SIOUX FALLS, S.D. (KELO) – The USD Sanford School of Medicine has a longstanding tradition in South Dakota, but what you might not have known is that it wasn’t always an institution where students could actually earn a medical degree.

How it started

For its first 67 years, the school only offered a two-year program and once students were finished with that, they had to go out of state to get their degree.

That was until 1974 when it became a four-year, degree-granting institution. Some believe the current medical landscape in South Dakota would not exist had Governor Richard Kneip not signed Senate Bill 30 that year.

Ted Muenster was in the room where it happened.

“I don’t think any of us knew how this would evolve over 50 years but it’s been quite a remarkable story,” Muenster, Gov. Kneip’s former chief of staff, said.

Starting in 1974, for the first time in the state’s history, South Dakotans could stay in their home state and earn a medical degree. And they were encouraged to stay in the state after graduation.

“South Dakota had a huge need for physicians,” Dr. Tim Ridgway, Dean of the USD Sanford School of Medicine, said. “At that time, there were a little over 500 physicians in the state of South Dakota. The physician to patient ratio was last in the country.”

The man behind the change

Muenster says Dr. Karl Wegner was the driving force behind the creation of the four-year program for the medical school.

“It was his personal credibility explaining to the legislature and others that we can do this,” Muenster said. “We can have a fine quality school with very specific purposes — primary care in rural areas especially.”

The creation of a four-year program was controversial and had failed twice before in the legislature because some were worried it would be too expensive. In order for the state to afford a four-year medical program 50 years ago, the school got creative.

“The interesting thing was when they were going to become a four-year school, most medical schools at that time had a big university hospital — one key hospital where everybody got their training,” Ridgway said. “That would’ve cost tremendous amounts of money. So we became a school without walls. That is, we utilized clinical facilities throughout the entire state of South Dakota to help provide the clinical training for our students in their third and fourth years of medical school.”

Muenster says Wegner is who coined the term ‘medical school without walls.’

“Without his personal credibility, I doubt if we would have a medical school today,” Muenster said.

The medical school of today

The idea of a school without walls continues today with four campus locations and multiple FARM sites.

“We have over 22 hundred faculty with our school of medicine and they are in every area throughout South Dakota,” Ridgway said. “We also have a Frontier in Rural Medicine program we call it and we have 13 students that go to eight small communities to get their first clinical year of training.”

Dr. Meghan Grassel, a 2023 alumna of the USD Sanford School of Medicine, says the emphasis on rural medicine helps make South Dakota stand out.

“You can do anything you want going through USD and go anywhere you want but I think we really do rural medicine the best and you get to have those continuity relationships from the very beginning and see what it would be like to care for your patients and your community,” Grassel said.

The mission of the medical school may have stayed the same throughout its 50 years, but the way it’s taught has evolved. From chalkboards and old computers to a simulation center filled with the latest technology.

“We got lots of hands-on experience and USD really allows you to delve in right away,” Grassel said. “The teachers and staff and everyone you interact with is really invested in your education and helping you be a better doctor for the future of other South Dakota patients.”

And the USD Sanford School of Medicine is looking ahead to the future of health care in South Dakota.

“One of the things that is really taking off is Artificial Intelligence,” Ridgway said. “I just returned from a council of deans meeting and we talk about this. It’s here and our students are starting to utilize it. So I’m really excited to embrace it and make sure that it’s utilized appropriately.”

The impact

50 years ago, the people watching Gov. Kneip sign Senate Bill 30 might not have known exactly how the medical school would evolve but Muenster is proud of what it’s become and the impact it continues to have.

“To have seen the development of the two big systems of Avera and Sanford in Sioux Falls and the VA and the developments in Rapid City and in Yankton, I don’t think any of that would’ve happened, at least to that extent, without the four-year program,” Muenster said.

“We still have work to do but we never shy away from our mission and I would shutter to think about what health care would look like in the state of South Dakota if our four-year school hadn’t come into existence,” Ridgway said.

On March 15, 61 new doctors received their post-graduate residency assignments and 14 of them will be staying in South Dakota.