How to start a residency program?

[littleemma]

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I would appreciate some help from program directors of this forum.

We are a multi-specialty large private practice (only adult patients) but not associated with a medical school and not affiliated with a hospital.

Half of our patients are medicare patients.

IS there any way we could start an ACGME residency program?

I did look into the ACGME website institutional requirement, but it is quite difficult to figure out.

Thank you very much.

 

[NotAProgDirector]

You absolutely would need some sort of affiliation with a hospital. Even in the more outpatient focused specialties (like FM, and Derm), inpatient experience is required. You will also need to demonstrate ongoing academic productivity from your current faculty.

You can start with the Program Requirements for the field you're considering. Go through it line by line, and see what you'd need to provide.

 

[Apollyon]

You absolutely would need some sort of affiliation with a hospital. Even in the more outpatient focused specialties (like FM, and Derm), inpatient experience is required. You will also need to demonstrate ongoing academic productivity from your current faculty.

You can start with the Program Requirements for the field you're considering. Go through it line by line, and see what you'd need to provide.

Is it a hospital affiliation, or a med school? Like, Carolinas is affiliated with UNC-Chapel Hill (140+ miles away).

 

[Mass Effect]

I don't see how you could ever get a residency program approved without hospital affiliation. All residents need education in hospital medicine.

 

[gutonc]

Is it a hospital affiliation, or a med school? Like, Carolinas is affiliated with UNC-Chapel Hill (140+ miles away).

Hospital only. There are plenty of community based residencies and fellowships out there without even a tenuous connection to a led school.

To the OP though, I have a bigger question.

Why?

What would be your goal in starting a residency or fellowship program?

Running a GME program, even a small one, is a ton of work. What’s the “hook”?

 

[ThoracicGuy]

Hospital only. There are plenty of community based residencies and fellowships out there without even a tenuous connection to a led school.

To the OP though, I have a bigger question.

Why?

What would be your goal in starting a residency or fellowship program?

Running a GME program, even a small one, is a ton of work. What’s the “hook”?

All that sweet, sweet government money?

 

[IMGASMD]

All that sweet, sweet government money?

I would think by mentioned 1/2 of the patient is Medicare patients, OP is thinking compensation is already ****. Maybe the group can get some more subsidies from the government? Or worse, cheap labor.... but that just my cynical self talking out loud.
Not to say the group/hospital/program shouldn’t get compensated. But I don’t believe anyone would start a residency program out of the goodness of their heart. Or the fact that the OP don’t even have anyone to consult IRL, in concerning.

 

[littleemma]

You absolutely would need some sort of affiliation with a hospital. Even in the more outpatient focused specialties (like FM, and Derm), inpatient experience is required. You will also need to demonstrate ongoing academic productivity from your current faculty.

You can start with the Program Requirements for the field you're considering. Go through it line by line, and see what you'd need to provide.

aProgDirector, I do appreciate your input, especially your non-judgemental comments. It seems hospital affiliation is something our practice could not get over.

A little more information to clarify others' speculation. We were affiliated with a hospital and did run a residency program. Unfortunately due to an administration change, we are losing the hospital affiliation and the residency program. However, we hired a bunch of residents and we really hope there is a way we continue their education till their graduation.

Our practice does not get a single dollar from the government. On the contrary, we provides everything for the education expense.

CHEAP LABOR would leave to anyone who think it is.

This would be the end of discussion. Thank you ALL!

 

[IMGASMD]

we hired a bunch of residents and we really hope there is a way we continue their education till their graduation.

I am not sure what this means. Are they orphaned residents? Can they go somewhere else to finish? You hired them to do what? as what? If they’re no longer affiliated with a residency program, what are they?

I will be the first one to say I don’t have any academic experience and I am jaded. But i applaud you for doing everything out of the goodness of your heart.

 

[gutonc]

aProgDirector, I do appreciate your input, especially your non-judgemental comments. It seems hospital affiliation is something our practice could not get over.

A little more information to clarify others' speculation. We were affiliated with a hospital and did run a residency program. Unfortunately due to an administration change, we are losing the hospital affiliation and the residency program. However, we hired a bunch of residents and we really hope there is a way we continue their education till their graduation.

Our practice does not get a single dollar from the government. On the contrary, we provides everything for the education expense.

CHEAP LABOR would leave to anyone who think it is.

This would be the end of discussion. Thank you ALL!

For the record, I wasn't being judgmental, it's a reasonable question. Starting a residency is a ton of work, you have to have a really good reason to want to do so. Which you do...so good on you. Your OP falls under the common SDN category of "more than meets the eye" where a seemingly simple question is actually much more complicated with a massive backstory.

I guess another follow up question (which you probably won't answer) is, is there another hospital/system that you can get an affiliation with that has a GME program (or is willing to front the money/time to start one)? That's the most likely option for you.

As an example, in my town, there's the university (with tons of residency and fellowship programs) and 2 community hospital systems with IM residencies of their own, but that also host residents (and some fellows) from the University in Surgery, Gyn and some of their sub-specialties. If a surgery or OB/Gyn program in the next town over (which doesn't actually exist, just an example) closed down, I'm sure one of these hospitals could relatively easily absorb it into the existing GME structure. The few true community hospitals in the area OTOH would have a really hard time making that work.

 

[Neuronix]

Wait, aren't you from the rad onc forum?!

We have a tremendous oversupply of residents in rad onc and the job market is disintegrating.

You want to open up yet another residency program? Are you really in radiation oncology? 😱

 

[Merely]

Lol this guy got really sensitive after being asked reasonable questions