Hey all-
My name is Dave and I'm a 2nd year podiatry resident at a west coast program. We've been trying to get permission to visit surgical centers in the area, but have met difficulty with regard to the affiliation agreement and also permission from our institution. Anyone here with experience dealing with this, or has anyone purchased malpractice insurance on their own?
Thanks, Dave
Dave,
I know that it would be a great opportunity to be able to scrub in on foot and ankle cases at surgical centers to increase your surgical volume during your residency training.
As I am involved with the residency program at my hospital, I do deal with some of the issues with the residents going to surgical centers. I can tell you that it is very complicated and can see why some teaching institutions are hesitant in sending residents out to surgical centers. If you have any questions, please do not hesitate to PM me.
One of the main purposes of the affiliation agreement is to delineate if there are any financial obligations between the surgical center and the teaching institution and also extend the resident's malpractice coverage so that the resident will be covered when he/she scrubs cases at the surgical center. It is not a good idea if you are trying to circumvent the affiliation agreement by simply buying your own malpractice insurance for the surgical center. CPME and ACGME requires that the sponsoring teaching institution must have an affiliation agreement with all teaching sites off campus. Technically, without this affiliation agreement, the surgery cases at that surgical center can not be logged and can not be counted towards your surgical volume, since the surgical center is not a teaching site for your residency program. Your residency director has to submit a copy of the affiliation agreement of all new teaching sites that were added each year, during the annual report that your residency director submits to CPME. When your residency program undergoes CPME on site reaccreditation visit, they will be looking at this very closely.
Lastly, you may be wondering what financial obligations that a surgical center may have with a teaching institution. In general, there are usually none between the two institutions. However, a surgical center may request some sort of reimbursement from the teaching institution for each resident that scrubs cases at the surgical center. Remember, each time a resident scrubs a case, they will be using an extra gown, extra gloves, extra sutures, etc.... The teaching institution usually gets reimburse for these costs through the Medicare funding that the institution gets for each resident at the hospital. Since surgical centers are not teaching institutions, they are not eligible for Medicare funding. Hence, surgical centers would have to eat the cost, unless they request funding from the teaching institution.
