$42.8M medical school buyouts ‘absolutely’ worth it, dean says

The University of Saskatchewan’s cash-strapped medical school spent $42.8 million to buy out about 100 tenured physicians over the last two years — about 65 of whom accepted severance packages worth up to $450,000 each before signing on to continue working at the college as paid contractors.

The buyouts cost the college $17.8 million more than expected when the program was announced, and all but drained its reserves. However, according to its dean, Preston Smith, the expense was “absolutely” worthwhile because it increased the faculty from 130 physicians who combined to provide 35 full-time equivalent teaching jobs to about 250 accounting for 80 full-time equivalent positions.

Most of the $42.8 million expense was expected to be incurred in the 2016-17 fiscal year, but the College of Medicine was able to “accelerate the timeline,” according to the university. That expense caused the college’s total spending on salaries to jump 39 per cent, to $154.4 million from $110.5 million, in the 2015-16 fiscal year, according to university records.

Smith acknowledged the timing is “horrible” but said the buyouts were part of a necessary response to a 2013 report that described the college as facing “a crisis in the core aspects of its mission” as well as a 2012 letter from the Student Medical Society of Saskatchewan that said students were concerned that problems such as a lack of instructors were affecting their education.

“It’s kind of (an) ‘If not now, when?’ kind of change. This had to happen if this was ever going to be the high-flying medical school that it has the potential to do,” Smith said in an interview two weeks after the university revealed that the medical school is expected to fall $17 million short this year, bringing its total deficit to $57 million and causing “unhealthy tensions” on campus.

The university has attributed the college’s fiscal situation to the provincial government holding back a total of $40 million in funding in 2015-16 and 2016-17, as well as its ongoing struggle to secure accreditation. The College of Medicine has twice been placed on probation and the expenses are necessary to avoid an “unprecedented” third probation, according to the university.

The Saskatchewan Party government, meanwhile, contends that it has provided the college with plenty of support since it was first elected in 2007, despite the fact that it has been criticized for cutting $18 million from the university’s $312 million operating grant as part of a broader effort to trim about $600 million from a $1.2 billion deficit this year.

Advanced Education Minister Bronwyn Eyre was not available for an interview this week. In an emailed statement, she said the government provided the college with $69 million this budget year, bringing its 10-year total to $560 million, of which $150 million was earmarked for costs associated with accreditation — which has been an issue for the medical school for almost 15 years.

While the university is autonomous and must decide for itself how to manage and allocate funds, the government redirected $20 million to the college from the university’s operating grant this year, and “will continue to monitor issues and concerns related to the college’s upcoming accreditation review,” she wrote.

In an interview with the StarPhoenix earlier this month, Eyre said the university also has to “look at challenges they’re facing in new and different ways.”

Smith said buying out the tenured physicians was important to “engage” doctors in the community — it’s common in other similar-sized cities for all local physicians to work in its medical school — which allows medical students to learn from more specialists as well as ensure those doctors are accountable for their academic work. That was not always the case previously, he said.

“It was certainly a fresh start.” It remains unclear, however, how the college will address its $57 million shortfall or whether the provincial government will provide the $17.3 million university administrators have said it needs to cover its costs and start paying down the deficit next year. Eyre told the StarPhoenix earlier this month that those decisions are part of the 2018-19 budget cycle and need cabinet approval.

Smith said the college — which spends between 75 per cent and 80 per cent of its money on salaries, including those of about 100 faculty who teach undergraduate biomedical courses separate from its medical doctor program — must continue to persuade funders that the province is better off with a medical school, as its own fundraising and cost-cutting efforts won’t solve the problem.

“I’m willing to sit down with government and work through the numbers to demonstrate that we’re actually no more expensive than other medical schools,” Smith said.

I’m willing … to demonstrate that we’re actually no more expensive than other medical schools.