A Senate bill remains alive that would require University of Hawaii medical school students to remain in Hawaii for two years after they complete their residencies, but the House version has died.

House Bill 221 and Senate Bill 101 would require students who pay in-state tuition to attend UH’s John A. Burns School of Medicine to work in Hawaii for two years after their residencies or fellowships.

If they don’t, they would have to pay the state the difference between their in-state tuition and the cost, nearly double, of nonresident tuition: $36,372 for each academic year, compared with $71,328.

The bills are just one part of the ongoing effort to retain health care workers across the islands and keep them from leaving for the mainland — especially in a state that needs hundreds of more doctors.

But Rep. Andrew Takuya Garrett (D, Manoa) — who chairs the House Higher Education Committee — called HB 221 and SB 101 “misguided” and “flawed.”

Although he said he understands the desire to fill the demand for health care workers, Garrett said both bills would have “unintended consequences.”

According to Garrett, the requirement of a two-year commitment could deter enrollment at JABSOM and punish local doctors-­in-training who cannot find residences in their specialized fields and force them to relocate to the mainland where there are more opportunities.

Both bills were referred to their respective higher education and money committees in the Senate and House.

Garrett has killed HB 221 this session.

“I’m not planning on hearing the bill,” Garrett told the Honolulu Star-Advertiser on Monday. “This bill, if I don’t send it to FIN (Finance) by this Friday, the bill is dead — and I have not scheduled it for a hearing. We’ll see if the Senate bill comes over.”

“I understand what they’re trying to do, but the way they’re going about it is all wrong,” Garrett said. “We all recognize there’s a terrible shortage. But these kind of mandates have the effect of making JABSOM less desirable.”

Garrett shares JABSOM’s desire to increase the number of students it can accept for each year’s incoming classes, and hopes the Legislature provides more funding for additional instructors to accommodate bigger numbers.

At the same time, he supports JABSOM’s effort to expand residencies and specialties in local hospitals to train more local doctors, offer them more professional opportunities and give them reasons to stay to take care of local patients.

No one had submitted testimony on HB 221 as of Monday.

The Senate Higher Education Committee passed out SB 101 last week. It’s now waiting to be scheduled for a hearing before the Senate Ways and Means Committee.

Johnnie-Mae L. Perry submitted a one-sentence, written testimony in support of SB 101 and said JABSOM graduates should be required to stay in Hawaii even longer.

“Five (5) years commitment instead of 2 years as (proposed),” Perry wrote.

Carol Linde said in her written testimony, “We have a scary shortage of doctors in Hawaii, especially in rural areas. I can often see the difference in the quality of experience between doctors who understand what it means to live in and love Hawaii and those who do not. I believe this initiative is a good way to encourage more local students to make their home and grow their practice here in Hawaii, for the betterment of the whole community.”

And the Hawaii Primary Care Association submitted testimony that it “believes that requiring graduates who benefited from receiving their medical education at reduced costs to serving in Hawaii for a period after residency or fellowship is not only appropriate but desperately needed given how urgent the workforce shortage is for qualified physicians in the State.”

But Stephen Hazam called the Senate version “a misguided effort to solve the problem of a lack of health care professionals. This will only reduce the number of Hawaii residents studying medicine in Hawaii, which is counterproductive. If they don’t (choose) to practice in Hawaii, this is unlikely to change their mind.”

And Garrett shares the concerns of JABSOM Dean Sam Shomaker, Associate Dean Lee Buenconsejo-­Luma and Michael Bruno, UH Manoa’s provost.

They wrote in opposition to SB 101 that requiring graduates to remain in Hawaii for two years after medical school and their residencies “may be daunting for most applicants. This could discourage individuals from attending JABSOM, negatively affecting the number of applicants, especially residents.

“Typically,” they wrote, “medical education takes four years to complete. After earning their M.D. degree, students must undergo a graduate medical education (GME) residency program, which involves three to five years of training in their chosen specialty. … Furthermore, students or residents wishing to further sub- specialize need additional fellowship training, which lasts from one to four years, before they can become board-certified in that sub-specialty.”