Why Should Delaware Care?
Delaware is set to open its first medical school in 2028. For years, lawmakers and healthcare leaders have pointed to healthcare worker shortages in the state, especially below the C&D Canal. And as Delaware gets older and sicker, more physicians and specialists will be necessary to meet the demand.
Last week, Delaware announced it would open its first medical school in partnership with Thomas Jefferson University, bringing one of Gov. Matt Meyer’s campaign platforms to life.
Meyer hoped the school would help to close the medical professional shortage gap in the state. When the federal government announced last summer it would dish out billions of dollars across all 50 states to build out their rural healthcare infrastructure, the possibility of a medical school came into focus.
But some questions still remain unanswered about how exactly the school will operate, and how some of the more technical agreements will work between more than a dozen state institutions taking part in the venture.
The state has committed to funding dozens of students’ educations if they commit to working in rural Delaware following their graduation, and nearly a dozen hospitals and higher education institutions have rallied around Jefferson as a “consortium” to stand up the medical school. Currently, students are set to begin classes in 2028.
But Spotlight Delaware has yet to see any signed agreements between Delaware’s hospitals, higher education institutions or the state, so the exact operations of the medical school remain unclear. A public records request for those materials is pending.
Here is what we know about Delaware’s first medical school, and its potential impact on the state’s healthcare landscape.
Who’s paying for this?
A federal taxpayer grant, for at least five years, will pay for Delaware’s medical school. But state officials have said that following those five years, the medical school will be able to sustain itself.
The grant, the Rural Health Transformation Program, is aimed at improving rural health across the country. It was created last summer to court Republican senators hesitant to support more than $900 billion in cuts to Medicaid, which could disproportionately impact rural communities and their healthcare facilities.
In February, Meyer’s office released an initial batch of requests for potential vendors to carry out programs that will be funded by the federal grant.
It came weeks after the state received its first award from the federal government totaling more than $157 million. The full RHTP award amount for the state remains unclear, but Delaware will receive at least $500 million from the multi-year program.
In plans submitted to the federal government, Delaware budgeted more than $100 million to run its medical school for five years. But Neil Hockstein, chair of the Delaware Health Care Commission, said the signed contract allows Jefferson to run the school for $78 million.
Asked how the state is required to spend the remaining funds, he said Delaware is allowed to reallocate that money to any of its other 14 RHTP initiatives.
Hockstein added the state intends to spread those leftover funds across multiple different programs instead of reallocating them to just one initiative.
Additionally, Hockstein said when the federal money runs out for the medical school, it would be “self-sustaining without an influx of state dollars.” Still, he said he hopes the state’s philanthropic ventures would help to support the medical school’s future.
Free medical education?
When the state announced Jefferson would run the medical school last week, Meyer also said students in the first cohort would be eligible for a free education. To qualify, Meyer said students would need to commit to practicing in one of the state’s rural hospitals.
That would likely mean five years of work at Bayhealth, Beebe Healthcare or TidalHealth. But at the moment, TidalHealth – western Sussex County’s principal hospital – is not a part of the agreement between the dozen healthcare and higher education institutions to collaborate on the medical school.
Students in that first cohort receiving free education would be allowed to leave the state for their residency, but would be required to return to Delaware following that post-graduate education. For that first cohort, Delaware officials said that tuition would be funded through the federal grant.
“Students who enroll in the Primary Care–Rural Health pathway, or who complete their clinical training in Delaware, may be eligible for financial awards covering the full cost of their education in exchange for a commitment to practice in rural Delaware after completing their training,” a spokesperson for the Delaware Department of Health and Social Services (DHSS) said.
Why UD, will it move downstate?
For months, as questions loomed over who would run Delaware’s maiden medical school, the location remained just as unclear.
So when officials announced last week that the University of Delaware would host medical school classes in Newark, questions arose over why the state would select a northern, suburban venue if it wants to bolster rural health.
Representatives from the university did not answer whether there are plans to move the campus downstate at any point, but state officials have made the argument in the past that where the campus is located is not as important as the curriculum it offers.
“Jefferson and UD have worked together to educate Delaware students for decades, and this partnership builds directly on that foundation,” a spokesperson for DHSS said.
According to a FAQ page for UD about the medical school, students enrolled in Jefferson’s program would attend two years of classes at its campus then be placed into clinical rotations somewhere downstate.
The university’s webpage also said the new medical school would have no impact on its tuition or programs, and that the university is not running the medical school, simply hosting classes for Jefferson.
The rural health grant prohibits Delaware from using any money for new construction. Still, the university said last week that space on its campus would be “refurbished” using the federal grant and would supplement the work of its College of Health Sciences.
According to the federal government’s requirements for the grant, capital expenditures for the state’s entire grant cannot exceed 20% of its budget.
The state has two other large capital expenses it will likely incur using RHTP funds, its two proposed homeless shelters in Kent and Sussex counties, though it is unclear at the moment how much these renovations will cost.
What happens to DIMER?
For those who heard news that Delaware would be opening its own medical school, some within the state may have asked about existing state programs meant to place Delawareans into medical education.
The Delaware Institute of Medical Education and Research, better known as DIMER, is the state’s most prominent medical education program. Currently, it places Delaware students into nearby medical schools like Jefferson and the Philadelphia College of Osteopathic Medicine (PCOM).
Jefferson reserves 20 seats annually for Delawareans and PCOM reserves 10. With both of those universities having competed to run the medical school, and Jefferson winning the race, some questioned whether DIMER would become obsolete.
It appears, however, that DIMER will continue to operate as normal, but may evolve in the coming years. At a Delaware Healthcare Commission meeting on Thursday, Hockstein said the medical school and DIMER programs serve different purposes.
“One is to give Delawareans an opportunity to get into medical school, and the other is to bring students from around the country to Delaware, where they can train,” Hockstein said during the meeting.
Hockstein also hinted that the program might shift toward specialty training and sending students away to bring back clinical skills the state sorely lacks.
In a statement from PCOM, a spokesperson said the college is “committed” to its DIMER partnership with Delaware. Hockstein also said the state and PCOM had discussed its role in DIMER and that the college was “very enthusiastic” about continuing its work in the program.
A key part of the state’s strategy in training and retaining doctors in Delaware is banking on students who complete their residency in the state and stay for the long term. On top of the financial aid incentives built into the federal grant, the state hopes to close the physician gap.
“Together, these investments are designed to strengthen Delaware’s long-term physician workforce and improve access to care in communities that need it most,” a spokesperson for DHSS said.
