Not a done deal: Here’s what’s next for proposed Charlotte med school.

Several significant questions remain about a proposed four-year medical school for Charlotte, a project that could generate millions of dollars for the region’s economy and bring a wave of new medical professionals to the area.

The proposed school — part of a broader project in which Atrium Health, Wake Forest Baptist Health and Wake Forest University plan to create a new health care system — could generate hundreds of millions of dollars in annual economic impact for the Charlotte region, according to one Pennsylvania health care consultant.

But the school, announced in mid-April, is not a done deal, and much remains unclear about the project as the three groups negotiate terms this year.

For one, the campus would need approval from a national body that issues accreditation to medical schools. It’s also not known yet where the Charlotte school will go, as the three groups have not disclosed such details.

Here’s a look at what the school might mean for Charlotte, what needs to happen next and challenges the project might face.

Economic impact

A medical school would provide a big economic boost to Charlotte, said Paul Umbach, founder and president of Pittsburgh-based Tripp Umbach health care consulting firm.

The campus could generate up to $675 million in estimated economic impact annually, according to Umbach, whose firm produced a report in 2015 on the feasibility of a four-year medical school in the Charlotte region.

One way the school could lift the economy is through new jobs, according to the report. It projected that the school could generate as many as 4,500 jobs, including from spin-off business activities, in the region over time.

In the U.S., Charlotte is a rarity for a city its size that lacks such a campus, the report found. “It’s the largest city that doesn’t have one,” Umbach said.

But the school would not immediately generate $675 million annually, according to Umbach’s study.

It could take 15 years to reach that level, the study said, noting that the school would initially produce about $85 million in annual economic impact once all four years of medical education are in place.

New medical schools tend to receive smaller amounts of federal research dollars and have smaller class sizes than more established schools — which factors into the lower economic impact at new schools, the report said.

Umbach said recently that estimates in the 2015 report were “extra conservative” because they were based on a regional four-year campus of the UNC School of Medicine at the University of North Carolina at Charlotte.

Accreditation needed

Charlotte-based Atrium and the Wake groups, which are based in Winston-Salem, also will need to receive accreditation for the school before it can open.

The groups have described the school as a second campus for Wake Forest School of Medicine and have said it could take a few years for the campus to open.

The Liaison Committee on Medical Education in Washington, D.C., accredits medical schools.

New medical schools seeking accreditation must prove that they have adequate space and funding, among other things, said Donna Waechter, assistant secretary of the committee. The majority of new schools are accredited, Waechter said.

Typically, it takes at least a year for an applicant to receive preliminary accreditation, she said.

According to the committee’s website, the most recent schools to be given accreditation are Kaiser Permanente School of Medicine in California and New York University Long Island School of Medicine. Both received accreditation this year.

Nationwide, the pace of new medical school growth has increased in recent years, Waechter said. From 2002 to this year, 30 new medical schools received accreditation, compared with none from 1983 to 2001, she said.

“There’s been much written about the need for more doctors in the U.S., so that has spurred some places on to establish their own schools,” Waechter said.

Atrium’s involvement in the proposed Charlotte school is not unusual. Some health care systems have become interested in helping establish medical schools as a way to generate more doctors who might eventually go to work for those systems, Waechter said.

North Carolina has four accredited medical schools, according to the Liaison Committee on Medical Education.

Those are Brody School of Medicine at East Carolina University; Duke University School of Medicine; Wake Forest School of Medicine, part of Wake Forest Baptist Health; and UNC School of Medicine, part of the University of North Carolina at Chapel Hill.

As for the success of new medical schools, Waechter said those that have opened since around 2008 are still in operation.

“Most of them have increased their class size, too,” she said. “Financially, they’ve been able to do that.”

Specialized schools aren’t guaranteed success, though, as evidenced by the collapse of Charlotte School of Law. In 2016, the American Bar Association pulled the for-profit school’s accreditation, citing “persistent” and significant problems with its admissions, curriculum and student performance on the bar examination.

CMC Atrium
Atrium Health’s flagship hospital in Dilworth. John D. Simmons

‘Simply insurmountable’

Plans for the medical school in Charlotte do not involve the UNC system, which already has a satellite campus of the UNC School of Medicine in Charlotte. That campus has been in Charlotte since 2010 under a partnership with Atrium, and teaches third- and fourth-year medical students.

Last month, UNCC Chancellor Philip Dubois and the UNC School of Medicine dean wrote an Observer opinion column arguing that now was not the right time for a four-year UNCC medical school. Public and private funding challenges to build such a campus “are simply insurmountable at this time,” Dubois and A. Wesley Burks wrote.

Dubois and Burks stand by their opinion piece, UNCC spokeswoman Buffie Stephens said. Neither Dubois nor Burks knew about Atrium and the Wake groups’ plans when they wrote it, she said.

It is unclear how the new medical school will affect Atrium and UNC’s satellite campus.

In a statement, Julie Byerley, UNC School of Medicine executive vice dean for education, said the school would hate to see its partnership with Atrium end.

“We have an outstanding UNC School of Medicine campus in Charlotte which we believe has been mutually beneficial,” Byerley said.

“Many of our alumni have become their employees through this partnership,” she said. “At this very early stage, we are waiting to see what happens.”

In his 2015 report, Umbach, the consultant, argued that the quickest and best way to develop a four-year medical school in Charlotte was through a partnership between the UNC School of Medicine-Charlotte campus and UNCC.

“It was clear to me during the time when we tried to develop a medical school in partnership with UNC that the leadership in Chapel Hill had very little interest in developing a program that would advance economic development in the Charlotte region,” he said Wednesday.

But Byerley said UNC School of Medicine values its campus in Charlotte.

“We are confident that the physicians we produce both there and across the state, and our annual $484 million in total research funding not only help accomplish our mission, but also add to the economic prosperity of our state,” she said.

UNCC did not make Dubois available for comment.

In a statement provided by UNCC, Dubois said he did not disagree with Umbach’s conclusions and recommendations. But “he had not talked extensively with our colleagues at the UNC School of Medicine nor had he prepared a financial feasibility analysis,” Dubois said.

‘Enormously expensive’

One challenge Atrium and the Wake groups might face is funding the school, said Kevin Schulman, a professor at Stanford University School of Medicine.

Specifically, it would be tough to develop the basic-science research faculty the school might have, he said.

Faculty at medical schools are required to obtain grant funding for their research, a very competitive process, said Schulman, a former professor of medicine at Duke University who has received millions of dollars in research funds.

Once grants are obtained, medical schools generally have to match them, he said. “Building a faculty of this type would be enormously expensive,” Schulman said.

A key funding source for medical research is the National Institutes of Health. Last year, Duke was awarded more than $475 million in funding from the National Institutes of Health, the most of any recipient in North Carolina, according to the federal agency. Second was UNC Chapel Hill, which received more than $446 million in awards.

Wake Forest Baptist Health was third, with more than $112 million.

Atrium and the Wake groups have not yet disclosed their faculty plans for the Charlotte school since signing their agreement this month.

In a statement, Paula Faria, spokeswoman for Wake Forest Baptist Health, said conversations about the school are in the early stages. For Charlotte, the three groups are planning an innovative school of medicine, she said.

But the Charlotte plans do not involve replicating everything at Wake Forest Baptist’s Innovation Quarter, a 330-plus-acre mixed-use district in Winston-Salem, Faria said. The district is home to some Wake Forest School of Medicine programs, as well as apartments and other housing and companies, including those involved in biomedical science, nanotechnology and chemistry.

In a statement, Atrium noted that in-depth discussions about the new medical school are just beginning.

“Based on the groundswell of community support this announcement has received, it is clear this region is well prepared and positioned to support a medical school of the future,” Atrium said.

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Deon Roberts has covered Charlotte’s financial services industry for The Charlotte Observer since 2013. His beat includes Bank of America and Wells Fargo. He attended Loyola University in New Orleans and is a native of Lafitte, La.