Thanks for your email. Let me do my best to answer your questions. If
I miss any of your questions, please let me know.
It is true that there are changes taking place here at the University of
Chicago Medical Center. Like many centers across the country, the U of
C must make adjustments in response to the rapidly deteriorating
national economic environment. The overall strategy of the U of C is to
maintain robust support for its core missions of patient care, education
and research by A) reducing costs and B) fostering the development of
formal relationships with other institutions on the South Side of
Chicago. The layoffs you've read about are being experienced by many
medical centers across the country (google "medical center and layoffs"
to get a sense of this). The strategy for cuts is designed to close
certain areas of the hospital, NOT shift ancillary responsibilities onto
the house staff. You may recall that collaborating with and supporting
other hospitals in our underserved service area is an important part of
our Medical Center's "Urban Health Initiative" (UHI). For our residency
program, this medical center strategy means the development of a new
inpatient experience at Holy Cross Hospital, just 20 minutes from our
Hospital. This experience will replace our present community hospital
rotation in the western suburbs (MacNeal Hospital) with one that 1) is
much closer to the U of C, 2) utilizes OUR academic medicine ward
attendings for supervision and teaching, 3) places our house staff in
proximity to a more diverse and underserved environment and 4)
contributes to the very important goals of the South Side UHI. For the
Medical Center, this strategy means the development of a network of care
not unlike that seen at most academic medical centers, a network that
includes a University Hospital plus any or all of the following: VA
Hospital, County Hospital, City Hospital, and Community Hospital.
The information in the article regarding our Chairman of Medicine is
correct. Dr. Garcia stepped down from his position as of Friday
February 6th. The Department of Medicine is quickly making its
transition to a new chairman with discussions taking place between our
Dean and one of our most talented Section Chiefs. It is absolutely fair
to ask the question "How will this change affect my training?" Let me
answer this question the same way I have answered it though the years
for U of C students and other students worrying about such circumstances
at other institutions. In academic medicine, a chairman stepping down
is not an uncommon event. The tenure of chairman tends to be between 4
and 5 years, so such an event should not be a surprise during the course
of ones residency and fellowship training. The real question is whether
the program director and program leadership are stable. Here at the
University of Chicago Internal Medicine Program the leadership is
stable. Another way to look at this issue is to consider the fact that
our Department of Medicine has seen 4 Chairs and acting Chairs over the
last 20 years. Yet through all that change, the character, values and
excellence of our training program have remained steady and strong.
After a period of growing the size of the entering class over the past 7
years largely to meet the increased inpatient service obligation with
resident duty hour restrictions, we will be returning our class size to
what it was 5 years ago. This change has been made possible largely due
to the expansion of the nonteaching hospitalist services which provide
care for multispecialty patients enabling our housestaff to focus their
clinical service on a more balanced mix of experiences, including
ambulatory care which is consistent with the ACGME focus on strenthening
ambulatory care experiences for IM residents. We also believe this will
be a positive change since our program has always been smaller than our
peer institutions and central to our culture of housestaff comraderie
and high quality faculty-resident interaction.
The implementation of our EPIC medical record will be affected by the
financial crisis. The full blown electronic documentation piece has
been delayed but we will be completing implementation of computerized
order entry and continue to use EPIC to follow medication regimens etc.
Hope this helps. Again, contact me for further questions.
