Anyone who wants to go into those specialties must leave the state, Bar-on said. And health officials say physicians tend to stay and work where they complete their residency training.

Overall, Nevada's physician-to-population ratio ranking is 46th in the country.

It is especially deficient in the fields of endocrinology, pulmonology, cardiology and gastroenterology.

Pediatric specialties are also in short supply, Bar-on said.

Nevada also has the lowest number of physicians in residency training per population among states with medical schools.

In the past five years, only 39 of the 257 School of Medicine graduates stayed for residency training, according to the Association of American Medical Schools.

One-fourth of this year's graduating class chose residency programs that aren't offered through the School of Medicine.

"People don't understand it's not where they get their education. It's where they do their residency training. That's the jurisdiction that they seem to stay in and open their practices or join a hospital,'' said Steve Sisolak, a Nevada System of Higher Education regent.

"This exemplifies the need for a Health Sciences Center. We need to get the private hospitals working on the same page,'' Sisolak said.

The idea behind the Health Sciences Center, which is only in the conceptual stage, is to connect the higher education system's eight institutions and establish a relationship between them and Nevada's private hospitals.

The goal is to standardize and expand medical training, such as residency programs.

All graduates awarded a degree of Medical Doctor must participate in a certified Graduate Medical Education training program before becoming a practicing physician.

Those wanting to go into subspecialties such as pulmonology, cardiology or sports medicine, need fellowship training as well.

Only five hospitals in Reno and Las Vegas offer residency programs through the School of Medicine: University Medical Center, Sunrise Hospital, Mike O'Callaghan Federal Hospital, Renown Regional Medical Center and the Iannis A. Lougaris VA Medical Center.

Valley Hospital Medical Center has its own residency training program, but it accepts only doctors of osteopathic medicine, said Dr. John McDonald, dean of the School of Medicine.

He said the School of Medicine, Nevada's only public medical school, offers residency programs to graduates who have earned both Doctor of Medicine and Doctor of Osteopathic Medicine degrees.

None of the St. Rose Dominican Hospital's medical facilities have residency programs, officials say.

Sunrise Hospital is the only hospital within the Sunrise Health family to offer residency programs.

"They have to come on board,'' McDonald said, referring to private hospitals creating residency programs. "We also need more funding from the Legislature.''

Each of the School of Medicine's 2007 graduates was accepted into at least one residency program in the United States.

"I think this means one of two things. We do not offer some of the subspecialty residency programs that other states offer, and the conclusion is, if we had those residency programs, those students presumably would have had an opportunity to apply for them,'' McDonald said.

"With respect to the nine that stayed, that's actually not a bad number out of a class that size. Most of them went into primary care. I think that's good because there's a need in the state.

"Also, if a student is accepted into a residency program that's considered one of the best in the country -- and our programs are great too -- that says a lot about the quality of the education we're providing.''

Still, McDonald said, the School of Medicine is going to do its part to help bolster the state's physician pool by attracting and enrolling more medical students and residents.

To do that, the school must expand its residency programs. And one way to do that, officials say, is to fund the Health Sciences Center.

But funding for the project is a question mark.

Gov. Jim Gibbons has proposed putting $110 million toward the Health Sciences Center.

The Nevada System of Higher Education had been asking for $200 million.

The state's legislative session is in its final days. To date, there is no word on how, or if, the center will get any funding.