As one of the smallest medical schools in the country, the Virginia Tech Carilion School of Medicine turns away hundreds of qualified applicants every year — not for a lack of talent, but due to limited capacity.
Now the school’s leadership is planning an expansion of both its campus and its enrollment while maintaining a commitment to small class sizes.
While the project is still in the planning phase, Dr. Lee Learman, the dean of the school, said that it is the top capital improvement priority for Virginia Tech.
Over the next four years, leadership at the medical school aims to double enrollment with the construction of a new, 100,000-square-foot building. The opening is tentatively set for July 2028.
Currently, about 196 students are enrolled in the medical school. With the expansion, Learman said total enrollment could increase to 400.
The proposed building will likely be located on a lot off Old Woods Avenue, near South Jefferson Street, and within walking distance of the Riverside complex that currently houses the medical school. The lot is owned by Carilion Clinic, but negotiations are underway between the two partners.
A capital budget request posted on the Virginia Tech website lists building costs at $183.7 million, but that total is likely to change as plans develop, said Mark Owczarski, interim vice president of communications and marketing at Tech. The numbers proposed now, both for enrollment size and plans for the new facility, are a jumping-off point and are subject to change, he said.
However, the school secured a $9 million planning grant from the General Assembly earlier this year with the help of Del. Jason Ballard, R-Giles County.
“Roanoke and Blacksburg have come to be known statewide — and now nationwide — as a premier biomedical hub. This has very positive ramifications at the local level as medical students and doctors recruited to this area will contribute to our local economies and qualities of life,” Ballard said by email.
“The General Assembly has recognized this regional strength and has made strong investments because it knows that the doctors it produces and the spinoff companies/technologies it creates will have a lasting positive impact on the regional and state economy. I’m just pleased to have been able to play a role in it.”
In 2026, the university plans to ask for $153.7 million in general fund support for construction from the General Assembly, according to the capital budget request. The remaining $30 million will be requested as a revenue bond authorization to be repaid over time.
Since the medical school welcomed its inaugural class in 2010, students have shared space with the Fralin Biomedical Research Institute at VTC in a building that’s about 151,000 square feet. Over the first four years of operations, the class size grew from 42 students to 49 per class. 
The newest class that was welcomed a few weeks ago has 51 students.
“We’re really at our absolute limit,” Learman said. “We now have some of our faculty and staff units that are not even in this building. They’re in adjacent buildings.”
The space currently being used by medical school students, about 51,000 square feet, would be renovated to expand laboratory space for the Fralin Biomedical Research Institute, according to the budget request.
The research institute is one of the nation’s fastest-growing biomedical research enterprises, and its operations support a $174 million grant portfolio, according to the budget request.
The economic impact of both the research institute and the medical school has been significant in the community, said Marc Nelson, director of economic development for the city of Roanoke.
“The expansion really reinforces the notion that Roanoke is coming on the map,” he said. “I think there’s a great deal of civic pride, too. The medical school is relatively young, and it’s quite an achievement that they’re ready to look to the future and expand.”
The school receives about 6,900 qualified applications every year, but the program only has space for about 50 students per class. With a new building, Learman said the school could double its enrollment while maintaining its unique curriculum.
“When you look at the physician workforce issues that are occurring around the country and in Virginia, and the fact that of over 600 students who are from Virginia who get into medical school, less than half of them stay … so why would we not grow?” Learman said.
Leadership at the medical school have started to develop a plan to incrementally increase class sizes. The plan allows for 56 students per class in 2025, and, in the following year, could accommodate up to 64 students per class, Learman said.
Small, intimate classes have become a hallmark of the program, and according to Learman, this would remain the case even with increased enrollment.
The Virginia Tech Carilion School of Medicine uses a problem-based learning curriculum in which small teams of students, usually about eight in a group, work through patient cases that represent the most common clinical conditions that physicians see in Virginia.
Students are also required to work with a mentor on a research project that meets publishable standards by the end of their education.
“This is a very different kind of a learning experience than a big-box medical school where everyone sits in a big classroom and listens to someone who’s lecturing,” Learman said.
The school will also need to plan for sufficient clinical rotation opportunities in the hospitals, along with the expansion of instructional faculty, research faculty and administrative staff to support larger classes.
Clinical rotations are a key part of medical school training and take place during students’ third and fourth years. During this time, students explore specialties and get first-hand experience under the supervision of physicians and other practitioners.
Through its partnership with Carilion Clinic, the medical school largely relies on local Carilion facilities for student clinical rotations. Students from other medical schools also complete rotations and residencies at these sites. Learman said that the school is exploring the possibility of expanding rotation sites to include the Carilion New River Valley Medical Center in Christiansburg.
Leadership teams at Virginia Tech and the medical school will be selecting an architect soon and plan to visit other medical schools before creating a design for the new facility.
Learman said the design decisions will not be made with additional growth in mind.
“In the intermediate term, I think we’re going to be where we’re at for a very long time once we hit that number in the new building,” Learman said.
