EM Programs Losing Accreditation 2014

Discussion in 'Emergency Medicine' started by SoyMilk, 09.25.14.

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  1. SoyMilk

    SoyMilk 7+ Year Member

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    For those of us applying this year and casting a wide application net, I'm sure I'm not alone in wondering...What programs are in trouble or facing loss of accreditation?
     
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  3. DocEspana

    DocEspana Bullish 5+ Year Member

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    Bad ones.
     
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  4. diphenyl

    diphenyl Dancing doctor 7+ Year Member

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  5. trkd

    trkd 10+ Year Member

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    USC? Surprising. Wonder why.
     
  6. DeadCactus

    DeadCactus SDN Lifetime Donor Lifetime Donor 10+ Year Member

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    I think USC relatively recently changed their program format, they're probably on probationary status because they're a "new program"...
     
  7. kmb1908

    kmb1908 7+ Year Member

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    and what about Shreveport?
     
  8. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD Partner Organization 10+ Year Member

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    Or perhaps, like other county programs in that area of California that have closed, they rely on residents to do basic technician tasks. The plus side of a county program is you "get to do it all and see it all." The downside is you have to do it all and see it all. Not to mention you are unlikely to learn any of the customer service skills that ensure success, for better or for worse, at most community jobs in the country.

    I had a good friend at MLK/Drew when it closed. He knew it was in trouble when he signed on but the location was very good for him. It was a very big deal to go to another program when it did go under. I wouldn't go to a program under probation unless I couldn't match anywhere else, even one with a reputation like USC's. Residency programs can and do close all the time and those residents then go begging for any spot they can get.
     
  9. dawnbreaker

    dawnbreaker 5+ Year Member

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    The reasons for our probationary status are complicated, but rest assured have nothing to do with the education or having to do "basic technician tasks." For a county institution, we are amazingly scut free (i.e. you will never have to draw your own labs, do your own EKG, push people to CT or Xray, etc). We have been very candid with all applicants and rotators about the reason for our probation and have been nothing but open in our discussions about it. Our program director has made it a point to bring it up unsolicited with every student, interviewer, and rotator who comes through, and allay any concerns they might have.

    Our probation had to do with politics at the administrative level and some discontent amongst the faculty with the leadership of the department. The concerns of the ACGME were specific to one person in the department. With the resignation of our Chair, the department and our program director firmly believe that the probationary status will be lifted at the end of this year. The overall sentiment of the department including faculty and residents is that this change was for the best. The causes of the probation had absolutely nothing to do with the quality of the education, pathology, or the enthusiasm of the residents in serving our population which have remained unchanged throughout all this. All the crazy stories your hear about "Big County" are true...come check it out for yourself (don't just take my word or some other random person on the internet's word). The department and the hospital are NOT imploding as some might believe.

    Anyway...for the rotators and applicants, if you guys have any questions or concerns about this issue when you come by our hospital, feel free to ask ANY of us our thoughts, feelings, and details on the matter...we are more than happy to share! We're really excited about where we are and where we're headed at this program!
     
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  10. TimesNewRoman

    TimesNewRoman 2+ Year Member

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    Thanks for the update. I had a hard time believing the people that make EM:RAP, Hippo:EM, Essentials, etc didn't take resident education seriously.

     
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  11. WilcoWorld

    WilcoWorld Senior Member 10+ Year Member

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    No no no, this has to be in error. USC is a top-ten program according to Doximity. Someone should let the RRC know about that, I'm sure they'd clear it right up.
     
  12. hoot504

    hoot504 PGY-II 7+ Year Member

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    I can confirm most of the things Dawnbreaker said because I rotated at USC. They do indeed bring this issue up completely unsolicited with all of the rotating students. They sounded very confident that the issue had been resolved and their probationary status would be lifted this year.
     
  13. diphenyl

    diphenyl Dancing doctor 7+ Year Member

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    EM programs are pretty good about taking on residents from programs that close down. About half a dozen or so have closed since 2000. The medicare funding goes with that resident to wherever they end up. Corpus Christi ended up taking most of the King Drew residents to name one example. They were opening up a new program and jumped at the chance to have some upper level residents to supervise their new freshman intern class. I have never heard of a resident being left out in the cold when a program shuts down unless that person was incompetent to the point they would have been fired anyway had their program stayed open.
     
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  14. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD Partner Organization 10+ Year Member

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    Probation because of an issue with one person? Not sure I buy it. At any rate, if they're not under probation by the time you submit your rank list, I guess there's nothing to worry about, right?

    Still, if I'm applying to 30 programs, get interviews at 15, and would be happy at 12 of them, why bother with the only one on probation? Seems like an easy screen for the top applicants.

    "Okay, 140 programs. Let's start by throwing out all the ones on probation. Now we just have 138. Crap, how am I going to find one I like now?"

    I'm sure USC will be fine, but I wouldn't bet my residency on it. You may feel differently. Or perhaps its a chance for a mediocre applicant to slip into a "top 10 program" since many top applicants will be scared away by the probationary status. Dunno.
     
  15. dawnbreaker

    dawnbreaker 5+ Year Member

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    You are entitled to your opinion. But the fact is, that after an exhausting investigation by the ACGME which included interviews with every single active faculty member and non-intern resident, along with interviews with past faculty members, there were 4 citations made against the program. Three of these citations had to do specifically with the Chair of the department and his conduct. The other citation is a commonly made citation against county programs which had to do with throughput time in the ER (see the Code Black documentary). Immediately after the notification by the ACGME of the specifics of these citations, our Chair resigned and was replaced by Ed Newton who was the former chair for 10 years and whose name you may recognize from the front cover of Rosen's textbook. He is an amazing person, leader, educator, and physician.

    It has also been made clear to us that our probationary status would not be taken off by the time rank lists come out...this is just the facts. The ACGME notified us of their recommendations in early August and will be returning for another site visit some time in February to evaluate actions taken to rectify the causes of our probation. Their response to this site visit is expected to return some time in June or July at which time we fully expect to have the probationary status removed. As you can see, this time table means that we will still be on probation come rank list time, but is merely a reflection of the ACGME's scheduled visits, and not necessarily our actual compliance.

    There may be 167 programs to choose from, but I don't think they were all created equal...just my opinion though. Anyone who sees our Emergency Department and program will likely agree with this. And lastly, if "stats" and "scores" are any indication of the quality of applicants, this year will turn out to be one of the most competitive ever at our program with over 800 highly qualified applicants. I've worked with many of the rotators so far this year and can attest to the fact that we will have no trouble at all filling our spots with the best med schools have to offer, and have conversely received amazing feedback from the students.
     
  16. Modafinil

    Modafinil 2+ Year Member

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    Nope. We're taking all the good ones.
     
  17. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD Partner Organization 10+ Year Member

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    How weird, an emergency doc who thinks his or her residency program is the greatest one in the country. I agree that not all programs are created equal. Some for instance are on probation. Others, require you to stay for an extra year. Occasionally, you see one with both issues. :)

    I'm not surprised to hear about throughput issues at a county program. I didn't interview at USC (3 year programs only) but did at Harbor UCLA, and the less-emergent patients there showed up with a pillow and 3 sack meals when they came to the ED. 24 hour waits were not uncommon.

    So, are you (or someone who interviewed there) going to say what the PD did to get the program on probation? At this point we're all assuming he slept with one resident, killed another, and blackmailed the mayor.

    I'm also curious if 800 applicants is unusual for a residency program. I mean, if there are 167 programs, and maybe an average of 12 residents per program, and most people apply to 50 programs, it would seem to me that having more than 600 applications would be normal for a residency program, especially a large program located in California. Or is that 800 highly qualified applicants, plus another 1000 qualified applicants, plus another 1000 unqualified applicants? I mean, I don't recall the exact numbers at my program, but it seems like we interviewed 10 for every position we had, and most applicants didn't even get offered an interview. I assume most programs are similar.

    Like I said, despite my giving you a hard time, I'm sure USC is a great program and those who go there will be just fine. But I recall hearing similar things about how Drew was awesome despite being on probation the year I applied.
     
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  18. EMIM2011

    EMIM2011 5+ Year Member

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    What did the chair do?
     
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  19. ihearttriangles

    ihearttriangles 5+ Year Member

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    Zing!!!
     
  20. kmb1908

    kmb1908 7+ Year Member

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    Again, does anyone have any information on Shreveport?
     
  21. scummie

    scummie 5+ Year Member

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    +1
     
  22. cahn9088

    cahn9088

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    2nd year EM resident here. rotated at USC when i was a med student so just wanted to back up some of what dawnbreaker said. USC is a phenomenal program and i had a great time there as a student. the PD as well as all of the faculty and residents that i met were super into teaching and it truly is unlike many other programs with its acuity and volume. that being said the chair when i was there was a complete dingus. i won't drop any names but he was extremely rude to both medical students and residents (would force them to put on their white coats, chew them out during presentations, etc.). i got extra flack too for being a DO student (which was beyond what I had experienced in the past; ironic as they've taken DO's before as residents and a DO just got named to one of the to positions in the USC medicine hierarchy but i digress).

    all i have to say is if the chair was the only reason the program was placed on probation, then having the chair leave/step down is the BEST thing that could've happened to the program. the EM program at USC is national renown for many reasons and applicants should not be dissuaded based on their current probationary period. to drop them in rank or to not even bother applying would be doing themselves a disfavor.

    that being said i love my program and being done in 3 years beats 4 years anyday :)
     
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  23. gman33

    gman33 Moderator Emeritus 7+ Year Member

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    Being on probation does not mean a program is going to close.
    You have to look at WHY they are on probation.
    I have no knowledge about USC. If it's an isolated issue that is now resolved, I wouldn't worry about it.
    I'd be more concerned if it was a whole bunch of stuff that was unlikely to be fixed.
     
  24. SoyMilk

    SoyMilk 7+ Year Member

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    Bump. Anyone hear anything regarding Shreveport?
     
  25. two guys

    two guys 2+ Year Member

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    For anyone applying to these programs it is probably wise to consider your source. Unless you hear it from the ACGME themselves, it is likely very few people know specifically why certain programs are on probation. It doesn't mean stay away, it just means there better be a reward for the risk you are taking.

    As far as programs openly discussing probation: isn't that what you'd expect them to do? If I was a progam director I'd make darn sure everyone knew the side of the story that situated my program in the best position for future success. That side of the story would sound identical to we're hearing on here which is: everything is perfect here expect one thing and it is now fixed!

    It may very well be true, but it is the same story anyone would be telling even if it wasn't. I'd ask the residents and people who rotated at USC to consider where they got their information from, the ACGME? or the Program Director? Do you truly know exactly what was on the ACGME report?

    I'm not telling anyone to avoid USC or calling anyone on here dishonest. I'm just trying to say that there is SOME risk in this situation.

    I wouldn't consider having my name next to Rosen as a positive, just saying.

    That being said, it is a very well known program in a location some people love with a very distinct set of pathology and educators. The reward is likely high.
     
  26. FoundAWay

    FoundAWay 2+ Year Member

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    Hello, I'm a current resident at LSU-Shreveport. We were put on probation with our last site visit last spring. The major issues to be addressed were the number of attending hours of coverage (per pt volume) and the number of ICU months. During the visit, the inspectors were informed that faculty had been hired, but had yet to start (so could not be counted) and there was confusion about what could be counted as a critical care months. In June, 5 additional full time faculty were hired and starting now we have added a neuro ICU month to comply with the ACGME critical care months needed. Though those issues were addressed, we can not be re-evaluated until Feb of 2015. Administration has assured us that the probation status will be lifted.

    Oddly, if you look on the ACGME website, it lists us on probation for 2 years. The site visit was around March of 2014, the probation status was started June 24, 2014. Their "year" is July through June, so the last week of June counted as probation for the 2013-2014 year, and now currently counts for the 2014-2015 year.

    As far as the program goes, the training is good. We have a sick, under served population, large volume, and a large catchment area as we are the trauma center for much of East Tx, the Southern most parts of Oklahoma and Arkansas, and cover the top 1/2 of Louisiana. The ED is recently built with a great layout, faculty are approachable, and the residents all get along and are quite happy.

    Though I understand the reservations about looking at a program on probation, I would still highly recommend our program.
     
  27. dawnbreaker

    dawnbreaker 5+ Year Member

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    Thanks for bringing this up. The official ACGME letter outlining our reasons for probation was provided for every resident and faculty to read for themselves, and the residency office reviewed it with the entirety of the residency program. The points I made were based on seeing the actual letter, so no secondhand information. I do encourage anyone who comes to USC, or any other program for that matter, to ask the questions you want the answers to from faculty and residents at that institution...and don't take an anonymous person on a website's word for it (including mine). Cheers!
     
  28. doctorFred

    doctorFred intensive carer 10+ Year Member

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    dawnbreaker on USC: "..the department and our program director firmly believe that the probationary status will be lifted at the end of this year."
    FoundAWay on Shrevesport: "..we can not be re-evaluated until Feb of 2015. Administration has assured us that the probation status will be lifted."

    respectfully, what else are they going to say? "we'll still be under probation for a few more years, but come here anyway!"
     
  29. dawnbreaker

    dawnbreaker 5+ Year Member

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    Just wanted to let all the applicants know that we got word from the RRC today that USC has officially been taken off probationary status and if you applied to our program, you will be receiving a letter from our program director. The ACGME website already reflects the fact that we've been taken off probation and hopefully this will provide reassurance about the things I've been saying above.
     
  30. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD Partner Organization 10+ Year Member

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  31. islandAddy1881

    islandAddy1881 2+ Year Member

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    I can second the reasons for LSU Shreveport being on probation. I rotated and interviewed at Shreveport and the reasons listed above are almost verbatim what was expressed to me by multiple staff members. They also said that they anticipate the probation will be lifted on the next site visit.
     

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