Dental residencies closing

Started by Montrealer
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Montrealer

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Hi all,

I've been reading all your posts for while but never dared to post something.

But here is something interesting for those who are interested in postgraduate dental education: did you guys know that cutbacks in Graduate Medical Education (GME) funding could force universities to make major cutbacks and, perhaps, even close, many dental residency training programs!

check out these links:
http://cpmcnet.columbia.edu/dept/gc/pdf/talking_points.PDF
http://cpmcnet.columbia.edu/dept/gc/issues/gme_draft_letter.doc
 
Interesting...the only two dental residencies that I can think of that has to do with GME are OMSs and GPRs. It'll be interesting to see what happens.

I want to say a 1/3 of OMS residencies are hospital sponsored, meaning that it's not affliated with any dental schools (Mt. Sinai in NYC for instance). I believe that it is these OMS residencies that will be affected if any OMS residencies are getting cut back back GME. Obviously it will be at some smaller hospitals that only accept 1 resident a year instead of big name hospitals like Mt. Sinai. I don't believe dental school affliated OMS residencies will be affected, unless it's a 6-year OMS/MD program.

Interesting indeed........
 
Interesting. Creates some possilbe conflicts of interest. The ADA, for the economic sake of its members, may not be all that opposed to the ruling. The 1997 Budget Act which effectively reduced the numbers of allopathic and osteopathic residencies was not entirely unwelcome by the AMA.

Also opens the door for expanding the pre-doctoral DDS/DMD program to a standard 5 year curriculum with the fifth year essentially becomming a year long practical licensing board exam monitored by hard nose attendings. Welcome to the real world D5's. You will now be expected to produce a quality product at an ever increasing level of productivity in order to deliver a handsome profit to the school clinic before we hand you that license. Ouch. More blood, sweat, tears, and debt for the students. The cost shifts have to go somewhere since there is no such thing as a free lunch. You know the old saying about poop flowing downhill.
 
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Originally posted by groundhog


Also opens the door for expanding the pre-doctoral DDS/DMD program to a standard 5 year curriculum with the fifth year essentially becomming a year long practical licensing board exam monitored by hard nose attendings.

I actually think this wouldn't be such a terrible idea.

Then again, perhaps under this format it would be.

Either way I think an internship should be a mandatory part of the dental education, be it a specialty or a PGY experience in AEGD/GPR. I truly hope legislative bodies lean towards this method of education.
 
I'm not opposed to the idea of a five-year curriculum, Gavin, but I personally hope legislative bodies stay as far away from defining our professional competencies as possible. That's a decision that needs to be made by dental schools and the dental profession as a whole; not by elected officials who know more about buying TV campaign spots than human biology. Dentistry has come a long way by being self-governed...I'd just as soon keep it that way.
 
Hey Everyone,

GPR, Pedo, and OMFS are the LEAST likely residencies to be affected by this change in funding, BECAUSE they are hospital based. The change in GME funding is that financial subsidies will no longer be available for dental-school based residencies (i.e. ortho, perio, endo, etc) that are not hospital based.

For example, if you go to the University of Washington for Ortho, there is a tuition fee for obtaining the MS in Orthodontics. Ordinarily, the GME money offsets the cost of program tuition, so you only end up paying for living costs, which can be primarily offset by moonlighting (either explicitly or implicitly). Under the new legislation, this funding is no longer available to Ortho, Endo, and Perio programs that aren't providing hospital-based services.

This is just a legislative move to narrow the definition of graduate medical education to encompass only residencies that are hospital-based. The only impact this may have on OMFS is that 6-year programs may only have funds to pay residents during their non-medical school years (some programs pay for all 6- years).

Cheers.

AjM
 
Originally posted by aphistis
I'm not opposed to the idea of a five-year curriculum, Gavin, but I personally hope legislative bodies stay as far away from defining our professional competencies as possible. That's a decision that needs to be made by dental schools and the dental profession as a whole; not by elected officials who know more about buying TV campaign spots than human biology. Dentistry has come a long way by being self-governed...I'd just as soon keep it that way.

Sorry for the confusion, Bill. I meant legislative bodies such as the ADA and ADEA, not politically-elected legistlative bodies.
 
We just got a message from our dean at nyu about this topic. Not sure if it pertains to NYU or all dental schools...(btw, interesting note on how NYU had to accept more students for this upcoming fall in order to offset the potential loss of funds...)

Dear friends and colleagues- As you may have heard by now, we have achieved
a marvelous result from the Center for Medicare and Medicaid Services (CMS)
on our Graduate Medical Education (GME) issue. Although our lawyers are
still reviewing the specifics of this complex rule, I think it is absolutely
the best result we could have achieved from this agency. The specifics are
that the CMS has eliminated the retroactive aspects of the proposed rule, in
which they sought to recover funds for resident training already provided or
committed at dental schools. In addition, they have agreed to honor
commitments to dental residents who entered their programs on or before
October 1, 2003 until the end of their residency, or for three years,
whichever comes first. Since all dental residencies (except Oral Surgery
which is hospital based, and therefore exempted) are for three years or
less, all of our currently enrolled residents will be covered through
completion of their programs.

This is wonderful news, and it eliminates budget deficits at the dental
school. We will not need to continue to attrite employees, nor to implement
the large layoff we had planned; and, we can restore most of our other
budgetary cuts. In addition, although we are committed to a larger D1 class
in the fall because the admissions process is complete, I do expect to get
back on our strategic plan to continue to make the College smaller beginning
in September '04. However, we will not reverse out the revenue generating
activities that we put in place during the crisis, because these changes
also make for better patient care and better education.
Finally, I want to take a moment to thank you all for your help through this
crisis. I had the sense, based on many conference calls with dental deans
nationwide, that the university administration at NYU responded faster and
better than any other. Whether it was generating a presidential letter, a
congressional response, a legal analysis, or a budgetary finesse, we seemed
to be there first. Moreover, you, my friends and colleagues at NYUCD, were
simply terrific. I estimate that NYUCD generated about 3,000 INDIVIDUALLY
WRITTEN letters. Indeed, we sent so much mail to CMS that when I went to
Baltimore in June to argue the case with CMS on behalf of ADEA and ADA, a
staffer begged me to "turn off the spigot". I told her that is not going to
happen, and felt great pride that NYUCD had made such an impact on them.
All in all, it was a great example of teamwork. Thank you!
 
The hospital I volunteer at recently shut down its GPR clinic due to it losing money (its inner city......a lot of patients with little or no dental insurance) and expanded its OMS dept from 2 residents per year to 4(Major cancer cases=$ for hospital). So I guess when it comes to a hospital $ is the only thing that matters 🙁
 
Please disregard what I write....half of the time I don't even know what I write or what I'm talking about...

😀
 
That's OK Yah-E when you are speculating about events that are somewhat subjective in nature. A famous and successful CEO of a large corporation was once asked what set him apart from the crowd. He responded that he had been right a bit more than 50% of the time during his career.
 
My classmates who were in the area this summer all wrote letters similar to what Montrealer posted trying to convince CMS that they were making a VERY bad decision.

That said, does anyone know what the actual final decision is? Are they cutting GME funding for the non-hospital based programs? I thought it took forever for Congress to make decisions - it took them since the late 90s to get HIPAA into place for 2003. How do they go about cutting GME funding in a matter of weeks without letting the dental community know about it (so we could have effectively fought back)? By the time dental schools had found out what CMS was up to, it was almost kinda too late I think.

For me and my fellow fourth years, the threat of losing GME is BAD NEWS. If I go through with my plans to specialize, I am looking at adding 3 more years of serious debt (in addition to the debt from dental school) if I have to pay my own way at pricey places like NYU & Tufts. Looks like I'll be doing some serious moonlighting during residency to pay the bills...
 
Pi_Guy's post seems to indicate that those speciality programs which are not hospital based will not receive funding from CMS to provide residency salaries to students accepted into those programs after October 1993. OMS, GPR, and maybe some Pedo will be OK in the future, but AEGD, Perio, Endo, Ortho, Pros etc. may be out of luck post 10-03. Is that correct?
 
groundhog, i think you're right...
i was talking to a prostho resident a week or two ago, and that's exactly what she said:

"Pi_Guy's post seems to indicate that those speciality programs which are not hospital based will not receive funding from CMS to provide residency salaries to students accepted into those programs after October 1993. OMS, GPR, and maybe some Pedo will be OK in the future, but AEGD, Perio, Endo, Ortho, Pros etc. may be out of luck post 10-03. Is that correct?"
 
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