Collision course: the privatization of graduate medical education at one university.

Full Abstract

On December 18, 2003, Tenet Healthcare Corporation, an investor-owned hospital corporation, announced the closure of Medical College of Pennsylvania Hospital, a historic institution that was home to many of Drexel University College of Medicine's (DUCOM's) faculty, residents, and medical students. The authors summarize the steps that were taken and lessons learned to avoid a disruption in the education of over 200 residents. The authors highlight the response by the medical school; the concerns of the Accreditation Council for Graduate Medical Education (ACGME); the interaction between the Center for Medicare and Medicaid Services (CMS) and the ACGME; the importance of the designated institutional official (DIO) in a crisis situation; and the role of residents as students versus employees when their employer wishes to move or "trade" them to another institution. Through the lens of the DUCOM experience, the authors explore the legal, political, and educational conflicts that occur when an investor-owned company or private hospital employs residents but another entity holds moral and academic accountability for their future. Finally, the authors outline five lessons learned:
(1) the important role the ACGME plays as the educational conscience of graduate medical education (GME), (2) the dramatically different roles that the ACGME and the CMS play in regulating and funding the national GME system, (3) the need for constant communication with the affected residents, (4) the important role that the DIO plays in GME, and (5) the need for medical school leaders to remain focused on their educational mission and responsibilities to young physicians.

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Author information

Author/s: Klasko, Stephen K (SK); Ekarius, John C (JC);

Affiliation: College of Medicine, University of South Florida, Tampa, Florida, USA. sklasko(-atsign-)health.usf.edu

Journal and publication information

Publication Type: Journal Article

Journal: Academic medicine : journal of the Association of American Medical Colleges (Acad Med), published in United States. (Language: eng)

Reference: 2007-Mar; vol 82 (issue 3) : pp 238-44

Dates: Created 2007/02/28; Completed 2007/04/16; Revised 2007/11/15;

PMID: 17327710, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Academic Medical Centers - organization & administration
Centers for Medicare and Medicaid Services (U.S.)
Communication
Education, Medical, Graduate - organization & administration
Health Facility Closure

Health Facility Closure
Humans
Internship and Residency - economics
Privatization
United States

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