New VA residency spots

[imgtointern]

I recently read about the VA adding 2000 new residency spots. I read a newspaper article and it didn't mention how and when this would be done. It also didn't mention whether this would be nation wide or it's just state specific legislation. I had some questions regarding the same:
1. Where all will these spots be added? And when? Will these be new programs or additions to existing programs?
2. How many VA programs are there in total?
3. Are most VA programs extensions of university based or community hospital based programs or do VAs have their own programs?
4. Most government agencies only hire citizens. Is that also true for VA programs or are they open to green card/visa holders?
Some of these questions are very basic but I am hoping this will help me and others that might have similar questions. Thank you!

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[ThoracicGuy]

I recently read about the VA adding 2000 new residency spots. I read a newspaper article and it didn't mention how and when this would be done. It also didn't mention whether this would be nation wide or it's just state specific legislation. I had some questions regarding the same:
1. Where all will these spots be added? And when? Will these be new programs or additions to existing programs?
2. How many VA programs are there in total?
3. Are most VA programs extensions of university based or community hospital based programs or do VAs have their own programs?
4. Most government agencies only hire citizens. Is that also true for VA programs or are they open to green card/visa holders?
Some of these questions are very basic but I am hoping this will help me and others that might have similar questions. Thank you!

To my knowledge, VA hospitals do not run their own residency programs. They are usually associated with medical schools that have programs. Perhaps some smaller VAs are looking to join up with more training programs?

 

[gutonc]

Cite your source or go home. Not to be rude but at this point, all you have is rumor. At the very least let us know if this was the NY Times or TMZ where you read this.

 

[RadOncDoc21]

Appears legit based on a proposed bill (albeit a crude google search):

http://www.baldwin.senate.gov/press...es-bill-to-address-va-medical-staff-shortage-

I'm not a fan of politics, but it seems like people are riding this VA controversy before really looking into the source of the issue. For all we know, it could be an administrative problem and not just simply "lack of care."

 

[BlondeDocteur]

There are a couple of residency programs I know of where you're based nearly full-time at the VA. You're still vaguely associated with a medical school and its major teaching hospital but the funding for the positions is through the VA, and you're explicitly matched into it. For example-- the LA VA has a PM&R residency, nominally affiliated w UCLA but run through them.

http://www.losangeles.va.gov/trainee/index.asp

So even if the bill proposed above is simple political grandstanding (likely), there is some precedent.

 

[Law2Doc]

Appears legit based on a proposed bill (albeit a crude google search):

http://www.baldwin.senate.gov/press...es-bill-to-address-va-medical-staff-shortage-

I'm not a fan of politics, but it seems like people are riding this VA controversy before really looking into the source of the issue. For all we know, it could be an administrative problem and not just simply "lack of care."

A bill proposed in the senate isn't the same as something actually happening. Still has to be passed by the houses and get past the president. Did you guys not every see the "I'm just a bill" song from schoolhouse rock? We aren't talking about something that has been agreed on. Hundreds of bills die every year. Even if this does pass, it might be at the expense of residency slots elsewhere (ie not a net gain of residencies) -- lot of horse trading happens. This is hardly a fait complete.

 

[imgtointern]

The two sources cited above and this one http://www.reviewjournal.com/news/military/va-medical-center-battles-doctor-shortage were what I read. I felt it may have been hearsay or at the least, not something that will happen soon, hence I needed the clarification. And yes as L2D states bill to law is a long process. Thanks everyone!

 

[IMPD]

The VA can fund more spots, but needs a University sponsored ACGME program to recruit, match and administer the residencies, just like they do everywhere else.

VA funding is not through Medicare, which makes it easier (?) to make changes. The total number of Medicare spots is definitely not increasing anytime soon, so it would be an interesting development to see VA-only spots increase and how they might do that.

 

[RangerBob]

The VA can fund more spots, but needs a University sponsored ACGME program to recruit, match and administer the residencies, just like they do everywhere else.

VA funding is not through Medicare, which makes it easier (?) to make changes. The total number of Medicare spots is definitely not increasing anytime soon, so it would be an interesting development to see VA-only spots increase and how they might do that.

That's mostly true, but the Greater Los Angeles VA Heathcare Sysetem (VAGLAHS) sponsors, pays for, and recruits it's own residents (for pm&r and psych, I believe). It's "affiliated" with UCLA, but that came later and UCLA doesn't really contribute anything towards the programs as far as I can remember (other that a few rotations and support staff needed for those, and possibly a little bit of funding)

I think that's the only example of a VA-run residency program.

In most cases, such as my program, things are arranged just as you say--the VA is affiliated with an academic center that runs the residency program. In our case, the VA is paying salaries/benefits/etc for a couple residents in the program--they expect and need three inpatient residents at all times plus another 2-3 outpatient residents. So they're basically funding 2 or so residents per class of 6.

I would imagine if the above bill passes that's what would happen--the VA wouldn't directly hire the residents--just pay for the rights to have more of them rotating through the VA at any given time, effectively giving them more residents.

That would theoretically mean programs could add more residency positions, though if the VA says they'll pay for say, one more psych resident per month, maybe the academic instruction will just decide to shift more psych rotations to the VA to cover that "extra employee" (instead of hiring a new resident) and then add another residency position in another specialty.

 

[DermViser]

A bill proposed in the senate isn't the same as something actually happening. Still has to be passed by the houses and get past the president. Did you guys not every see the "I'm just a bill" song from schoolhouse rock? We aren't talking about something that has been agreed on. Hundreds of bills die every year. Even if this does pass, it might be at the expense of residency slots elsewhere (ie not a net gain of residencies) -- lot of horse trading happens. This is hardly a fait complete.

I think you mean, "fait accompli".

 

[Law2Doc]

I think you mean, "fait accompli".

Yes. Spell check apparently "fixed" it for me...

 

[imgtointern]

I found this article on BBC too yesterday - http://www.bbc.com/news/world-us-canada-28535786. It doesn't talk about residency slots but talks about problems at the VA and congress's budget plan for the near future.