Medical school's partnership with 5 hospitals aims to ease physician shortages

A southeastern Florida medical school is teaming up with five area hospitals to expand residency training and bring more doctors to the region.

Officials at Florida Atlantic University's Charles E. Schmidt College of Medicine project that the graduate medical education consortium will create 250 to 350 residency positions within the next few years.

This isn't the first time a medical school has partnered with hospitals in such a way. Of the 683 institutions that sponsor GME programs nationwide, 15 are hospital consortiums, according to the Accreditation Council for Graduate Medical Education. Although most GME consortiums form to centralize and share resources, the new Florida consortium has the dual purpose of trying to address local physician shortages.

"This is a good example of how a group of hospitals can overcome their parochial and competitive interests to serve the good of their patients and communities," said Michael Friedland, MD, the college's dean and vice president for medical education programs. "No one hospital could do it alone. It is a matter of working together to reach the volumes we need."

Other GME consortiums in places such as Arizona, New York and St. Louis were created with the goal of using resources more efficiently.

For example, Washington University School of Medicine in St. Louis formed a consortium with Barnes-Jewish Hospital and St. Louis Children's Hospital in 1997 that now trains about 1,100 residents.

"Our consortium was formed to better organize our many training programs, now 82 accredited programs," said Rebecca P. McAlister, MD, associate dean for graduate medical education at Washington University.

A consortium established in 2006 between the University of Arizona College of Medicine and the University of Arizona Medical Center in Kino trains 97 residents annually. In New York, a consortium between Mount Sinai School of Medicine and 10 hospitals trains more than 1,800 residents. Formed in 1995, it is "dedicated to centralizing, enhancing and monitoring the education provided to house staff and all participating institutions," says Mount Sinai's website.

New opportunities

Nationwide physician shortages are expected to balloon to 62,900 doctors by 2015 and 91,500 by 2020, according to the Assn. of American Medical Colleges.

In Florida, physician shortages were a major consideration behind the creation of Florida Atlantic University's Charles E. Schmidt College of Medicine, which admitted its first medical class in 2004. It was initially an affiliate of the University of Miami School of Medicine but became an independent medical school in 2010.

A shortage of GME opportunities statewide means that many Florida medical school graduates move elsewhere after graduation, Dr. Friedland said. The state ranks 45th nationally in terms of allopathic residency positions per 100,000 people, the AAMC says.

"We are in pretty bad shape," Dr. Friedland said.

Hospitals participating in the new Florida consortium are: Bethesda Memorial Hospital in Boynton Beach; Delray Medical Center in Delray Beach; St. Mary's Medical Center in West Palm Beach; and Boca Raton Regional Hospital and West Boca Medical Center, both in Boca Raton.

By training more physicians locally, members of the consortium hope to bring more practicing doctors to the area long term, said Roger Kirk, executive vice president and chief operating officer at Bethesda Memorial Hospital.

AAMC statistics show that 59% of physicians who complete residencies in Florida stay in the state to practice. That's compared with a national GME retention rate of 45%.

"This will give us an opportunity to attract residents from all around the country and convince them to stay in Palm Beach County," Kirk said. "We have severe physician shortages in some specialties."

Boca Raton Regional Hospital has hosted medical students but has never had a residency program, said Charles Posternack, MD, the hospital's chief medical officer. The hospital will be the primary teaching site for the consortium's internal medicine and general surgery residency programs, which they hope will receive ACGME accreditation in two to three years, he said.

"Becoming the major teaching hospital of a new and innovative college of medicine is a truly amazing opportunity," said Dr. Posternack, associate dean for academic affairs and affiliate professor of clinical biomedical science at the Charles E. Schmidt medical college.

The residency positions will be funded by a combination of Medicare GME funding and money from the hospitals, Dr. Friedland said.