.
About three-fourths of qualified vet school applicants are not admitted to A&M’s program because of class size constraints, the report said, pushing more applicants to seek education out of state. In the 1990s, close to 80 percent of Texas vet licenses were granted to A&M graduates. That percentage has steadily declined as the number of vet licenses in the state has increased exponentially.
“Texas is blessed with one of the world’s best vet schools, and for many good reasons,” Loneragan said. “But the growth in Texas has exceeded the capacity of any one institution and we’re developing a complementary program that together will more fully meet the needs of Texas than any one institution is doing at the moment.”
Green, the dean of A&M’s vet school, rejected the idea that the need for rural vets couldn’t be filled by a single school. West Texas A&M, located in Canyon, less than 20 miles from Amarillo, houses internships, rotations and research opportunities for A&M vet students in a rural setting. A&M also places students in residencies in rural areas while offering them the benefits of a world-class teaching hospital as well.
A&M recruits students from rural communities and mentors them as undergraduates to find students who are likely to practice in rural areas. President Walter Wendler of West Texas A&M visited every high school in the Panhandle’s26 counties to recruit students during the first few months of his presidency in 2016. West Texas A&M is constructing a new agricultural center and two new veterinary research and classroom facilities on campus, further expanding opportunities for vet students in the Panhandle.
Green added that A&M only accepts students it knows will excel in its program, dismissing the narrative presented in Tech’s 2017 report that A&M is not capable of meeting demand based on its admissions numbers. A&M has also built a new veterinary school facility on its College Station campus, which Green said allows the school to welcome larger classes to accommodate the demand for instruction that Loneragan said it could not, without sacrificing quality of instruction. A&M has the potential to increase vet class size by a couple hundred more, depending on need.
Young vets want to move somewhere where their spouses can have job prospects and there are amenities for their children, making urban areas more appealing, Green said. Strategic recruiting of people who are already familiar with rural communities and nurturing students who demonstrate a real desire to serve in rural areas are far more effective strategies than increasing the total number of admitted vet students, she added. A 2016 report from The Texas Higher Education Coordinating Board said building a new vet school could saturate the market for urban vets without fulfilling the needs of rural communities.
“Going into rural practice is as much of a lifestyle choice as anything,” Green said. “It’s going to be very difficult to get someone from a densely populated urban area to go live in a rural area with a population of 300.”
Loneragan said the new vet school would also recruit vets from rural areas. He cited the Tech-commissioned report, which said more than 90 percent of Texas vets are employed, and disputed the idea the school would cause a job market saturation.
Taylor Powell, a veterinary intern from the small North Texas town of Henrietta, graduated in May from A&M’s vet school. Powell, who is also a Tech graduate, currently works at a equine clinic in Lamesa in West Texas, where she focuses on racehorse treatment and surgery and treats dogs and cats as well as livestock.
Most vet school graduates end up working in metropolitan areas treating small animals like household pets, according to the Texas Higher Education Coordinating Board report. But Powell said she was drawn to serve rural communities like the one where she grew up.
“Those were the kinds of people that helped me, that encouraged me along the way to get me started,” Powell said. “So my goal has always been to find a way to give back “
The Texas Higher Education Coordinating Board report recommended funding a loan forgiveness program to tackle the rural vet shortage. One of the key barriers for young vets to move to rural areas is the high loans they carry after vet school and the low financial returns offered in rural areas, said Veneklasen, the Canyon vet.
Forgiving loans would cost a fraction of the $4.1 million the state appropriated to launch the Tech project and the $90 million the university has raised to construct the new vet school facilities, Green said.
“It’s obviously a much better investment to increase the support for and capabilities of a world-class veterinary school, and I’m so proud of that for Texas,” Green said. “And all we need is a little, tiny bit more to do far more than a new vet school could ever do, right now.”
Loneragan said the new vet school would eventually wean off of state funding and become self-sufficient within eight years of opening.
The city of Amarillo, where the new vet school is slated to be built, is also excited about the prospect of new academic activity. Reagan Hales, marketing director at the Amarillo Economic Development Corporation, cited Tech’s feasibility report, which predicted the new vet school would have an annual economic impact of $76 million — that’s new money flowing into the city from more jobs and markets created by the school.
The Amarillo Economic Development Corporation, which is funded by municipal tax dollars, pledged between $15 million and $69 million to go toward construction of the new vet school. With additional private contributions, Techsecured enough money to meet its budget requirement of $90 million for the new vet school facilities. The school is also submitting a request to the Legislature for additional financing to jumpstart operating costs, but it aims to be self-sufficient within a couple years.
Barry Allbrecht, president of the Amarillo Economic Development Corporation, said the corporation supports all universities and has not engaged in the debates between A&M and Tech.
Veneklasen is opposed to Tech’s vet school, but he recognizes the need to keep vets in rural areas. He characterized Tech’s vet school as a misguided use of funds that could go to other uses, like public education in the Panhandle.
Though Veneklasen said he makes a comfortable living — he is renowned among vets for his work with equine cloning — and enjoys the rural lifestyle, he said the need to attract new talent to the area is real. He said he and many of his rural colleagues are confident that A&M can deliver on the need and that Tech’s vet school and the ensuing drama are detracting attention.
“It’s not a football game,” Veneklasen said.
Disclosure: Texas A&M University and Texas Tech University have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.
The TTU System Board of Regents will tour of the TTUHSC El Paso campus on the morning of March 1 as part of their scheduled two day meeting here in El Paso.
TTU System BOR Chairman Rick Francis, TTU System Chancellor Robert Duncan, and TTUHSC El Paso President Richard Lange will all be in the Sun City, holding the meeting at the TTUHSC El Paso campus.
This marks the fourth time the Board of Regents has met in El Paso and the first time since 2012. The last time a board meeting was held at a TTU System campus outside of Lubbock was in 2015, at Angelo State University (San Angelo, Texas).
Meeting materials and a livestream of the meeting will be available online. The meeting will take place in the MEB’s Jonathan and Patricia Rogers Lecture Hall (first floor, room 1100).
TTU System Board of Regents Meeting Schedule
Thursday, March 1
10:15 a.m. – Call to order; convene meeting of the board
Strategic Planning Updates
TTUHSC El Paso
Angelo State University
4:30 p.m. – Recess for the day
Friday, March 2
8:30 a.m. – Call to order; reconvene meeting of the board
The latest version of the U.S. News and World Report college rankings are good news for Texas private schools. Not so for the state’s top public universities: All of them dropped in the influential list of the best schools in the country.
Rice University, which is ranked 15 nationally, remains the clear No. 1 in Texas. It climbed three spots from 18 last year. SMU and UT-Austin are far behind in a tie for 56. Last year, SMU was 61 and UT-Austin was 52.
The U.S. News and World Report rankings are highly controversial. Critics call them too simplistic and say students and school administrators pay too much attention to them. But there is no question that the rankings are important. Gov. Greg Abbott has said he wants to see five Texas universities among the top 10 public schools. (Currently, there are none.) UT System Chancellor Bill McRaven has often cited the rankings during discussions of higher education policy in the state.
The biggest climber in the state was SMU, not counting Dallas Baptist University, which wasn’t ranked last year but came in 214 this year. The biggest fall came from Texas Tech University, which dropped eight spots to 176.
Here’s a list of the Texas schools. Their rankings last year are in parentheses.
15. Rice University (18 last year)
56. SMU (61)
56. University of Texas at Austin (52)
71. Baylor University (72)
74. Texas A&M University (70)
82. TCU (82)
146. University of Texas at Dallas (140)
176. Texas Tech University (168)
194. University of Houston (187)
214. Dallas Baptist University (unranked last year)
Read more higher education coverage in the Texas Tribune:
Less screaming, more diversity: Texas A&M’s Corps of Cadets is rebooting for the 21st Century.
Disclosure: The University of Texas at Austin, Texas A&M University, Rice University, Texas Tech University, the University of Houston and Southern Methodist University have been financial supporters of The Texas Tribune. A complete list of Tribune donors and sponsors can be viewed here.
Blair Cushing is just the kind of doctor Texas needs.
She’s training to be a family physician, one of the most sought-after types of practitioner in the state. And she wants to work near the U.S. border with Mexico, one of Texas’ most medically underserved areas.
But after graduating from the University of North Texas Health Science Center’s Texas College of Osteopathic Medicine last year, she shipped out to another border state: California. That’s where she found her best residency opportunity. And now she says she probably won’t come back.
Her situation is far from unique. The number of medical students in Texas has grown quicklyin recent years, with classes expanding and an unprecedented number of new medical schools being developed.
But even as it invests tens of millions of dollars in new schools, some state lawmakers warn Texas could end up shooting itself in the foot. Because it does not adequately fund the residency programs needed to keep medical students here, they say, the state is effectively creating an expensive pipeline that will funnel doctors elsewhere.
Some officials are questioning whether Texas hasstretched its resources by building so many medicalschools so quickly, suggesting it might be time to slow their proliferation.
“I am worried about continuing to expand higher education facilities beyond their ability or the willingness of the state to support them,” said Raymund Paredes, commissioner of the Texas Higher Education CoordinatingBoard. “I fear that it is a pathway to higher education mediocrity.”
Since 2009, the growth has been frenetic. The Texas Tech University System hasopened a school in El Paso. The University of Texas at Austin is building one on the southern part of its campus. And the University of Texas-Rio Grande Valley’s school will enroll its first class this fall.
Meanwhile, three other public universities are actively pursuing new schools. The UNT Health Science Center is partnering with Texas Christian University to open a new school in Fort Worth by 2018. The University of Houston wants one by 2019. And Sam Houston State is exploring the development a school of osteopathic medicine near The Woodlands.
Universities and state legislators have plenty of reasons to want those schools. Theirpresence on campus — or in a university system — helps build prestige and attract research funding. The schools can also dramatically improve local economies and health care systems.
But in fiscally conservative Texas, it can be hard to find the funds necessary to keep MDs around for their required post-graduate training.
For most specialties, that includes a three-to-seven year residency after four years of medical school. Graduates work at a hospital or clinic, overseen by faculty mentors, to gain experience required for state licensure and board certification.
The average residency slot costs at least $100,000 per year, according to industry group Teaching Hospitals of Texas. That includes what medical schools payto hire faculty as well as costs borne by hospitals to pay for a resident’s salary, benefits and malpractice insurance.
That investment is worth it in a state with a severe doctor shortage, said Maureen Milligan, the hospital group’s president and CEO. Texas currently lags in its relative number of physicians — 41st among all states, according to the Association of American Medical Colleges — and the state will need more doctors to keep pace with population growth and the turnover that comes with an aging workforce.
“If you have medical school grads and you don’t have these residency positions, then you’re just really investing in a flow that’s going to go somewhere else,” Milligan said. “Our concern is the bulk of the current residency programs are at risk.”
The federal government, through Medicare, is the largest payer for graduate medical education. But the state shoulders some of the costs as well.
Lawmakers last year passed Senate Bill 18, which created a roughly $300 million endowment to fund graduate medical education starting in 2018.
That measure was intended to make the number of residency slots in Texas greater thanthe number of medical students graduating — at a ratio of 1.1 residencies for each graduating MD — leavinga few residency slots left over to attract graduates from other states. The idea was to bolster the ranks of doctors practicing in Texas, but as more medical schools come online, churning out more graduates, that ratio will become more expensive to maintain, lawmakers said.
“The more people we graduate, the more it costs to reach our goal,” said bill author and state Sen. Jane Nelson, R-Flower Mound, in a prepared statement.
State Rep. John Zerwas, R-Richmond, a physician and chair of the House Committee on Higher Education, praised Nelson’s measure but warned of expanding costs as the number of medical students grows.
“We made a big step this last session to catch up with that, but that’s simply all it’s doing, is catching up,” he said. “If we add to the pipeline more medical students coming in, then we’re going to find ourselves back in the same predicament.”
In 2014, there were 7,400 medical students in Texas and 7,800 residents, according to the Association of American Medical Colleges.
But the universities appear undeterred. UH has already hired a dean, Stephen Spann, in charge of planning for its medical school. Spann said he understands state leaders’ worries, but UH is “far enough along in our exploration and assessment to conclude there is a need for a community-based, primary care-oriented medical school.”
Meanwhile, Michael Hicks, executive vice president of clinical affairs at the UNT Health Science Center, said his school understands the need for more residencies. But he said the state also needs more medical schools, and Fort Worth is the biggest city in the country without a school conferring MD degrees. If lawmakers wait until the residency shortage is taken care of to build new schools, it would take decades before both problems are solved, he said.
“We have the capacity to deal with these issues concurrently,” he said.
The UNT System has tried and failed for years to get state authorization for a new MD school. Its partnership with the private TCU, which will issue the degrees, allows it to proceed without that approval.
But Zerwas said investing in residency programs instead of opening new medical schools might be a better use of state money.
“There’s a limited pot of funds, and as budgets become crunched, one of the favorite places the Legislature will go is to compromise funding to higher education in general, which would include the health-related institutions,” he said. “We need to be thoughtful about the development of more medical schools, as opposed to just the ambitions of a university to have a medical school for whatever prestige that brings them.”
Cushing said her classmates at the UNT System school struggled mightily to find residencies nearby. Many had family ties to Texas but ended up leaving — sometimes separating from their spouses temporarily.
Once they’re gone, the chances of doctorscoming back are slim. As they complete their residencies, they start building connections and launchingtheir careers. Some start families, and the pressure to stay put when they’re done is immense.
Knowing that slots were so limited, Cushing applied to more than 30 programs and went to 18 interviews. Only about a third of them were in Texas. Now, she said, there’s a good chance she’ll stay in California.
“As much as I have the passion for the social problems of Texans, I also see how it would be far easier to stay put,” she said.
Disclosure: The University of Texas at Austin, Texas Tech University and Sam Houston State University are corporate sponsors of The Texas Tribune. The University of North Texas was a sponsor in 2014, and the University of Houston was a sponsor in 2013. A complete list of Tribune donors and sponsors can be viewed here.