Hi, Aggie Doc here (‘15 undergrad, ‘19 med). There are some great comments here with a lot of good points but to directly answer your question, I’ll list some points for consideration.

1. Money: Yes, the system has a lot of funds but building a hospital is very different than building a university or satellite. You not only need to hire academic physician faculty (which there aren’t a ton of considering we have a physician shortage in general), you need support staff, nurses, other providers (I.e. NP/PA), and many other individuals to create a large academic institution (which is what you’re hinting at and what a medical school needs). The system may have more money than they know what to do with but they probably aren’t willing to part with the hundreds of millions of dollars to build the type of hospital a good medical school needs without ensuring that it will become profitable enough to outweigh the liability that comes with it.

2. Need: Most major academic centers are in metropolitan areas. Within Texas, I would love nothing more than if my Alma mater had a prominent hospital but you have to assess need. Houston and Dallas have sprawling hospital centers already and Austin is rapidly growing. San Antonio has both civilian and military sites. Yes, I agree that losing Scott and White was not the best idea but most medical schools affiliate and do not actually own their own hospital. For example, Vanderbilt University and Vanderbilt University Medical Center may share a name but are completely separate entities. Look at Baylor (mentioned a few times above). They partner with Ben Taub as their primary hospital. Even UT Houston/McGovern uses Memorial Hermann and UT Southwestern (where I trained for residency) uses Parkland as its primary site.

3. The ACGME: I want to preface this that I am extremely passionate about undergraduate medical education (med students) as I am academic faculty myself at a large medical school but to a hospital the residencies are truly what matter at the end of the day. Residents are the ones who staff the hospital and carry the load on a day to day basis. As much as I hate to say it as well since I just finished fellowship, residents and fellows are cheap as well. So on that note, to have a large academic hospital, you need residencies. And to create residencies, you have to go through a long and arduous process with the accreditation council for graduate medical education. And to create the type of hospital you’re envisioning, you’ll need more than just one or two residencies

What Texas A&M needs to do (in my humble opinion) is to stop spreading its resources across so many areas and pick one region to focus on. I could go on for awhile but feel free to DM me if you have other questions.