Collaboration Is Key in Graduate Medical Education

Florida Atlantic University Partners with Five Leading Hospitals to Increase Much-Needed Medical Residency Positions

By David J. Bjorkman, MD, MSPH

With the number of medical school graduates continuing to increase, a projected 36 percent growth in the number of Americans over the age of 65, and one-third of all physicians expected to retire in the next decade, the creation of a Graduate Medical Education (GME) Consortium between Florida Atlantic University’s Charles E. Schmidt College of Medicine and five leading hospitals in Palm Beach County couldn’t have come at a better time. Leadership from our University and Bethesda Memorial Hospital, Boca Raton Regional Hospital, Tenet’s Delray Medical Center, St. Mary’s Medical Center, and West Boca Medical Center have aligned resources to collaborate on a shared goal — ensuring that we have an adequate and well-trained workforce in South Florida. In order to deliver great health care, we need well-trained physicians; graduate medical education is key.

To further our commitment to medical education and improve the quality of health care in Palm Beach County, we formalized our collaboration by signing the GME Consortium agreement in November 2011, with the goal of significantly increasing much-needed residency positions in Palm Beach County. As the number of medical school students continues to increase nationwide, this agreement is an important step in making sure that we can train and retain our FAU graduates in Florida residency programs.

Statistics from the 2009 Association of American Medical Colleges (AAMC) State Physician Workforce Database indicate that, as of 2008, 59 percent of the physicians who completed their residency training in Florida remained in Florida to establish their medical practices (compared to the national GME retention rate of 45 percent). The retention rate for people who complete both medical school and residency training in Florida is even higher: 75 percent. Yet despite the critical link between adequate access to residency and fellowship training and an adequate supply of physicians, Florida ranks 45th nationally in terms of allopathic residency positions per capita.

Further, the federal government has capped the number of residency positions funded through the Centers for Medicare and Medicaid Services (CMS) at 1997 levels, in spite of rapid population increases in Florida and other states. Because there is a shortage of Florida residency program opportunities, most physicians practicing in Florida received their residency training outside the state, and a significant number of Florida medical school graduates have no choice but to leave the state each year to complete their residency training.

We are in the planning and developmental stages of the consortium and are working to define the key specialties that will be offered for residencies at each of the hospitals’ respective training sites. As none of the hospitals have been involved previously in training residents, existing legislation affords these institutions a time-limited and financially narrow opportunity to secure CMS reimbursement for the new programs, which means we must be coordinated in our program development. The specialties we are jointly exploring are internal medicine, pediatrics, family medicine, obstetrics and gynecology, and general surgery. Others may be considered depending upon the available resources of our consortium members.

The consortium will provide access to clinical settings for education, research, and patient care services to support and enhance our medical school’s clinical training programs for residents. The consortium will also help ensure that all FAU medical students have the opportunity to interact with residents, a requirement of the Liaison Committee on Medical Education, the national organization that accredits U.S. and Canadian medical schools.

This is an exciting time for our young medical school — we welcomed our inaugural class last August — but we have important milestones and goals to accomplish as we do our part to prepare the next generation of physicians to serve our communities. Availing ourselves of economies of scale, reducing competition through collaboration, and creating these essential residency positions will help give our consortium a leading edge in a very challenging health care environment.

We are proud to be working with these five outstanding hospitals as we strive to make a real impact in South Florida during this critical time in health care.

—David J. Bjorkman, MD, MSPH, is dean of the Charles E. Schmidt College of Medicine at Florida Atlantic University. He can be reached in care of ggaloust@fau.edu.

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