By Kate Denning
The University of North Carolina System Board of Governors voted Thursday to let UNC-Wilmington move forward with the planning process for its proposed medical school. It’s the next step — though an unusual one — in the university’s effort to mend healthcare inequity by increasing access in Southeastern North Carolina.
The university announced its interest last month in opening a medical school that would offer a traditional four-year medical degree and a three-year accelerated track, leading to the resolution. But seeking approval to formally plan a project of this nature is outside of the norm.
With the large scope of the venture and because it will understandably garner a lot of attention, the Board wanted to take the additional measure of reviewing it ahead of time and leaving space for questions, UNC System President Peter Hans told news media.
“This is an extraordinary step in the normal course of business,” UNC System Senior Vice President for Academic Affairs David J. English said Wednesday.
“Campuses do not have to come to the Board of Governors to get a vote to begin the planning process. They can do that at their own delegated authority on the chancellor’s recommendation, and then the Board consideration comes ultimately at the up or down vote of creation of the program. Given the importance, the size, the magnitude of this topic, we believe it was important for the board to be able to weigh in prior to the planning process.”
Cost questions for UNCW
While this week’s vote merely gives UNCW the green light to begin planning and is not the official decision on opening the medical school, the response to the idea has been resoundingly positive so far.
Even so, the committee did raise questions regarding costs and funding avenues for the school. At this time, it’s difficult to give an exact number, UNCW Chancellor Aswani Volety said.
“What we do know is that it is a different model including an accelerated track, which is going to cut down on the cost of education,” he said. “My guess is that it’s going to be lower than existing support for medical schools in the state.”
Hans has also verified the “very, very, very, very strong possibility of significant private support” for the project, he said Wednesday.
Addressing healthcare needs
The university’s quest is a response to healthcare accessibility issues in the state’s southeast region and the greater Wilmington area.
This is partially due to the rate at which the area is growing, but also because of the lower number of medical students in the state, comparatively speaking. North Carolina ranks 40th out of 50 in terms of medical students per capita despite being home to a handful of the leading medical schools in the country.
“When you look at Southeast North Carolina, it is growing at 2-3% per year compared to 1% on average for the rest of the state,” Volety told the board in April.
“These shortages result in delays in healthcare; if you can even get an appointment, lengthy hours in emergency rooms, very, very long delays in terms of getting speciality care, perhaps going to far off places.”
UNCW not pursuing teaching hospital structure
The proposed UNCW School of Medicine won’t be a teaching hospital structure, a deviation from other medical schools in the state, but it will build upon the university’s existing portfolio of healthcare education. UNCW produces hundreds of nurses every year and is currently developing a Master of Physician Assistant Studies program to meet rising demand.
By not being a teaching hospital, UNCW would allow medical students to complete their residencies, which can take between three and seven years, at hospitals, clinics or rural health centers outside of the university but still in the region, Volety told CPP. This is what Volety calls distributed clinical placements.
The advantage of having a teaching hospital is that the school solves the issue of clinical placements and residencies, Volety said. But it also adds a lot of cost and complexity that he doesn’t feel UNCW needs given its existing positive relationship with Novant Health New Hanover Regional Medical Center.
A potential downside of distributed clinical placements is that it could lead to students completing their residency outside of the university’s target area, given the inherent flexibility it provides incoming residents. A 2026 study analyzing 20,233 family physicians showed more than half of graduates practice medicine within 100 miles of their residency program, and close to a quarter of them practice within five miles.
“Doctors have free will, or people training to be physicians have free will, and they don’t necessarily stay in the state or stay in that region,” Hans told CPP.
“They go elsewhere. That’s why it’s so important to be accompanied by those residencies. That’s what all the research shows has the biggest impact on where someone settles.”
So while Hans acknowledged the medical school is a step in the right direction, he said it must be part of a broader strategy to meet needs across the state.
“I wish it were, of course, as simple as starting med school to meet our needs in healthcare in a growing state,” Hans said.
“This has to be part of a broader strategy, which we have launched, of course, by expanding rural residencies in particular. We’re all concerned about the future of rural healthcare. What you find there is doctors are more likely to locate in an area if their residency performed in that area, not necessarily where they went to medical school. That can help, don’t get me wrong. That can be very beneficial.”
UNCW plans to have medical students on campus by 2029, which Hans agreed is “possible.”
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