570 residents, fellows scramble to find new jobs.
This article was first published on Monday, July 15, 2019 in MedPage Today.
By Kristina Fiore, Director of Enterprise & Investigative Reporting, MedPage Today
Some 570 medical residents and fellows are in limbo as the shuttering Hahnemann University Hospital in Philadelphia has announced plans to sell its training programs for $7.5 million to Tower Health – a smaller system that can't accommodate all of the trainees.
Given the limited availability, many have sought new offers -- but they can't accept them until hospital administrators can release them along with the federal funding that follows each trainee. That can't happen until the deal is approved by a U.S. bankruptcy court.
Hahnemann – the primary teaching hospital affiliated with Drexel University College of Medicine – announced on June 26 that it was filing for bankruptcy and closing its doors in September. The safety-net hospital, which is more than 170 years old, primarily serves Philadelphia's low-income and vulnerable patients.
"We are not officially 'orphaned.' That was halted during one of the bankruptcy court hearings," one medical resident who spoke on the condition of anonymity told MedPage Today, saying hospital administrators have told residents not to speak to reporters. "Hence, those of us with offers are on hold."
That's frustrating because competition for those spots is fierce: Jason Martinez, MD, a PGY3 general surgery resident at Hahnemann, said in a tweet that "we're all competing with our co-residents, some people with multiple offers actively hurt the next doc in line, as they're NOT getting that offer."
At issue is the federal funding that helps pay for residency training. Medicare covers part of the expense of training residents, and that funding stays with each program until the resident completes training, according to the Accreditation Council for Graduate Medical Education (ACGME).
A spokesperson for the American Academic Health System, Hahnemann's parent company, didn't return a request for comment on when its administrators might be able to approve residents' transfer requests. Another court hearing is set for later this week.
Last week, Tower Health said it would pay $7.5 million for the training programs; that too is subject to bankruptcy court approval. Yet Tower currently has only 118 trainees across its six hospitals, in just five of the 15 specialties offered at Hahnemann, according to the Philadelphia Inquirer.
In the meantime, the ACGME says it has located 1,000 available positions for displaced residents and fellows. "The ACGME accreditation teams and Review Committees are expediting the consideration of requests related to Hahnemann's closure, including temporary and permanent complement increase requests from programs that would like to accommodate the transfer of displaced residents/fellows," the organization said in a statement.
But programs may be hesitant to go forward with offers if there is no guarantee of funding, said Ivy Baer, JD, MPH, senior director and regulatory counsel for healthcare affairs at the Association of American Medical Colleges (AAMC).
"If a hospital receiving displaced residents wanted certainty that it would get those slots, and many do as risk is difficult, then that hospital would need to wait," Baer told MedPage Today.
Both the AAMC and the ACGME have filed motions in bankruptcy court to help ensure timely placement of residents.
"We really feel terribly for them, and that's why we want to make sure they remain in the minds of everyone as this is proceeding," Baer said. "It could be hard finding new spots, especially as residencies started July 1. Everyone was set for the year, and then this happened."
On Monday, Bernie Sanders appeared at a rally at Hahnemann with hundreds of supporters, urging administrators not to close the hospital.
"At a time when our country faces a major health care crisis, when 80 million Americans are either uninsured or underinsured, including tens of thousands of people here in the Philadelphia area, we should be moving, we must be moving forward to guarantee health care to all the people as a right," the presidential candidate said during the rally.
“It could be hard finding new spots, especially as residencies started July 1. Everyone was set for the year, and then this happened."”
Ivy Baer, Association of American Medical Colleges
Tower Health said it would pay $7.5 million for the training programs, subject to bankruptcy court approval.
Tower has only 118 trainees across its six hospitals, in just five of the 15 specialties offered at Hahnemann,
Many Hahnemann trainees have sought new offers -- but they can't accept them until hospital administrators can release them along with the federal funding that follows each trainee.