The medical school would rise like a mirage from the cow pastures and almond groves of Merced County. It would be powered by one of the world's great research universities to serve one of the most doctor-poor regions in the state.
As envisioned by its planners, a University of California medical school at Merced would produce a cadre of physicians poised to settle and practice here in the San Joaquin Valley.
A large number of its students would come from rural communities. Many would look like the Latino and Asian-American patients awaiting them here in a region of more than 3 million people burdened by poverty and a scarcity of doctors.
The goal is not to duplicate the UC system's five other medical campuses, but to offer a new, less expensive model of education geared for rural medicine and research, say the UC Merced officials behind the plan.
"We're going to be different from the other UC medical schools," said biochemist Maria Pallavicini, founding dean of UC Merced's School of Natural Sciences and the point person in the proposed school's planning process. "Our structure's going to be different. We're not going to own a research hospital."
Despite new delays and mounting financial challenges, Pallavicini and others remain determined to craft a School of Medicine that eventually would enroll nearly 400 medical students to help ease physician shortages in the Valley and throughout California.
Those students would train in existing local medical centers and clinics instead of a pricey "Grey's Anatomy"-style teaching hospital. World-class specialists from other UC schools would rotate through the Merced campus or employ new technologies to teach students far from their classrooms.
Students would be encouraged to train as primary care physicians as well as specialists, and to remain in the San Joaquin Valley, wedged between the Sierra and the coastal range at California's core.
Health care would improve dramatically in this sprawling region of 27,280 square miles — larger than Massachusetts, Connecticut, Rhode Island and Vermont combined — where agriculture is both the economic mainstay and a leading source of medical ills.
It is an audacious vision with national ramifications for the treatment of poor and rural populations. It is a vision drawn up at an isolated campus of 2,700 students that's not even four years old. UC Merced won't hand out degrees to its first full undergraduate class until next spring.
Storm clouds dim the vision
It is also a plan that may be derailed by a host of financial and political problems: worsening state budget woes, deep-seated social ills in the Valley and a national economy and health-care system both strained to their limits.
"Nobody denies that we need a medical school. But where's the money going to come from? Without money we can't do it," said UC Merced Chancellor Steve Kang in an interview last week at the 104-acre campus seven miles from downtown Merced.
Already, officials have moved back the projected year of the medical school's first entering class from 2013 to an undetermined date. Kang acknowledged that he is "not as optimistic as before as (to) when we can make it happen."
Wall Street is helping drive that calendar. The fast-weakening economy is sapping money from stock portfolios of would-be donors and from UC's own endowment, which lost $1 billion, or 15% of its value, in the first nine months of 2008.
Ever-darkening projections of state revenue already are wreaking massive cuts on state campuses. Potential medical students will probably find dwindling loan and fellowship money. Early this week, Gov. Arnold Schwarzenegger declared a "fiscal emergency," saying that without legislative action the state would run out of cash by early spring.