Medical School Told to Fix Problems

A national accreditation council has found deficiencies in one-fourth of UC Irvine medical school’s residency programs, serious enough to result in warnings or probation status.

The reviews, conducted by the American Council for Graduate Medical Education, cited problems such as inadequate supervision of medical residents, insufficient exposure by physicians-in-training to a variety of procedures and medical conditions and a failure to support research in 10 of UC Irvine’s 39 residency programs.

If the deficiencies are not corrected by the next review, UC Irvine’s medical residency programs could lose accreditation and would not be allowed to train doctors in those fields.

The most serious problems were found in the neurology and neurosurgery programs, where residents did not gain enough experience treating a wide spectrum of patients.

At any given time about 4% of the residency programs nationwide receive warnings or are put on probation by the accreditation council, said Dr. John Gienapp, executive director. The group reviews about 7,600 residency programs at medical schools and hospitals.

But Dr. Thomas Cesario, dean of UC Irvine’s College of Medicine, said most of the problems are easily correctable, requiring changes in documentation or the scheduling of formal monthly reviews with residents.

Residency programs provide training to medical school graduates.

Cesario said many of the deficiencies are a result of the declining number of patients, making it more difficult for UC Irvine to expose its 670 residents to the variety of medical cases, treatments and procedures necessary to maintain accreditation.

Managed care has reduced the number of hospital visits nationwide. In Orange County, even the Medi-Cal patients who once flocked to UC Irvine Medical Center in Orange are part of a new managed care program that sends many of them elsewhere, Cesario said.

Gienapp said that the repetition of certain deficiencies at UC Irvine indicates that “there may be some systematic problems. It could be luck of the draw, or it could mean that there are some issues they need to work on.”

In addition to neurology and neurosurgery, programs receiving warnings were: surgical critical care; child neurology; gastroenterology; hematology; medical oncology; infectious disease; rheumatology; and endocrinology, diabetes and metabolism.