CARBONDALE — Every year, about 72 first-year medical students arrive in Carbondale to begin their education at the SIU School of Medicine.

They study anatomy, physiology, biochemistry, genetics and pharmacology, building the fundamental knowledge necessary to begin working with patients, and eventually to decide what kind of doctors they want to be.

They are also encouraged to explore Southern Illinois, to experience its natural beauty and its healthcare challenges. As much of the country grapples with a rural doctor and nurse shortage, the hope is that students will choose to stick around.

“That is our mission,” said Dr. Sandra Shea, the Year One curriculum director at the SIU School of Medicine. “We recruit from the area,” of central and Southern Illinois, “and we want to return graduates to the area.”

It’s a mission supported and celebrated by university administrators on both campuses, as well as lawmakers throughout the region. However, the medical school has recently been caught in some big debates about how it should do its work.

At least three times in the last 15 years, state Rep. Jay Hoffman, a Democrat from Belleville, has sponsored legislation that would split the SIU system into separate Carbondale and Edwardsville campuses, to create separate governing boards that “could focus on the needs and the strengths of each individual campus,” he told The Southern in April.

It’s a massive proposal that seeks to ensure SIUE receives its fair share of state funding and controls its own finances and fate, free from the influence of the declining Carbondale campus, where enrollment is about half of what it was 25 years ago.

But it is extremely controversial. It was supported by SIUE chancellor Randy Pembrook and secretly by former SIU System President Randy Dunn, who was ousted when he got caught advocating for the split.

Current System President J. Kevin Dorsey, late SIUC Chancellor Carlo Montemagno, all of the Carbondale-based members of the Board of Trustees, and the entire SIUC Alumni Association, as well as some Southern Illinois politicians have spoken out against the bill, most using some form of what feels like a new SIU motto: “We’re stronger together.”

“Splitting the system isn’t good for anybody,” said Rep. Terri Bryant, of Murphysboro, “and from my conversations in the Higher Education Working Group (a bipartisan group of state legislators working to raise enrollment at Illinois universities), it’s ludicrous to think that SIU could be separated.”

When introduced this April, the campus split legislation backed by Hoffman and three other central Illinois lawmakers was framed as a way to equalize funding between SIUE and SIUC. But the bill does much more than that.

It effectively divvies up the university system’s assets between the two campuses, including the law and medical schools, two of the university system’s crown jewels.

Under Hoffman’s plan, the SIU School of Law would remain part of Carbondale, but the School of Medicine would be realigned with Edwardsville.

“Edwardsville has the School of Nursing, it has the pharmacy school, it has the dental school, and it makes sense to have health sciences under one umbrella,” Hoffman told The Southern in April, shortly after his legislation was introduced in the Illinois House.

But SIU School of Medicine officials say Hoffman’s plan isn’t the right answer for their institution.

“We’re committed and connected to Carbondale, and the Dean has articulated that message to various legislators,” said Wendy Cox-Largent, the med school’s Senior Associate Provost for Finance and Administration. “We have 440 faculty, staff and learners in Carbondale, from our first year med students and physician assistant students, to our Center for Rural Health and Social Service Development, which provides support to local rural health organizations, to our family medicine residency program,” which trains primary care doctors, many of whom remain in central and Southern Illinois to practice.

In the recent campus split discussions, some legislators appeared to misunderstand key facts about the med school, added Dr. Shea, perhaps due to the way it is spread around the state.

“One misconception was that there are no medical students in Carbondale,” Shea said.

All med students come to Carbondale for their first year of school. Then they move to Springfield, where more med school faculty are stationed, for year two. In years three and four, medical students begin rotations, working alongside doctors in Carbondale, Springfield, Decatur and Quincy, as they hone their skills and choose a specialty to pursue.

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Physician assistant students also spend at least a year in Carbondale before starting clinical rotations.

The dispersal of the med school’s departments had a “carefully constructed rationale,” when the school was founded in 1970, according to Professor John Jackson, a political scientist and former administrator who has been at SIUC for 40 years.

“The medical school was originally a unique design,” Jackson said. “It took advantage of the excellent College of Science we had here in Carbondale to administer year one, which is basic sciences education. Then we went to Springfield to take advantage of the big established hospitals there for the clinical years, rather than spend a lot of money to build a teaching hospital in the Carbondale area.”

Beyond overseeing year one education for med students at the Carbondale campus, School of Medicine faculty teach hundreds of undergraduates at SIUC, Shea said.

The Department of Physiology, which currently has about 100 undergrad majors, is within the School of Medicine, as are the Department of Anatomy, and the Department of Biochemistry and Molecular Biology.

Those School of Medicine researchers collaborate with diverse departments at SIUC and mentor graduate students.

Moving them would cost SIUC needed faculty and a lot of money, med school administrators explained.

“Basic science lab space is incredibly expensive to build out and hard to recreate,” Cox-Largent said. “I can’t imagine our researchers would want to move their families and facilities. It’s hard to fathom.”

Hoffman’s current bill, HB 5861, doesn’t wade into the specifics of moving millions of dollars of people and equipment, plus the IT systems support, grant reporting and compliance and other administrative departments that Carbondale and the med school share.

Despite repeated interview requests, Hoffman could not be reached for more details on his plan.

No action has been taken on HB 5861 since it was submitted to the Illinois House Rules Committee in April.

That committee, which decides whether to schedule a bill’s consideration on the house floor, is “often the graveyard for legislation that’s not going to pass and was probably introduced for symbolic reasons,” said Professor Jackson. “The fact it is languishing in the Rules Committee indicates there’s not enough support in the House for it.”

Meanwhile, the School of Medicine continues to strengthen its relationship with Carbondale and Southern Illinois Healthcare, a chain of local hospitals that is one of the region’s largest employers.

The School recently broke ground on a $17 million, 41,000-square-foot building on the corner of Oak Street and University Avenue, just north of Memorial Hospital of Carbondale, which will house SIU’s Family Medicine Residency and Physician Assistant Program.

The School of Medicine is also developing a pilot program called Lincoln Scholars, which will explore opportunities to offer all four years of med school in Carbondale, by creating new classes and residency programs locally, Cox-Largent said.

Though Hoffman’s bill continues to look like a major long-shot, the SIU Board of Trustees recently hired an external consultant to assess the fairness of the state funding balance between SIUC and SIUE, addressing one of the complaints that inspired HB 5861.

That should have little impact on the med school, which has maintained a separate budget and steady enrollment throughout SIUC’s crisis and continues to collaborate across SIU's campuses, working with SIUE on research and hosting workshops with the Schools of Pharmacy and Nursing.

“The School of Medicine is committed to all 66 counties of central and Southern Illinois,” Cox-Largent said. “[Representative Hoffman] is not wrong about the importance of collaboration between the campuses, but we can continue to do that from our current locations.”

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