program closures

[Arctic Char]

I heard that the ACGME has closed down 3 pathology residency programs. UT El paso, one in Philly, and one in Indiana. has anyone else heard this? if its true, i think its a step in the right direction . . .

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[Entgegen]

Not sure about those programs, but I can confirm that the Texas Tech program is being shut down (the last graduating class will be 2013). I know this because I had interviewed there this past season and the program coordinator called me 2 days ago to tell me they're withdrawing from the current match. She mentioned the closing was due to "budget cuts", and did not give further specifics.

On another note, I was unaware that UT El Paso had a path program. Perhaps it was really Tech that you heard was closing...?

 

[Arctic Char]

Not sure about those programs, but I can confirm that the Texas Tech program is being shut down (the last graduating class will be 2013). I know this because I had interviewed there this past season and the program coordinator called me 2 days ago to tell me they're withdrawing from the current match. She mentioned the closing was due to "buget cuts", and did not give further specifics.

On another note, I was unaware that UT El Paso had a path program. Perhaps it was really Tech that you heard was closing...?

yeah, Tech . . .El Paso . . . whatever. i don't know Texas well enough to know the difference. thanks for correcting me.

 

[Napoleon1801]

Word on the street is that Ball Memorial is losing their Path residency, not due to the ACGME though. The story I heard was that the CEO of the hospital decided to outsource the whole Path department (to whom I don't know...).

 

[Thrombus]

Word on the street is that Ball Memorial is losing their Path residency, not due to the ACGME though. The story I heard was that the CEO of the hospital decided to outsource the whole Path department (to whom I don't know...).

This is hilarious. With hospitals tightening budgets, they can no longer afford to subsidize "academic" pathologists with 30 faculty signing out 20K cases. Thats what you get when you overtrain residents....you lose your cush job to somebody much more efficient than you. Finally, the oversupply is starting to come back to haunt academia. Look for more of this in the future.

Hopefully it will follow that worthless papers and projects begin to dry up as these mediocre institutions get bought out/outsourced and that pathology trainees beging to dwindle.

 

[Entgegen]

When comparing the programs on the NRMP website against the FREIDA and ACGME websites, the programs that are not available to be ranked on the NRMP website in the 3 states mentioned by Arctic are Texas Tech in Lubbock, Texas (which I confirmed is being shut down), Conemaugh Valley Memorial Hospital in Johnstown, Pennsylvania, and Ball Memorial Hospital in Muncie, Indiana.

There may be others in other states for all I know, but these are the only states I checked.

 

[Arctic Char]

thanks for doing the leg work in getting a bit more information. i just got word of mouth and thought i'd throw it out there and see if anyone else had the scoop.

my sentiments are summed up with two words: good, damnit.

 

[jp123ok]

Given that there are around 2500 path residents in the country, I'm not sure that the loss of 25 residency spots at 3 programs is going to have much of an impact on the job market. Also, you've got to think that if whole departments are being outsourced to more efficient outside institutions it is actually worsening the job market. From what I understand, academic jobs are relatively easy to come by, so I'm not sure that anybody who is worried about the job market should be cheering about their loss, at least not in the short to medium term.

 

[coroner]

I do remember when I started residency, FREIDA listed 152 Pathology programs. Now it's at 146 and with these additional ones being mentioned it will be down to 143...It may seem like a step in the right direction for those insistent on reducing the supply of trainees; but, I agree with previous references that the diverted workflow will be handled with a relative smooth transition from hospitals/labs in the vicinity in absence of any kind of huge void in qualified personnel to handle it. But, I guess most would agree 9 fewer programs offers a more secure outlook than 9 more...

 

[KCShaw]

Still, it's an interesting feedback loop. I wouldn't exactly want to let the future of the specialty hang on its tenuous threads, and it's possible the system could find its own equilibrium given enough time without outside influences. But it's interesting that an argument could be made that a relative surplus of pathologists generally working for "less" money right now may be at least partly influencing the closure of the same programs who created them, decreasing the numbers of future pathologists and possibly increasing their future demand -> income. (It would also be worth looking to see if the change in numbers of programs actually equates to a change in the numbers of finishing residents taking/passing the boards.)

Or it may not work out that way at all. Either way, not really worth simply waiting around a few decades/generations to see -- I rather suspect there are better things to try in the meantime.

 

[2121115]

Good points above. Interestingly, the pathologists most likely to be helped by there being fewer graduating residents are the graduates of the programs most likely to be closed. Weird feedback loop.

 

[rockit]

There was a rumor that Temple was going to be closed in Philly, but apparently it's going on heavy probation. I have no first-hand knowledge of this, so it may not be entirely true.

 

[sbp]

anybody know whats going on in Temple, why are they on probation??

 

[pathstudent]

There was a rumor that Temple was going to be closed in Philly, but apparently it's going on heavy probation. I have no first-hand knowledge of this, so it may not be entirely true.

I have first hand knowledge that it is going on double secret probation.

I am friends with the chief resident who has been there for ten years. He's a hoot.

 

[2121115]

I have first hand knowledge that it is going on double secret probation.

I am friends with the chief resident who has been there for ten years. He's a hoot.

10 years???????????

 

[pathstudent]

10 years???????????

Picture didn't come through. This is my chief resident friend.

 

[pathstudent]

Gosh. I have gotten a bunch of pms thinking that my comment is serious and wanting to know what "double secret probation" is and want to know who is the person I know there.

I can't believe I have to write this, but that is a line from a movie called Animal House and that person is a man named John Belushi who was in that movie and had memorable line about "seven years of college, down the drain." My goodness, it is a good thing you all are in pathology.

 

[KCShaw]

Art appreciation, out the window.

Dunno what to make of it now, but for some reason I scrapped an earlier reply containing something about Neidermeyer and a horse earlier.

For anyone who hasn't seen the movie, or was apparently under such toxicologic influences that they no longer recall, I pop zit on you.

toga..Toga...TOGA...TOGAAAAAAAAAAA

 

[Parts Unknown]

I am friends with

This should have been the red flag, right here.

 

[yaah]

Gosh. I have gotten a bunch of pms thinking that my comment is serious and wanting to know what "double secret probation" is and want to know who is the person I know there.

I can't believe I have to write this, but that is a line from a movie called Animal House and that person is a man named John Belushi who was in that movie and had memorable line about "seven years of college, down the drain." My goodness, it is a good thing you all are in pathology.

Amazing. Hopefully the people who PMd you were not from this country, because if they are they need help. I was reading something recently (maybe on Deadspin?) in which the writer complained about a piece of crap movie, I think the new Adam Sandler movie, and was saying how the worst part of it was that it was almost guaranteed to be someone's favorite movie. Some young person is going to see and think it is the funniest thing ever. And sometimes current movies like Meet the Spartans can be referred to as "this generation's Animal House" as though whatever the crappy current movie is is anywhere close to the kind of movie Animal House was.

here it is (borderline NSFW language and headlines, by the way) http://deadspin.com/#!5761134/an-inside-look-at-the-white-house-pooper

 

[amygdala_path]

The program is in big trouble with residents doing only scutwork and no teaching or sign out. This is what I heard from someone I met at an elective rotation.

 

[HbyHA]

The program is in big trouble with residents doing only scutwork and no teaching or sign out. This is what I heard from someone I met at an elective rotation.

i know two people who recently trained here and said the CP training was crap and the AP training wasn't exactly stellar. and another resident was trying to transfer to our institution from there. i trained in (and am from) the Philly area and my biggest reason for not going there was not getting shot at.

 

[WEBB PINKERTON]

Word on the street is that Ball Memorial is losing their Path residency, not due to the ACGME though. The story I heard was that the CEO of the hospital decided to outsource the whole Path department (to whom I don't know...).

What is going on at ball memorial? The lab used to be called PA labs and was sold to labcorp years ago. I had some friends that lost their jobs in PA's indy cytology department after labcorp's takeover. The hospital sold out to Clarian (or iu health as they are now called) in recent years. The whole situation seems weird.

Labcorp also bought out DCL labs in indianapolis last year and I heard they were moving people to DCL's location.

Gotta love the business of lab medicine!

 

[KCShaw]

Obviously I don't know, but my suspicion is that here and there medical school Deans and hospital CEO's are looking at labs as the biggest black hole of expenditure in the hospital side of the system, and think it's quicker and easier (so they don't lose their own jobs) to sell their souls to trim the fat. I'm not sure they all realize that for the most part the problem is probably their ordering physicians...residents who are being taught to shotgun order so they can answer every zebroid question the professor asks them during rounds and claim they already thought of that. They may not be taking into account that many other disciplines, such as most of the surgical ones, require a pathology teaching component. On the other hand, they may be looking and saying hey, if we trim 12 pathology resident jobs we can shift those positions over to surgery, IM, anesthesia, etc. "service" positions and get BigPath to handle all of the current path tasks for the same or cheaper. They not only save money, they add so-called service jobs.

 

[TMZ2007]

I disagree with your financial hypothesis, at least in my experience. Our lab produces (apparently) a net income of $150+ million per year, nearly all of which goes back to the main hospital to fill in revenue gaps in other departments. The lab is one the leading revenue generators (at this hospital, anyway).

 

[KCShaw]

Do you have a blood bank? Where I trained, that was supposedly the biggest sink by far, especially with things like Factor VII being apparently the coolest thing since iced tea. Mentally I probably lumped that in with the lab as a whole, and it's never escaped.

I know the CP labs used to be big revenue streams, but the way billing and reimbursement has changed I didn't think it was free money anymore. If someone else could do the job without the administrative and hardware overhead, and the hospital still gets a cut of the reimbursement, it seems like a win for them.

 

[gschl1234]

I disagree with your financial hypothesis, at least in my experience. Our lab produces (apparently) a net income of $150+ million per year, nearly all of which goes back to the main hospital to fill in revenue gaps in other departments. The lab is one the leading revenue generators (at this hospital, anyway).

This may have something to do with your ratio of medicare part A vs. part B patients. I've heard our lab is also profitable but we have a lot of outreach. And yes, we have a blood bank but it's not as if we're releasing Novo7 everyday.