touro branch campus

[DocEspana]

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This is more or less informational for those who like to follow do school expansions. Just announced yesterday/today depending on how closely your news media follows upstate NY news.

So apparently august 2014 will see the opening of a (slightly) upstate branch of TouroCOM-NY.

http://hudsonvalley.ynn.com/content/...orange-county/

(Link is different from text below)

Touro to launch med school in Middletown

Touro College of Osteopathic Medicine's planned campus in Middletown, N.Y., which will offer a four-year degree program for physicians, is the school's largest-ever expansion. The osteopathic medical school will accommodate about 500 students when it is fully operational.



Rotations for about 135 medical students have been arranged with hospitals in Orange and Sullivan counties. The opening class, set for August 2014, will have about that many students. "That's a big class for a medical school," said Dr. Jay Sexter, chief executive of Touro College of Osteopathic Medicine.



The new school will be an extension of Touro's Harlem campus and will share the same curriculum, with an emphasis on primary care. However, in contrast to Harlem's focus on urban medicine, the Middletown site will home in on rural medicine, with its catchment area of the Hudson Valley and Catskill regions. Students can take advantage of both campuses, said Dr. Sexter. The school also is considering training physical and occupational therapists, nurses and pharmacists.



The total project cost for Touro is about $28 million, including $3.5 million to equip the school, and a $24 million investment to renovate the facility, which Touro will lease from the property's owner, the Danza Leser Group. Touro received $1 million from the state's Regional Council Program, but had requested $1.5 million. The college hopes to attract additional state money but plans to use private funding for the venture.



Dr. Sexter said that the best lecturers in the Touro medical school system will record their lessons for students to view at their own pace. Students will use class time for exams and for discussions. The Touro college and university system, together with New York Medical College, which is sponsored by Touro, enrolls about 5,300 health sciences students annually.

 

[cliquesh]

Well that's ****ing terrible.

 

[DocEspana]

Well that's ****ing terrible.

hm? why?

I'm not personally jumping for joy, but i think it's pretty cool.

 

[DwightSchruteDO]

http://www.recordonline.com/apps/pbcs.dll/article?AID=/20130111/NEWS/301110340

http://www.hvinsider.com/articles/p...ol-to-anchor-rebirth-of-horton-hospital-site/

In theory this sounds like their most thought out school:

250 units will be made for housing students and faculty and potentially 344 residencies spots will open up in time for the graduating class to apply to. They already have contracts with the local hospitals for rotations and are putting together applications for residency programs.

 

[cliquesh]

let me answer that for you: zero

http://www.recordonline.com/apps/pb...ol-to-anchor-rebirth-of-horton-hospital-site/

In theory this sounds like their most thought out school:

250 units will be made for housing students and faculty and potentially 344 residencies spots will open up in time for the graduating class to apply to. They already have contracts with the local hospitals for rotations and are putting together applications for residency programs.

Rvu said they were going to have 400 residency spots...the DO degree will be trivial if this continues.

 

[DocEspana]

http://www.recordonline.com/apps/pbcs.dll/article?AID=/20130111/NEWS/301110340

http://www.hvinsider.com/articles/p...ol-to-anchor-rebirth-of-horton-hospital-site/

In theory this sounds like their most thought out school:

250 units will be made for housing students and faculty and potentially 344 residencies spots will open up in time for the graduating class to apply to. They already have contracts with the local hospitals for rotations and are putting together applications for residency programs.

Yea i agree with the bolded part.

Plus i grew up relatively close to there. The community has that one mid-size hospital (perhaps large, depends on how you feel about ~600 bed places) and there is absolutely zero teaching programs over there for hours of driving distance. And there are multiple very large hospitals nearby that have no other academic affiliations either. Its an area that has a huge population (over the three counties west of the hudson and prob putnam and dutchess east of it) that are totally untapped. And while I would normally say that "places that have never had education are not ideal" and it holds true... these hospitals are ones that would have education anywhere else due to size and pt volume, but just never had any. So they're missing the educational infrastructure but not the raw clinical experience (which is good. cause plenty of places lack both)

 

[DocEspana]

Rvu said they were going to have 400 residency spots...the DO degree will be trivial if this continues.

You forget that other schools (MD ones) have been opening and promising similar residency numbers.... and delivering.

RVU is sort of the anomaly in opening in a new area and not being able to even come close to its claims of residency numbers. I doubt any school will hit projections, but there is PLENTY of volume there for a lot of residents at ORMC. Prob a few some years down the line in the surrounding counties too.

 

[hamanassett]

Touro, Lecom etc franchising like Mcdonald's. The AOA may as well offer an online degree. The DO world is in a race to the bottom. The commercialization is disgraceful.

 

[piviti]

You forget that other schools (MD ones) have been opening and promising similar residency numbers.... and delivering.

RVU is sort of the anomaly in opening in a new area and not being able to even come close to its claims of residency numbers. I doubt any school will hit projections, but there is PLENTY of volume there for a lot of residents at ORMC. Prob a few some years down the line in the surrounding counties too.

Do you know anything about Orange Regional Medical Center (volume, teaching, surrounding area, academic focus)? For our class of 2015 we got rotation spots there but since its new, no one knows anything about it. I think they also threw in free housing for those rotating at that hospital.

 

[Textbookversion]

You forget that other schools (MD ones) have been opening and promising similar residency numbers.... and delivering.

RVU is sort of the anomaly in opening in a new area and not being able to even come close to its claims of residency numbers. I doubt any school will hit projections, but there is PLENTY of volume there for a lot of residents at ORMC. Prob a few some years down the line in the surrounding counties too.

Do you think they'll be able to get enough clinical rotation spots? That seems tough with how many medical schools in NY there are already. I mean every school announces they have all the spots and tons of extras too all lined up and a billion residency slots, but that rarely turns out quite as well as you'd like.

 

[DocEspana]

Do you know anything about Orange Regional Medical Center (volume, teaching, surrounding area, academic focus)? For our class of 2015 we got rotation spots there but since its new, no one knows anything about it. I think they also threw in free housing for those rotating at that hospital.

I grew up by there so I know a tiny bit. I know that its probably about an hour from manhattan to the northwest. I know that there used to be 3 hospitals (all small size) serving that area. Two closed and combined with the third (which then closed and moved to a new huge hospital). The hospital is ~600 beds and sees a ton of emergency stuff. It is in an area with no "good" hospitals anywhere nearby. Seriously. Its an hour from the city. about 2 hours from albany. an hour from any of the "big" NJ hospitals, you'd be the only people out there.

What i would guess is that it would be a pretty decent experience. The best would be a large university hospital with a long history of teaching. This area will have no history of teaching, but there is definitely the sort of volume that the "big" centers see. An issue that you see a lot in non-teaching/university hospitals is that they are also <200 bed places. This is a ~600 bed place. It definitely has the volume. It should be a very good "non-teaching" hospital. And given that the school is, apparently, really dedicating to having a formal teaching program im sure it will be pretty close to the teaching curriculums im familiar with in probably two student cycles.

Do you think they'll be able to get enough clinical rotation spots? That seems tough with how many medical schools in NY there are already. I mean every school announces they have all the spots and tons of extras too all lined up and a billion residency slots, but that rarely turns out quite as well as you'd like.

There is nothign around there. go check out where any nearby medical schools are. NYMC is 45 minutes from there and its a touro affiliate. Albany med is 2 hours away. Everything else is 4 or more hours from there or in ,manhattan (where they would never move north for stuff haha. too good to go upstate). But in all honesty... ORMC and the two hospitals just over the river from it (vassar and St Francis) are huge hospitals which have never been used at all for academics. The big issue with trying to form education, and more importantly, trying to form residencies, is volume. Most places that havent been tapped dont have the volume. The <200 bed place cant support more than 20 or so residents. but the number of residents supportable goes up logarithmically with beds. so you get to 600 beds and you really can (not immediately, but eventually) support 150+ residents. Because you have enough patients you begin to have enough volume for every service to have residents. The entire swath of NY that is south of albany and North (or west) of Westchester County (since NYMC has westchester locked up) is entirely abandoned by any vestage of medical education But since they are still within the NYC metro area via the train systems they are still pretty populous areas.

"rural" in that area is not the same as "rural" anywhere else. Its "rural" in the sense that the 7 or so hospitals that cover 4 or 5 different counties are way way way overburdened but are the only jobs in town. that is a HUGE thing to tap into.

will the 'tap into' be perfect. no. and they could screw it up majorly. but the ceiling is huge there. but there is no competition for that stuff out there and they arent dinky little palces. they are huge,

 

[group_theory]

I grew up by there so I know a tiny bit. I know that its probably about an hour from manhattan to the northwest. I know that there used to be 3 hospitals (all small size) serving that area. Two closed and combined with the third (which then closed and moved to a new huge hospital). The hospital is ~600 beds and sees a ton of emergency stuff. It is in an area with no "good" hospitals anywhere nearby. Seriously. Its an hour from the city. about 2 hours from albany. an hour from any of the "big" NJ hospitals, you'd be the only people out there.

I don't know anything about the region or the hospital but I found this on their website

According to the hospital's own website, the new Orange Regional Hospital will only have 383 beds.

"Q - Why is Orange Regional building only 383 beds, which is less than its current bed complement?

A - Orange Regional is currently licensed for 450 beds on its two campuses. However, on any given day, our patients occupy fewer than 300 beds. In fact, in 2008 our average daily census (the number of beds occupied) ranged from a low of 252 in August to a high of 333 in March and averaged only 287 year-round, well below our new hospital capacity of 383 beds."

http://www.ormcnewhospital.org/index.php?/site/common_questions

So, it's nowhere near the "600" beds that you are describing (either currently or with the new hospital), especially if the bed census range from 287-333. It's a medium-size hospital. For comparison, Flushing Hospital in Queen has 293 beds, Jamaica Hospital in Queens has 384 beds, Staten-Island University Hospital have 785 beds, Coney Island Hospital have 371 beds, Jacobi Medical Center have 477 beds.

Certainly enough beds to support a few residency programs, but probably not enough pathology to offer a wide-range of programs.

My main concern about starting de novo residencies at a hospital:

If you are starting residencies at a hospital that does not have any history of medical students, let alone residents - it's actually really hard to start one. First, it will have to get its paperwork in order for ACGME accreditation (since the AOA and ACGME are merging), and there is a LOT of paperwork involved. You will need people who will know how to fill out those paperwork, and you will need an active GME office/staff and DME. Then you will need to find program directors for each residencies that you propose, along with getting program coordinators to support such paperwork (like preparing documents for their respective RRC and their site meeting). Plus it cost tens of thousands of dollars (per residency program) just to pay to ACGME for accreditation.

And where are you going to get funding for GME? Medicare GME funding is fixed at a certain level (and may be reduced in the near-future as Congress deal with the budget issue) - and $100,000/year/resident gets very expensive on the hospital expense report when you have more than a dozen residents (and residents cannot bill for their services, the attending will still need to bill).

These are the challenges that Orange Regional and Touro will face.

 

[DocEspana]

I don't know anything about the region or the hospital but I found this on their website

According to the hospital's own website, the new Orange Regional Hospital will only have 383 beds.

"Q - Why is Orange Regional building only 383 beds, which is less than its current bed complement?

A - Orange Regional is currently licensed for 450 beds on its two campuses. However, on any given day, our patients occupy fewer than 300 beds. In fact, in 2008 our average daily census (the number of beds occupied) ranged from a low of 252 in August to a high of 333 in March and averaged only 287 year-round, well below our new hospital capacity of 383 beds."

http://www.ormcnewhospital.org/index.php?/site/common_questions

So, it's nowhere near the "600" beds that you are describing (either currently or with the new hospital), especially if the bed census range from 287-333. It's a medium-size hospital. For comparison, Flushing Hospital in Queen has 293 beds, Jamaica Hospital in Queens has 384 beds, Staten-Island University Hospital have 785 beds, Coney Island Hospital have 371 beds, Jacobi Medical Center have 477 beds.

Elsewhere on their website they list themselves as having >550 (I forget exact number) of "private inpatient rooms". So either the term I saw is misleading or they have facts messed up on their own website. With that said, yours is from their FAQ and seems super specific so I assume its then accurate figure.

Certainly enough beds to support a few residency programs, but probably not enough pathology to offer a wide-range of programs.

My main concern about starting de novo residencies at a hospital:

If you are starting residencies at a hospital that does not have any history of medical students, let alone residents - it's actually really hard to start one. First, it will have to get its paperwork in order for ACGME accreditation (since the AOA and ACGME are merging), and there is a LOT of paperwork involved. You will need people who will know how to fill out those paperwork, and you will need an active GME office/staff and DME. Then you will need to find program directors for each residencies that you propose, along with getting program coordinators to support such paperwork (like preparing documents for their respective RRC and their site meeting). Plus it cost tens of thousands of dollars (per residency program) just to pay to ACGME for accreditation.

I have no issues with the above. Touro has had minor success with starting due novo out in north jersey, but even there the approval is half of the projected amount of spots. I figure they don't hit their mark, but I think you miss that other places (I'm thinking the new MD schools) are doing fine at making due novo residencies where there were nomne before. Its possible, but the paperwork and infrastructure creation is quite the arduous task. No doubt.

And where are you going to get funding for GME? Medicare GME funding is fixed at a certain level (and may be reduced in the near-future as Congress deal with the budget issue) - and $100,000/year/resident gets very expensive on the hospital expense report when you have more than a dozen residents (and residents cannot bill for their services, the attending will still need to bill).

These are the challenges that Orange Regional and Touro will face.

You're totally off base here. Saying residency funding is fixed is like saying that high cholesterol is entirely what you eat. Its common knowledge, and it's factually incorrect. Game funding increases by quite a bit every year. The cap is not on total spending. The cap is on growth within existing programs. Aka, if a program has never had residents it can be cleared (theoretically) for hundreds of positions which will be added to gme,not carved out of a pre existing fund. Every year this is the case for multiple new hospitals entering the residency businesses. Add in that any hospital, new or old, can file for more/new IM, FM, or TRI positions if they are in an underserved area as that's an exception to the game cap per hospital. Also anywhere can file for pediatrics, as that is funded by an entirely seperate money source (which is capped, but isn't at its cap yet)

I think I know what you're getting at with resident billing, but since residents were generally looked at as money generating investments (hospital gets paid ~100,000 per resident, pays them 50k, pockets 50k as covering for resident waste costs, which I doubt ever actually approach that) I can't see a good argument for them costing money. Some argue they cost you in efficiency, but 6 residents no matter how inefficient can be in more places at once muilktitssking over 1 attending who swings by and signs off on anything that isn't complicated so billing can go by unimpeded.

 

[Pisiform]

Like this one, it will end up losing the rotation sites or smth.
They should atleast wait and consolidate what they already have instead of opening more branches.

 

[group_theory]

You're totally off base here. Saying residency funding is fixed is like saying that high cholesterol is entirely what you eat. Its common knowledge, and it's factually incorrect. Game funding increases by quite a bit every year. The cap is not on total spending. The cap is on growth within existing programs. Aka, if a program has never had residents it can be cleared (theoretically) for hundreds of positions which will be added to gme,not carved out of a pre existing fund. Every year this is the case for multiple new hospitals entering the residency businesses. Add in that any hospital, new or old, can file for more/new IM, FM, or TRI positions if they are in an underserved area as that's an exception to the game cap per hospital. Also anywhere can file for pediatrics, as that is funded by an entirely seperate money source (which is capped, but isn't at its cap yet)

I think I know what you're getting at with resident billing, but since residents were generally looked at as money generating investments (hospital gets paid ~100,000 per resident, pays them 50k, pockets 50k as covering for resident waste costs, which I doubt ever actually approach that) I can't see a good argument for them costing money. Some argue they cost you in efficiency, but 6 residents no matter how inefficient can be in more places at once muilktitssking over 1 attending who swings by and signs off on anything that isn't complicated so billing can go by unimpeded.

OK, first I want you to back up the claims that you just made.

Tthe Balance Budget Act of 1997 fixed the total amount of residents per hospital, that Medicare will spend.

In an effort to control federal spending, Congress passed the Balanced Budget Act in 1997, which capped the number of residency slots supported by Medicare at the then-current level.

The cap is hospital-specific, meaning Medicare contributes to a certain number of residency slots. Hospitals may choose to create more slots-and they have-but Medicare will not help fund them. The Balanced Budget Act also capped the number of residents used in the IME payment formula.

https://www.aamc.org/newsroom/reporter/july09/68622/july09_gradmed.html

Hospitals are free to shift around the residents in their institutions, so they can decrease the amount of pathology residents and increase the number of family medicine residents, but the overall funding is fixed at the december 31, 1996 level,

There is an exception in the BBA 1997, and that is for rural underserve area where they can increase their cap to 130% of their december 31, 1996 cap. I don't see where hospitals can have this unlimited growth in rural area that you suggested. If this were the case, then you would have seen an explosion of new residencies in rural underserve hospitals after 1997, which you simply don't see.


*there is ongoing debate about whether having residents are a positive financial resource or a negative financial resource and there appears to be no clear concensus. The following is just argument that it is a negative financial resource but I can also easily make the same argument that it is also a positive resource. Personally I believe it comes out as a wash.*

As for $100,000, half of that is salary plus benefits (health, dental, malpractice). The other portion is to help pay for administrative cost (paying a program director to do administrative work, program coordinator, paying for programs to offer dinners/hotels/lunches for prospective interviewees).

And what you have suggested (6 residents running around independently with 1 attending billing) is actually against ACGME regulations. In clinic, an attending can supervise 4 residents at the most (and that attending cannot have his/her own patients at the same time). Inpatient settings there are ACGME limits on how many patients an intern can see. Plus per medicare rules, the attending will still have to see, and examine each patient that he bills. I would argue that if you have interns and residents running around doing stuff and the attending is there just to sign notes and bill, then not a lot of education is going on (service over education)

Of course, the cost of hiring a NP or PA to do some of the work that the resident is doing is going to be more expensive (and NP/PA can bill whereas the resident cannot) so there is cost savings in having residents.

 

[DocEspana]

Group theory, given I'm working out of a brand new tablet today and not my document rich lap top I can't give you documents yo show the residency rules, but I can tell you that I work pretty directly with the ama and acgme in their pushes for more residency spots. I've worked intimately with people in Chicago (mama, acgme leaders) and DC (legislators) on this see stuff. I know asking for faith on a message board is like asking for steak sauce from a shark (it makes no sense) but I've put so much identifying info up here over time, anyone could, and has, identified me in real life and check my qualifications to say this. They line up. I deal with this many hours a week to some capacity be it directly petitioning hospitals to consider entering the resident education business, or petitioning congress for modifications to the existing system.

The only caps are a number of residents per hospital, approved at the time of first residency approval. There was an assumption in 1997 that no new hospitals wouild elect to go into the education business, and the few who might would be infrequent and approved for small numbers. That assmption was undercut by hospitals entering the training theatre with renewed vigor in 2003/4 onward and schools aiding hospitals to file (a distinctly AOA trend until recently). There are many untapped hospitals that have no residency programs because they have no educational backbone and without that their alloted number would be far too small. A specific example would be palisades and meadowlands hospitals in north jersey. They had never had a program so they were never allotted a cap. Eventually afterr4 years of taking medical students they felt they had enough backbone to apply. Federal gme funding is for about 120 positions for them. There is no "money cap" (that's a lie, there is but its irrelevantly high) there is per hospital cap. Now despite being approved for all of those, they only have about 60 residents because the AOA has only approved them for surgery and TRI (now recently FM as well) and that's the most those programs can support. But they are cleared for up to 120 if they can find departments up to snuff to take more.

As for the rural stuff. There is an explosion of rural FM and IM programs. Its amusing that you lined it up for me. Its in areas and hospitals no one wants to go to except those with ties to those areas. And most of those programs are small and the only program in the hospital. Smart hospitals don't buy into that because *if* residents are money makers, its going to be when there are many to create profits over PA/NP in many depts. The rural FM may be outside of the resident limits, but its only useful in places that have residents already and want to expand. My under standing is if you have none and apply for these rural residents you get evaluated for total allowance and at which point you end up like these small hospitals with 12 total FM residents and thats it, because while they could expand their FM program to the max it can carry: that max is 12 and the hospital is independently evaluastrd for 12 residents rendering it effectively locked in, unable to get new programs or expand their FM past the program limit since its capacity didn't pass the hospitals evlauatrdd capacity anyway.

If there are flaws in here, and there may be, they are small enough to never be noticed by any legislators or are close enough to what happens that the way I described it is clearly not incongruous with how it actually works, because I've seen it work from the inside.

 

[Dharma]

Touro, Lecom etc franchising like Mcdonald's. The AOA may as well offer an online degree. The DO world is in a race to the bottom. The commercialization is disgraceful.

🙄 Excellent first post...

 

[group_theory]

Group theory, given I'm working out of a brand new tablet today and not my document rich lap top I can't give you documents yo show the residency rules, but I can tell you that I work pretty directly with the ama and acgme in their pushes for more residency spots. I've worked intimately with people in Chicago (mama, acgme leaders) and DC (legislators) on this see stuff. I know asking for faith on a message board is like asking for steak sauce from a shark (it makes no sense) but I've put so much identifying info up here over time, anyone could, and has, identified me in real life and check my qualifications to say this. They line up. I deal with this many hours a week to some capacity be it directly petitioning hospitals to consider entering the resident education business, or petitioning congress for modifications to the existing system.

The only caps are a number of residents per hospital, approved at the time of first residency approval. There was an assumption in 1997 that no new hospitals wouild elect to go into the education business, and the few who might would be infrequent and approved for small numbers. That assmption was undercut by hospitals entering the training theatre with renewed vigor in 2003/4 onward and schools aiding hospitals to file (a distinctly AOA trend until recently). There are many untapped hospitals that have no residency programs because they have no educational backbone and without that their alloted number would be far too small. A specific example would be palisades and meadowlands hospitals in north jersey. They had never had a program so they were never allotted a cap. Eventually afterr4 years of taking medical students they felt they had enough backbone to apply. Federal gme funding is for about 120 positions for them. There is no "money cap" (that's a lie, there is but its irrelevantly high) there is per hospital cap. Now despite being approved for all of those, they only have about 60 residents because the AOA has only approved them for surgery and TRI (now recently FM as well) and that's the most those programs can support. But they are cleared for up to 120 if they can find departments up to snuff to take more.

As for the rural stuff. There is an explosion of rural FM and IM programs. Its amusing that you lined it up for me. Its in areas and hospitals no one wants to go to except those with ties to those areas. And most of those programs are small and the only program in the hospital. Smart hospitals don't buy into that because *if* residents are money makers, its going to be when there are many to create profits over PA/NP in many depts. The rural FM may be outside of the resident limits, but its only useful in places that have residents already and want to expand. My under standing is if you have none and apply for these rural residents you get evaluated for total allowance and at which point you end up like these small hospitals with 12 total FM residents and thats it, because while they could expand their FM program to the max it can carry: that max is 12 and the hospital is independently evaluastrd for 12 residents rendering it effectively locked in, unable to get new programs or expand their FM past the program limit since its capacity didn't pass the hospitals evlauatrdd capacity anyway.

If there are flaws in here, and there may be, they are small enough to never be noticed by any legislators or are close enough to what happens that the way I described it is clearly not incongruous with how it actually works, because I've seen it work from the inside.

You also have tendencies to make claims without backing them up on this board (most recent example is in this thread, with the number of beds that Orange Regional has).

I await your documents instead of "trust me on this"

 

[Textbookversion]

You also have tendencies to make claims without backing them up on this board (most recent example is in this thread, with the number of beds that Orange Regional has).

I await your documents instead of "trust me on this"

He's right. The DO world does this all day long. They go find a community hospital, stick students in it. After a couple of years they help the hospital file the paperwork to get residency slots, get loads approved, and set up a FM and IM residency to start off. It's 100% based on the hospital never having been approved for residency slots before.

This is definitely not made up and I think it's pretty much common knowledge in the AOA world (which I have some contact with).

 

[group_theory]

He's right. The DO world does this all day long. They go find a community hospital, stick students in it. After a couple of years they help the hospital file the paperwork to get residency slots, get loads approved, and set up a FM and IM residency to start off. It's 100% based on the hospital never having been approved for residency slots before.

I mean I'm not sure where to get documentation for this kind of thing but AZCOM in AZ has been doing this with their students in all the medium/small sized hospitals that the U of A hadn't touched and that weren't a part of the Good Sam, St. Joes, or County systems (all the GME systems in AZ). Mountain Vista for example is where they have pushed through approval for a bucket full of residency slots. They also have a bunch of rural hospitals that have sketchy amounts of volume (like in kingman) that they've managed to get funding for but only the volume for EM and IM residencies.

This is definitely not made up and I think it's pretty much common knowledge in the AOA world (which I have some contact with).

I know there are new AOA programs ... I'm just curious about federal funding for new residency programs - this claim that the BBA of 1997 somehow doesn't apply to new programs in hospitals without residency programs, or that there is an unlimited funding potential for rural hospitals, or that pediatric programs are also funded differently.

I don't doubt that Orange Regional will be able to start up a couple residency programs - probably small in size given its bed capacity and average daily census. Probably not to the extent that DocEspana have commented on earlier in this thread. I'm just curious about the funding source .


*outside of the scope of this thread, but I'm also curious about the quality of education and pathology exposure of these brand new residencies taking place at small-medium hospitals, such as Palisades where it only has 202 beds, or Mountain Vista and its 178 beds. This applies to both AOA and ACGME programs.

 

[as1212559]

I cannot enter this debate but as a side note I find it interesting how the expansion of Touro's and Lecom's are bemoaned by the masses but the expansion of OU-HCOM is never even mentioned.

HCOM is certainly well supported and has a reasonable rotation system but their expansion has come on quite quickly just like these other schools. The class sizes of the expansion campuses are much smaller than these other schools though. I think the first class in the Columbus, OH expansion site will be ~50 students.

 

[Textbookversion]

Yeah IDK how these AOA programs are going to fair with the merger. My guess would be that after the grace period of accreditation expires a lot of them will have to shut down. Although at the very least I can see the FM programs surviving.

The funding source is definitely federal.

I don't really see the issue with DO schools expanding like crazy as long as they can get rotation spots. MD schools should have been expanding like crazy to erase Caribbean schools, which is a ridiculous racket that only existed because of the difference between the number of US graduates and the number of residency slots. It's great the DO schools are stepping in to fill a void the LCME wasn't willing to step up and fill.

 

[calvinhobbes]

I have a friend who lives in Middletown, and he said that old Horton Hospital Site where this new branch campus will be is HAUNTED! (http://www.hvinsider.com/articles/p...ol-to-anchor-rebirth-of-horton-hospital-site/)
Be careful TouroCOM students!

 

[bajastapler]

Touro, Lecom etc franchising like Mcdonald's. The AOA may as welloffer an online degree. The DO world is in a race to the bottom. The commercialization is disgraceful.

Well when you say it like that of course it's gonna come off negative.

Residency matching is another matter, but I think (outside of rvu) that DO school expansion is a great thing, so long as they can secure rotation sites.


Couldn't one argue that the UC system is a franchise? Sprouting up in god awful places to live like Merced,CA? Or what about the stony brooks? Don't they have multiple campus in NY?

I think regardless of where you go, it's up to you to shine during 3rd and 4th year/residency matching. No ones going to hand you anything in life. Plus no one's FORCING you to go a specific school, go DO, or even go medicine for that matter. An applicant should research before applying/matriculating into a school.

 

[gmcguitar4]

Well when you say it like that of course it's gonna come off negative.

Residency matching is another matter, but I think (outside of rvu) that DO school expansion is a great thing, so long as they can secure rotation sites.


Couldn't one argue that the UC system is a franchise? Sprouting up in god awful places to live like Merced,CA? Or what about the stony brooks? Don't they have multiple campus in NY?

I think regardless of where you go, it's up to you to shine during 3rd and 4th year/residency matching. No ones going to hand you anything in life. Plus no one's FORCING you to go a specific school, go DO, or even go medicine for that matter. An applicant should research before applying/matriculating into a school.

You mean the SUNY's? Each one is completely different with their own curriculums and way they do things. The Touro expansion will have all the same managing parties and curriculum.

 

[DwightSchruteDO]

While there are similarities, Touro-CA, NV, and NY so far have different curriculums and the way they do things; the most different being Touro-NY. This middletown one is supposed to, however, share the same curriculum as the harlem campus.

 

[azide10]

Talk about neglecting your already existing campuses. If they have new hospitals to use, put them towards the already existing campuses first and see how things go. NYMC and Touro-NY aren't exactly rich in rotations at this point. NYMC will be losing yet another site soon, albeit a minor site, which continues the trend of them losing their rotations but not gaining any new ones.

It seems obvious touro just wants to cram as many students as possible into the rotation sites, decreasing the quality of these sites.

It's not a great area for a medical school. It would provide nice additional rotation sites. Hopefully they pursue what's in the best interest of their students.

 

[DwightSchruteDO]

Talk about neglecting your already existing campuses. If they have new hospitals to use, put them towards the already existing campuses first and see how things go. NYMC and Touro-NY aren't exactly rich in rotations at this point. NYMC will be losing yet another site soon, albeit a minor site, which continues the trend of them losing their rotations but not gaining any new ones.

It seems obvious touro just wants to cram as many students as possible into the rotation sites, decreasing the quality of these sites.

It's not a great area for a medical school. It would provide nice additional rotation sites. Hopefully they pursue what's in the best interest of their students.

I definitely agree with you. As far as I know, Touro has been sending some students up there for rotations; I think they started this past year. I think the quality of some of their rotation site definitely needs to be improved; with the creation of new residency programs hopefully this can be achieved...within a few years. NYMC is pretty autonomous from the Touro mothership; for now they only have the name.

 

[Butterfly23]

so people who run new campus will be same faculties from Touro Harlem?? Will Dr.G and Dr.S will be the same dean for that new campus??

 

[Butterfly23]

so people who run new campus will be same faculties from Touro Harlem?? Will Dr.G and Dr.S will be the same dean for that new campus??

I go to Touro Harlem just letting u know

 

[DwightSchruteDO]

No, even satellite campuses have their own deans and faculty. They will share resources and even some faculty but they will have their own as well.

 

[DocEspana]

No, even satellite campuses have their own deans and faculty. They will share resources and even some faculty but they will have their own as well.

As far as the faculty know, Dr S (I like that this is somewhat subtle) is taking over for in house dean at middletown.

Someone said that its not a good area for a school. I grew up there, that is laughably incorrect as it is a massive area full of people and hospitals with no clinical affiliations until now. It is an untapped resource and one that remains very barely tapped even now (really just Nyack and orange regional) but actually putting a school there would almost certainly cause the many other very very large hospitals in nearby areas to at least consider going into the med student business.

Would it have been nicer to have gotten this area, locked it down, and had it be upstate rotations for Harlem? Sure but even a casual Google search into the area would tell you the mayor there made it a campaign promise to build a medical school on the campus of the hospital and use the live-in students as a way to bolster the local economy. Soup to nuts if Touro didnt put school there then orange regional would have sided with whomever did put a school there and there has been a long standing attempt by a local university to create a medical school one county over, so there was a legitimate competitor for the area.

 

[calvinhobbes]

http://www.dailyfreeman.com/articles/2013/05/16/news/doc5194f1251ce66702768297.txt

Touro Medical College gets final approval for Middletown campus
Published: Thursday, May 16, 2013

By Mid-Hudson News Network



Click to enlarge
MIDDLETOWN, N.Y. - Touro Medical College has received final approval for a school at the former Horton campus of Orange Regional Medical Center.

"The Touro College of Osteopathic Medicine in New York City has received approval from the American Osteopathic Association's Commission on Osteopathic College Accreditation for a substantive change of an additional location (with a class size increase) for a campus in Middletown, N.Y.," said association spokeswoman Nicole Grady.

The campus will fall within the parent college's accreditation, she said.

Kingston Mayor Shayne Gallo has said a medical school might be a good fit for the Kingston Hospital campus in Midtown, if HealthAlliance of the Hudson Valley closed the hospital as planned.

Middletown Mayor Joseph DeStefano said the school with be "transformational" for the city in terms of education, business and economic development.

"From the gas station right up to retail. The economic impact, in the $20-plus million range, about the money spent in the community from the school of 550 students plus faculty, staff and other employees of the facility, and that is only a portion of the building, so more will be coming for development of the Horton project," DeStefano said.

The owner of the complex expects to have other tenants in the remaining space.

Touro College already has the state approvals for the new medical campus.

 

[DocEspana]

Well that's good.

 

[DwightSchruteDO]

Dr. S...smh

 

[DocEspana]

Dr. S...smh

not an uncommon response from what I've seen.

 

[calvinhobbes]

Just got this email from our Associate Dean at NYCOM, and FYI, Robert Goldberg and Kenneth Steier from Touro-COM were CC'ed on the email:

On behalf of NYCOMEC, I am pleased to announce that Palisades Medical Center has been approved by our Board of Directors as NYCOMEC's newest Clinical Campus, beginning July 1st. Palisades is located in North Bergen, New Jersey across the river from Manhattan.

Palisades is a 202 bed hospital with over 35,000 emergency department visits annually. They have active medicine, surgical and obstetrical services. Palisades will be collaborating with several other hospitals in their region to offer multiple residencies and fellowships and provide well rounded programs.

They currently have 4 AOA approved programs with trainees: Traditional Rotating Internship, Family Medicine Residency, General Surgery Residency and Internal Medicine Residency. The following programs are in various stages of development: Anesthesiology Residency, Dermatology Residency, Diagnostic Radiology Residency and Ob/Gyn Residency. They are also considering fellowships such as Gastroenterology. They have fully embraced osteopathic graduate medical education including the teaching of osteopathic manipulative medicine and the building of a patient simulation center.

Their Director of Medical Education is Maurizio Miglietta, D.O. He is a 1996 graduate of NYIT's College of Osteopathic Medicine. He completed his General Surgery residency at NYCOMEC/St. Barnabas' program in the Bronx, New York and fellowships in Surgical Critical Care and Trauma Surgery in Maryland. He is a former Director of Emergency and Trauma Surgery at New York Presbyterian Hospital/ Columbia University Medical Center. He also currently serves as Liaison Police Surgeon with the United States Secret Service.

For more information about their osteopathic residency programs please call the NYCOMEC office or contact their Medical Education office directly at 201-710-2716. You can also visit their website at http://www.palisadesmedical.org/Content/78/medical-education.html.

Not sure if this means NYCOM students will be able to rotate there for third year, but it makes sense, since NYCOM has begun losing its rotation spots at North Shore LIJ b/c of Hofstra medical school. But hey, GME programs are always a plus! DocEspana, any thoughts?

 

[NYDOC112]

Just got this email from our Associate Dean at NYCOM, and FYI, Robert Goldberg and Kenneth Steier from Touro-COM were CC'ed on the email:



Not sure if this means NYCOM students will be able to rotate there for third year, but it makes sense, since NYCOM has begun losing its rotation spots at North Shore LIJ b/c of Hofstra medical school. But hey, GME programs are always a plus! DocEspana, any thoughts?

Makes sense. Its a NYCOMEC hospital now, Touro is a member of NYCOMEC. Technically anything opening in NYCOMEC is accessible to NYCOM students, because NYCOMEC is run by NYCOM (although it will be available after touro fills its slots, just like touro can use NYCOMs slots after NYCOM is finished filling them.)

 

[DwightSchruteDO]

more students in an already crowded hospital (s? - not sure if they can rotate through all of NJREMC).

(fyi - NJRMEC is New Jersey Regional Medical Educational Consortium - about 6 hospitals and numerous ambulatory centers and private offices in the north jersey area where Touro students rotate for 3rd and 4th year rotations. The consortium currently has about 10 AOA GME programs - 5 of which are out of Palisades).

 

[NYEMMED]

more students in an already crowded hospital (s? - not sure if they can rotate through all of NJREMC).

(fyi - NJRMEC is New Jersey Regional Medical Educational Consortium - about 6 hospitals and numerous ambulatory centers and private offices in the north jersey area where Touro students rotate for 3rd and 4th year rotations. The consortium currently has about 10 AOA GME programs - 5 of which are out of Palisades).

Not completely sure but I thought as part of the conditions of Touro-NY becoming a member of NYCOMEC, they had to hand over all of their facilities to NYCOMEC, in exchange for being the first to fill those facilities. I could be wrong, but I believe this was the agreement.

 

[DwightSchruteDO]

Touro paid money to join NYCOMEC from what the dean was saying. Also since NYIT-COM wont be rotating at any of Touro's other hospitals I don't think that was the condition.

It doesn't seem to benefit Touro unless NYCOMEC (who already has changed its name) is run by both schools...not just NYIT-COM. As it is now, even though Touro is a member of NYCOMEC, certain NYCOMEC hospitals won't allow touro (or any other med school) students to even do electives there...or have decided to blacklist the entire school and not interview a single touro student for a certain residency program (granted these are based on individual institutions, they should still be 'put in check' by NYCOMEC). Touro has enough rotation spots so it doesnt really need more and 4th year students are allowed to do electives at most places of their choosing and have no trouble getting residencies at NYCOMEC hospitals if they choose to do so.

 

[DrWBD]

Not sure if this means NYCOM students will be able to rotate there for third year, but it makes sense, since NYCOM has begun losing its rotation spots at North Shore LIJ b/c of Hofstra medical school.

This is a tragedy, albeit a thoroughly predictable one. NYCOM (sorry, "NYIT-COM's") clinical rotation sites in the North Shore/LIJ university hospitals set it apart from most other osteopathic schools in terms of rotation quality. It seems that NYIT-COM administration is determined to bring the school down to the point where every rotation site is at a community hospital 50+ miles away from campus.

 

[NurWollen]

Just got this email from our Associate Dean at NYCOM, and FYI, Robert Goldberg and Kenneth Steier from Touro-COM were CC'ed on the email:



Not sure if this means NYCOM students will be able to rotate there for third year, but it makes sense, since NYCOM has begun losing its rotation spots at North Shore LIJ b/c of Hofstra medical school. But hey, GME programs are always a plus! DocEspana, any thoughts?

So do hospitals just jump ship as soon as an MD program pops up because they feel like it? Or does it have to with DO schools not paying enough to keep their rotation sites?

 

[DrWBD]

So do hospitals just jump ship as soon as an MD program pops up because they feel like it? Or does it have to with DO schools not paying enough to keep their rotation sites?

Not because they "feel like it" but because being a real university hospital affilated with an MD program is a feather in the cap for any large hospital. There isn't the same level of prestige associated with being an affiliate of an osteopathic program.

In the case of North Shore/LIJ, it's also a logistical thing. They can only accomodate so many students, so the NYIT-COM students get the boot.

 

[NYEMMED]

So do hospitals just jump ship as soon as an MD program pops up because they feel like it? Or does it have to with DO schools not paying enough to keep their rotation sites?

Hofstra medical schools official name is: north shore LIJ/ Hofstra medical school. It is partially owned/funded by the north shore LIJ system, so of course they are going to give the rotation spots to their own students. It isn't so much of them taking the spots away, it's more of "our students need to be accommodated first" which is understandable.

 

[DocEspana]

Just got this email from our Associate Dean at NYCOM, and FYI, Robert Goldberg and Kenneth Steier from Touro-COM were CC'ed on the email:



Not sure if this means NYCOM students will be able to rotate there for third year, but it makes sense, since NYCOM has begun losing its rotation spots at North Shore LIJ b/c of Hofstra medical school. But hey, GME programs are always a plus! DocEspana, any thoughts?

Sounds more like Palisades is just being officially moved into the NYCOMEC fold. Sounds more like a press release (since organizations like NYCOMEC literaly derive their strength, future hospitals, from trying to be newsworthy as often as possible and any of these might draw a small byline somewhere after a press release) than anything relevant. Im sure there is some cross-over of Touro and NYITCOM core rotations coming at some point, but up to right now it is just Touro holding the western and northern NYCOMEC sites and NYIT holding the eastern ones with a straggler from NYIT popping up at Trinitas or St John's occasionally.

Stuff like this probably has very little immediate value.

 

[TriagePreMed]

Does anyone know if you'll have to apply to this new campus individually or if it's an application to the now TouroNY and there are two sites where you might end up?

 

[DocEspana]

Does anyone know if you'll have to apply to this new campus individually or if it's an application to the now TouroNY and there are two sites where you might end up?

I am not sure, but the precedent (set by LECOM) would suggest that it is one application where you mark what your preference is on the application. Really though... not known as of yet.

 

[TriagePreMed]

I am not sure, but the precedent (set by LECOM) would suggest that it is one application where you mark what your preference is on the application. Really though... not known as of yet.

Well, I hope it's going to be a pick one campus deal because I'd be interested in this school and feel most applicants would apply to the Harlem Campus. Harlem sounds so fun and full of rich history, but I'm going to med school for business, not pleasure.

 

[DocEspana]

Well, I hope it's going to be a pick one campus deal because I'd be interested in this school and feel most applicants would apply to the Harlem Campus. Harlem sounds so fun and full of rich history, but I'm going to med school for business, not pleasure.

Just graduated with the ceremony at the Apollo theater. The photo ops with famous little things inside the theater was worth it alone.