Stanislaus County's revamped physician training program has received full accreditation and is poised to start training physicians under a new banner in July.
Early this week, the Accreditation Council for Graduate Medical Education gave the program the maximum three-year accreditation, and it's far more than a certificate to hang on the wall.
The council's approval was critical to continuing a training program that was dealt a near-fatal blow last year when it lost federal funding. The program serves to recruit doctors to the area and is a cornerstone of the county health system serving 70,000 to 80,000 low-income residents each year.
"We are elated," said Dr. Peter Broderick, program director. "We have a great residency that has been fully accredited for 35 years and we had a tremendous effort from faculty and residents to create an even better residency under this new consortium."
Broderick said no hurdles stand in the way of the transition to the new program in the next five months. According to the plan, the Stanislaus Family Medicine Residency Program will close June 30 and reopen the next day as the Valley Family Medicine Residency of Modesto.
The incoming class will have 10 medical school graduates, one more than the current class size. First- and second-year residents in the existing program will be absorbed into the new one. Memorial Medical Center will be added as a training site.
There will be no change in faculty; Broderick will remain as director.
Feared losing program
The county feared losing the program after the Centers for Medicare and Medicaid Services said it didn't meet requirements of the Balanced Budget Act when it moved from the defunct county hospital to Doctors Medical Center in 1997.
County officials haggled with the agency for more than 18 months before going public with the issue in March.
Even though an administrative contractor for many years approved funding for the training at Doctors, the hospital and county had to repay more than $19 million federal officials said was paid in error from 2001 to 2008. The issue had nothing to do with the quality of the training.
For the training to continue, CMS officials said, the county could create a new program, but it needed to have a new curriculum, a new faculty and a new director, and the training needed to stop for a year.
Local officials said gutting the program would have crippled the county's health system, because the 27 doctors-in-training and 30 physician faculty members are the backbone of the county health clinics.
County officials and congressional representatives urged President Barack Obama's appointees to the Department of Health and Human Services to spare the program. A breakthrough in the talks with CMS came in late July when the agency relaxed requirements for the new program.
Working with hospitals
The county formed a consortium with Doctors and Memorial to oversee a residency, increasing the training slots from 27 to 30, and then worked on getting approval from the accreditation council.
"It was exciting to learn that the accreditation has come through," Mary Ann Lee, managing director of the county Health Services Agency, said Thursday. "It was an essential step to our resolving this."
The program starting in July will retain the focus of training medical school graduates as primary care physicians.
Broderick is talking with Memorial about using the hospital for teaching emergency medicine, surgery and pediatrics. Doctors still will be a training site, and Broderick is talking with Kaiser Permanente about subspecialty training in the treatment of patients with arthritis and diabetes.
Lee said the consortium is complying with the CMS rules issued last year, so she expects it will receive federal funding. The hospitals will submit cost reports in May 2011 for reimbursements from CMS.
Federal funding has covered 65 percent of program expenses. The county and the hospitals in the consortium will provide the balance of program funding. Interim funding from the county and Doctors has supported the residency in the past year.
The accreditation is a relief and source of pride for the current residents. Officials had expected no more than provisional approval from the council, which would have required a review after one year.
"It has been pretty difficult," said Jerry Chastain, a third-year resident who recently finished a term as co-chief resident. "We heard so many comments from nurses and other doctors asking what we would do if the program closes."
A valuable experience
Chastain said it was a valuable experience for residents to be involved with creating the new curriculum. "It forced us to re-evaluate the excellent program we have now and try to make it better," he said. "I can only see good coming out of this."
Although medical school graduates usually stay away from residencies with an uncertain future, interest remains strong in the local program, Broderick said.
It received applications from 583 medical students for the class to start in July, compared with 530 applications the previous year. Of the people who interviewed, 50 percent were from medical schools in the United States and 30 percent were American students who attended Caribbean medical schools, Broderick said.
"We have been upfront with the residency applicants on our Web site and kept them informed (about the status of the program) during the interview process," Broderick said.
Bee staff writer Ken Carlson can be reached at firstname.lastname@example.org or 578-2321.