2 University of Arkansas Medical School residency programs on probation

LITTLE ROCK

Two family medicine programs for training doctors that are operated by the University of Arkansas for Medical Sciences are on probation by an accrediting group for deficiencies in supervising doctors in training while they delivered babies and for weakness in continuing education for physicians.

The residency programs cited by the Accreditation Council for Graduate Medical Education are the Area Health Education Centers in northwest Arkansas and Pine Bluff. UAMS has eight of the health education centers throughout the state, and six have family medicine residency programs.

The probation does not affect funding for the centers but continued problems could lead to a loss of accreditation.

A physical medicine and rehabilitation program was removed from probation on Aug. 24 after it was re-examined by the accrediting body.

The council in January listed 16 citations for the northwest center that included emphasizing revenue-generating patient services over educating students and insufficient resident experience with pediatric, obstetric and geriatric patients.

The center in Pine Bluff was put on probation in May for 13 citations that included limiting the number of patient visits and types of patients and a failure to ensure that residents perform enough deliveries.

The programs can have their probationary status lifted after another review.

UAMS has 62 accredited programs across the medical specialties, including the six Area Health Education Centers’ residencies.

Officials at the centers say many of the citations grew from problems with paperwork instead of actual deficiencies in the residency programs.

The northwest education center originally received 23 citations, but seven were rescinded after education center officials provided additional information. The Pine Bluff center initially had 16 citations, but three were rescinded.

Dr. Charles Cranford, executive director of the Area Health Education Centers program, said he is confident the problems will be cleared to the satisfaction of the accreditation body.

“It’s just a bit of a wake-up call that we need to do a better job of submitting the data that is required to the residency review committee, and we’re going to have that done. I have no doubt about it,” Cranford said.

Cranford said he expects both programs to be off probation within a year.

Regarding the northwest center, the accrediting council said in a June 2006 letter, “There is insufficient evidence that the sponsoring institution is adequately committed to graduate medical education.”

The council cited a lack of institutional oversight, a failure to respond to past citations regarding staff shortages and a failure to ensure that residents don’t exceed duty hour limits. The council also said UAMS had lost faculty because of an emphasis on clinical services at the expense of education and that supervision of residents had diminished.

Cranford said UAMS encouraged the northwest center to increase its clinical services because the center’s productivity was below the average for health education centers. Cranford said UAMS is fully committed to education at the northwest center.

“They have more support than any other residency program in the state. So there is no factual basis in that allegation,” he said.

The northwest center receives nearly $1.8 million annually in state funds. Only the Pine Bluff center receives more, $1.9 million. The total budget for the northwest center is $8.7 million, the largest of the Area Health Education Centers.

The northwest center had been over budget but, under Dr. Bob Gullett who became director in 2006, officials say the center is again on sound financial footing and brings in additional physicians to see patients if the faculty members need time to teach.

Officials say a documentation error at the northwest and Pine Bluff centers led to them being cited for residents not performing an adequate number of deliveries.

Officials say the northwest center now contracts with a different area obstetric group that will supervise more deliveries.

The Accreditation Council for Graduate Medical Education accredits 8,437 programs nationally. Of those, 73 are currently on probation, including the two in Arkansas.

Information from: Arkansas Democrat-Gazette, http://www.arkansasonline.com

– Associated Press



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