When the state-of-the-art Kaka'ako facility opened in 2005, the vision for the new John A. Burns School of Medicine (JABSOM) was that it would generate enough income to eventually support the new campus. This long-term vision has not yet become reality.

Although research grants, contracts and practice plan income continue to provide the majority of funding for JABSOM, university officials have had to seek additional legislative support for a portion of the medical school operation costs beyond those already committed. Funds committed to the school support about 15 to 20 percent of its operating budget of $110 million-pus. As with any program, school, or entity that is supported by taxpayers' dollars, it is appropriate to ask the question of JABSOM's value to the state.

First, let's look at the financial landscape at the medical school more carefully. The new facility at Kaka'ako was envisioned to contribute to the development and expansion of the university's biomedical research enterprise, and in doing so, provide the intellectual environment and infrastructure to ignite the state's emerging biotechnology industry.

Besides educating Hawai'i's future doctors, JABSOM's faculty members are conducting world-class research on diseases that disproportionately affect our ethnically diverse communities. Fulfilling its goal of expanding the university's biomedical research enterprise, the new campus has begun to ignite the state's emerging biotechnology industry.

JABSOM now receives more than $70 million each year in research support from the National Institutes of Health and other local and national funding agencies. These are dollars that are spent in Hawai'i. Our faculty compete successfully for individual and program grants to conduct basic, clinical, and translational research, provide education and training, and work with our communities to improve health outcomes.

In the last month alone, two programs were funded in the total amount of $15 million in direct costs to JABSOM faculty for their work in cardiovascular health and neuroscience. Other research and training programs focus on advances in infectious disease and tropical medicine, substance abuse, maternal and child health, mental health, asthma, aging, diabetes, and obesity. Furthermore, as the only medical school in the Pacific Islands, JABSOM plays a vital role in linking research, education and training programs throughout the Asia-Pacific region.

Second, and of greater importance and often overlooked, is the direct impact that JABSOM has on healthcare and the availability of healthcare providers in the state of Hawai'i.

The American Association of Medical Colleges (AAMC) predicts a nationwide doctor shortage of up to 200,000 doctors by 2020. In response, the AAMC has encouraged the nation's 124 accredited medical schools to increase their class size by 30 percent to meet this critical need.

Ninety percent of the medical school's students are Hawai'i residents and have long-term ties to Hawai'i after they graduate and complete their residency training programs. Thus, it is not surprising that over 50 percent of the practicing doctors in Hawai'i are JABSOM graduates. States without medical schools will continue to have a much more difficult time attracting doctors, even with a cost of living that is significantly lower than ours.

Hawai'i is the most geographically isolated state, with living expenses that far exceed most comparable Mainland communities. It is also a state that poses significant challenges to those seeking a private practice and other medical settings. Indeed, these factors have already affected the availability of qualified physicians in Hawai'i, particularly on the Neighbor Islands.

The medical school, in partnership with our affiliated community hospitals, also provides opportunities for local doctors to participate in residency training and work with highly trained and experienced JABSOM specialists and sub-specialists in many fields of medicine — well- known incentives in attracting new physicians to any community.

It also increases the availability of highly trained physician specialists in our community to meet its medical needs. To be sure, currently 60 percent of Hawai'i's doctors are formally affiliated with JABSOM, which is a strong indicator of how important it is is to the local medical community.

The citizens of Hawai'i can be proud of their medical school and the role it plays in education and research, and as an emerging economic engine for the future of biotechnology. The most important reason to be proud is in JABSOM's role in meeting the daily health needs of our state. The new campus is only two years old. With time, the medical school will not only survive its growing pains, but it will thrive in the spirit of a healthy Hawai'i.

Gary K. Ostrander is interim dean, John A. Burns School of Medicine and vice chancellor for research and graduate education, University of Hawai'i at Manoa. Meda Chesney-Lind is a professor of women's studies and Ostrander's special assistant. They wrote this commentary for The Advertiser.