There’s a serious doctor shortage in Texas.

Catching up will be hard to do, but three new medical degree programs in the state are scheduled to open classes in 2018, including a joint program in Fort Worth between the UNT Health Science Center and Texas Christian University.

So what impact will the new schools have?

Texas comes in near the bottom of the list when it comes to doctors per resident. Here, there are about 186 physicians for every 100,000 people, according to the Texas Medical Association. The national average is 236 per 100,000.

And if the state keeps turning out the same number of medical students, UNT Health Science Center President Michael Williams has a warning:

“We’ll never catch up to the deficit,” Williams says. “Ever.”

Yes, Williams says it sounds bad. But he’s got a plan. For years, the president of UNT’s Health Science Center has been dreaming about handing out more diplomas to doctors in Fort Worth. That city one of the largest in the country without a medical degree program.

In just a few years, that’s going to change. UNT’s Health Science Center and Texas Christian University have partnered to create a medical degree program. In fact, by the fall of 2018, three new MD programs will be up and running in Central, North, and South Texas – adding hundreds of new doctors to the state.

The Need For Primary Care Doctors

Dennis Andrulis, a senior research scientist at the Texas Health Institute, says what Texas needs most are pediatricians and primary care doctors, not highly paid specialists.

“Having a new medical school offers such great opportunity for a community,” Andrulis says. “The big question is the extent to which this med school will reach out to community based care rather than being caught up in the romance and allure of specialty surgery (…)  big money makers.”

The average compensation for a specialist in 2014 was $284,000. For primary care docs it is closer to $190,000, according to a 2015 Medscape report.

UNT Health Science Center president Michael Williams says you can’t corral students into a primary care.

“At the end of the day,” he says, “I can say ‘well we want to have all primary care doctors’ but I don’t have any control over that reality.”

Still, Williams points out the Health Science Center’s College of Osteopathic Medicine has a good track record.

“We’ve been the leading medical school in Texas for a number of years in graduating and turning out primary care physicians,” he says.

Williams says to get more primary care doctors in Texas, you need the right culture, and more in-state residency slots for graduates to work in after they graduate.

Other Solutions To The Primary Care Shortage

Linda Green, a professor of health care management at the Columbia Business School has another fix for the primary care shortage — one that involves a shift in the office.

“Where there’s much more of a team approach,” she says.  “Other professionals like nurse practitioners and physician assistants have at least the same quality [of care] as primary care physicians for dealing with things like flu and strep throat and the kinds of things primary care physicians often see.”

More states are allowing nurse practitioners to practice to the full scope of their abilities — allowing primary care doctors to see more patients and handle more complex cases. Texas has removed some restrictions on nurses ability to practice medicine, though supervision is still required.

[Read more: North Texas Nurses Gain New Freedom To Treat Patients]

Green says a combination of new medical schools like the one in Fort Worth, higher reimbursements and a culture of teamwork are all necessary to get more primary care doctors in Texas.