BAKER CITY, Ore. -- Oregon has an uphill battle to train enough rural doctors to replace their retiring baby boomer predecessors and then to keep them from moving to the city, says the president of Oregon Health & Science University.

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Joseph Robertson and other OHSU officials delivered that message during a swing through northeastern Oregon that he said was a followup to a tour he took 18 months ago during his first 100 days as president of the state's doctor training school.

"When we toured the state last time, I knew the health care crisis was bad, but I didn't know how bad," Robertson said.

He said there's a current need for 200 to 250 new doctors a year in Oregon, but a lack of state funds over the past two decades has resulted in a limited class enrollment of 96.

"As you get out on the road, you see that the crisis has not abated," he said.

With medical school graduates carrying an average debt of $140,000 when they complete their training, Robertson said, many new doctors feel compelled to practice in Portland and other urban areas where the customer base is larger and doctor incomes higher than in rural towns.

He outlined other measures, some already in progress, some under consideration and some that will need money from the Legislature:

-- Agreements with the University of Oregon and Portland State University to allow students to complete their first year of medical training during their fourth year at those universities. That reduces medical school from eight to seven years, he said.

-- A loan forgiveness program for medical school graduates who practice in rural communities. Also under consideration is a proposal to give applicants in rural areas priority in scheduling medical license examinations.

-- A rural residency program in which more graduate medical students will have a chance to serve their residencies in rural hospitals and clinics, based on a prototype program in Klamath Falls. Robertson said nearly 80 percent of the students later practice in rural areas.

-- Stepping up recruiting students from rural towns for medical school, which Robertson said increases the odds that the student will return to his or her rural roots to practice medicine.

-- Allowing pairs of doctors to rotate so each spends half of the year serving in a rural medical clinic or hospital, and the other half doing research or teaching at OHSU.