Interesting article about SGU clerkships and New York HHC hospitals

[DrWBD]

This article was posted in another SDN forum but I thought it would be worthwhile to bring up here:

http://www.nytimes.com/2008/08/05/nyregion/05grenada.html?_r=1&ref=health&oref=slogin

Why this could be very relevant to osteopathic medicine:

When I was a student, NYCOM didn't pay their clinical affiliates for taking the third and fourth year students (at least that was the official party line from administration). I recall that in one of my rotation sites, a private hospital in an inner-city underserved area, it was mentioned that they would rather take the foreign students from SGU and Ross over the NYCOM students because they paid for the privilege of being there. Since this hospital was always in the red, money from anywhere was appreciated.

My concern is that SGU is setting a precedent for other Caribbean schools to follow. It would not be surprising to see other offshore schools start paying for the privilege of guaranteed exclusive clerkship sites. Many of NYCOM's 'affiliates' in NYC are also SGU and/or Ross sites, and losing these sites would mean losing some of our best clerkships. I'm not sure where TOURO-COM NY's sites are, but I'd imagine they're mostly going to be in the five boroughs.

If this were to happen, we'd then be stuck with the weaker community hospitals on Long Island and upstate NY, assuming that we wouldn't lose those as well. Or, our tuition would go up even more in order for us to match the foreign schools' offers to hospitals.

I hope that the schools' administrations and the AOA are paying attention to this issue.

---

Members don't see this ad.

 

[fbf]

That's interesting. The threat is actually directly pointing to most of medschools in NY area. I wouldn't be surprised that SGU would buy off more clerkship positions in the next a couple of years.

 

[Toohotinvegas33]

NYCOM sets up residencies in NY. For each resident the Federal Gov pays something like 90k, out of that 40k-50k goes to resident. I wonder where the rest goes?. Take St. Barnabas Hospital, NYCOM has about 120 funded slots,

90kx120 residents=10.8 mil
10.8mil-(50kx120)=6.3 mil left over

 

[AngryBaby]

Caribbean schools have been paying hospitals for years, this is nothing new. The NYC med school deans are saying that because of the increasing US and offshore med school class sizes there may now be a shortage of clinical spots whereas this wasn't a problem before (since there were fewer students all around). However it sounds to me that most of the problem is the precedent set by the magnitude of the commitment from SGU (length of contract) and of course the idea that maybe now they will have to up the ante as well.

SGU's tuition is on par with many private US schools (~43k/year over 4 years). It's an interesting debate, I think, but is being muddied by a few deans of Albert Einstein and NYU SOMs calling into question the capability of Caribbean students and it's teaching model.

Here's a link to an interview on a NYC public radio station with the Chancellor (owner) of SGU and a dean of Albert Einstein SOM. It's about 25 min long.

http://www.wnyc.org/shows/bl/episodes/2008/08/06/segments/105252

BTW, I attend SGU.

 

[DrWBD]

NYCOM sets up residencies in NY. For each resident the Federal Gov pays something like 90k, out of that 40k-50k goes to resident. I wonder where the rest goes?. Take St. Barnabas Hospital, NYCOM has about 120 funded slots,

90kx120 residents=10.8 mil
10.8mil-(50kx120)=6.3 mil left over

GME has always been a cash cow for hospitals.

It's not inconceivable, though, that a hospital in bad financial shape might want to have it's cake and eat it too. What would stop a hospital from accepting zero, or a minimum amount of osteopathic students, in favor of more profitable foreign students, while at the same time maintaining its osteopathic residency programs? Maybe the OPTIs and osteopathic medical schools have some sort of arrangement to prevent this from happening, I honestly don't know.

 

[Taurus]

I think wanna_be_do has legitimate concerns. The problem will become more acute as the med school enrollment increases over the next few years and the competition for clinical rotations sites intensify. The Caribbean schools probably will have to strike up more of these exclusive agreements in the future to prevent from being shut out of the country completely.

 

[tkim]

TUCOM-CA already does this for their Socal sites - specifically Arrowhead Regional, which is where a lot of COMP students rotate. There are a fair number of TUCOM students who rotate there and Arrowhead gets paid for every TUCOM student, but not for COMP.

Makes no difference, eventually Arrowhead will be UC-Riverside SOM's exclusive site. Or so I hear.

 

[bth7]

TUCOM-CA already does this for their Socal sites - specifically Arrowhead Regional, which is where a lot of COMP students rotate. There are a fair number of TUCOM students who rotate there and Arrowhead gets paid for every TUCOM student, but not for COMP.

Makes no difference, eventually Arrowhead will be UC-Riverside SOM's exclusive site. Or so I hear.

yeah, and how many of Touro's students actually get to go to this site? How many Touro students are rotating at "sites" where the preceptors get paid $ 0.00?

I think its amazing that St George actually negotiated this extensive of a contract on behalf of its students. I wish my med school would do the same.

Thanks for this posting.

 

[lilzelda2]

I remeber the NYCOM dean saying something last year about having to possibly pay more to clerkship hospital's b/c of the opening of TUCOM-NYC and soon to be Hofstra. I know for sure NYCOM puts a lot of money into St. Barnabas.

Half the doctors in St. Barnabas are foreign, hell most of the attendings weren't even trained in the US. Also Einstein has just setup a new contract with Barnabas for certain clerkships, so I think their arguement is stupid and their basically looking out for themselves.

I don't think just because a clerkship is in NYC its automatically a good clerkship, the most pretigous hospital NYCOM is connected to ain't in the city.

 

[DrWBD]

I remeber the NYCOM dean saying something last year about having to possibly pay more to clerkship hospital's b/c of the opening of TUCOM-NYC and soon to be Hofstra. I know for sure NYCOM puts a lot of money into St. Barnabas.

Half the doctors in St. Barnabas are foreign, hell most of the attendings weren't even trained in the US. Also Einstein has just setup a new contract with Barnabas for certain clerkships, so I think their arguement is stupid and their basically looking out for themselves.

I don't think just because a clerkship is in NYC its automatically a good clerkship, the most pretigous hospital NYCOM is connected to ain't in the city.

By 'best' I didn't just mean prestigious. Even NYCOM's most high-profile affiliate on Long Island is considered by many to be very over-rated. It would be hard to argue that any of NYCOM's NYC affiliations are well-regarded institutions academically (except, maybe, Maimonides Hospital).

However, as a student rotating through, the experience can be invaluable even if the hospital itself isn't great. If you want to really learn Surgery, Ob/Gyn, or emergency medicine, often the best places to be are the county and community hospitals in the ghetto where you'll get hands-on experience rather than just being an observer.

Additionally, NYCOM has to place 200+ students somewhere each year. It's ridiculous that NYCOM has clerkship sites 4 hours away from the campus, but it's a necessity due to the class size. Losing even a few of the NYC clerkships can present a big logistical problem for NYCOM. You can only fit so many students into Long Beach, after all

 

[bth7]

Additionally, NYCOM has to place 200+ students somewhere each year. It's ridiculous that NYCOM has clerkship sites 4 hours away from the campus, but it's a necessity due to the class size. Losing even a few of the NYC clerkships can present a big logistical problem for NYCOM. You can only fit so many students into Long Beach, after all

Try a four hour FLIGHT
.

At Touro we were bounded around to LA, Oregon, Michigan, & NY. That's ridiculous.

 

[DrWBD]

Try a four hour FLIGHT
.

At Touro we were bounced around to LA, Oregon, Michigan, & NY. That's ridiculous.

For third-year clerkships?
That's not ridiculous, that's insane.

 

[bth7]

For third-year clerkships?
That's not ridiculous, that's insane.

Yup, yup and Yup.

That is so my reality. And it sucks.

bth

 

[igcgnerd]

Yup, yup and Yup.

That is so my reality. And it sucks.

bth

They don't have any core sites set up where u can do like 3-4 months in the same place?

 

[bth7]

They don't have any core sites set up where u can do like 3-4 months in the same place?

Oh yeah, sure. You can do your whole 3rd year at one place. It's just going to be 3,000 miles from your medical school.

bth

 

[igcgnerd]

Oh yeah, sure. You can do your whole 3rd year at one place. It's just going to be 3,000 miles from your medical school.

bth

Do a lot of people stay in the bay area?

 

[bth7]

Do a lot of people stay in the bay area?

The bay area can be even worse, because there you are driving to different sites every month, sometimes hours away from SF.

I think a little bit less than a third of the class of 120 stay in the bay. That mean of course, that 2/3 are required to pack up their homes in the Bay Area, and leave.

The way its presented to us is that "if you really want to stay" in the Bay Area, you can. But you have to be prepared to make sacrifices, not being at a teaching hospital for your entire 3rd year. Which some students feel compromises their education. Of course, many student who stay say this is not the case.

bth

 

[tacoman2493]

You think its bad now, wait till all these 30 new 4th tier trash american med schools open up. Some of them are so ridiculous, they arent even PLANNING for 3rd/4th year rotation sites yet, just opening up the first 2 years and then saying to their students "good luck" on finding clinical spots scattered around the country.

LCME and AOA should revoke the accreditation of any med school that cant guarantee 100% of clinical rotations on site. If your school cant guarantee this, then they shoulda never opened in the first place and the region clearly doesnt need a med school if it doesnt have enough local hospitals to feed its students into.

 

[bth7]

You think its bad now, wait till all these 30 new 4th tier trash american med schools open up. Some of them are so ridiculous, they arent even PLANNING for 3rd/4th year rotation sites yet, just opening up the first 2 years and then saying to their students "good luck" on finding clinical spots scattered around the country.

LCME and AOA should revoke the accreditation of any med school that cant guarantee 100% of clinical rotations on site. If your school cant guarantee this, then they shoulda never opened in the first place and the region clearly doesnt need a med school if it doesnt have enough local hospitals to feed its students into.

 

[Toohotinvegas33]

I always wondered what touro-ca did with its students. Being that there isnt a significant amount of DO residencies in the area with other big name schools competing for hospital space.

 

[bth7]

there isnt a significant amount of DO residencies in the area

make that NO DO residencies in the area. None.

 

[TruthMD]

..................... no need to start.