Board Affirms Decision; King/Drew Training of Surgeons to Halt June 30

An accreditation council on Friday upheld its decision to strip Martin Luther King Jr./Drew Medical Center of its ability to train aspiring surgeons, throwing into doubt the hospital’s ability to function as a trauma center.

The Accreditation Council for Graduate Medical Education ordered the program to close as of June 30, quashing the hopes of doctors and administrators who had pleaded for a reconsideration.

Outside experts said the decision -- which is final -- will have a devastating effect on the hospital in Willowbrook, just south of Watts, and the largely poor, minority population it serves.

It is “almost inconceivable” for a busy urban hospital to lose its ability to train surgeons, said Dr. Paul Lin, surgery program director at George Washington University Hospital in Washington, D.C.

“It’s a major blow, without question,” said Dr. Jeffrey H. Peters, surgery program director at Los Angeles County-USC Medical Center. “It would be a rare trauma program that functions without a residency.”

King/Drew’s trauma center treats nearly one-quarter of the county’s gunshot and stabbing victims and 11% of those involved in car accidents, assaults and other life-threatening injuries.

Surgery residents reacted with anger, saying that about 30 of them will be forced to find other hospitals where they can complete their five-year curriculum.

“We are shocked and we are in utter disbelief,” said resident Dr. Almaas Shaikh, making a statement on behalf of her colleagues. “It is an abysmal display of the failure of leadership and lack of accountability that have allowed these circumstances to occur.”

On Friday, the union representing the residents condemned officials at the hospital and Charles R. Drew University of Medicine and Science, which runs the 18 training programs at King/Drew. The union accused them of underestimating the threat to the program’s future, leaving residents to believe their positions were secure.

“Either they didn’t get how serious it was or they were deliberately distorting how serious it was,” said Josh Rutkoff, area director for the Joint Council of Interns and Residents. “I’m not sure which is worse.”

Surgery isn’t the only doomed training program at King/Drew. Last fall, the accreditation board revoked approval for the hospital’s radiology residency program, a decision that also will take effect June 30. That means the county also has to find placements at other facilities for 14 radiology residents.

The accreditation council first indicated it would summarily withdraw approval for the surgery program in August. The immediate reason cited was that the program was training more residents than it was allowed.

But the surgery residency already was on probation because the council previously had found that trainees were not provided enough surgical experience, faculty research was inadequate and the curriculum did not follow recommended guidelines.

The hospital asked the council to reconsider the revocation, but on Friday the council upheld the withdrawal.

Dr. Thomas Garthwaite, director of the Los Angeles County Department of Health Services, which owns the hospital, agreed that “there are multiple failures at various levels.” He called the accrediting council’s decision “disappointing, but not unexpected.”

King/Drew cannot apply to start a new surgery residency at the hospital because its overall graduate medical education program received an unfavorable rating by the accrediting council in 2000. The hospital had another review last month and is awaiting the results.

If it receives a favorable rating, it plans to seek approval for a new surgery program, said Walter Strong, vice president of university affairs at the Drew school. That process could take months.

Without the surgery residents, experts said, the county probably will have to spend much more money to hire more skilled surgeons from outside to take over at the 233-bed hospital.

Residents, typically recent medical school graduates being trained in specialties, earn less than $45,000 a year because they are still being trained, whereas more senior doctors can cost the county $100,000 to $150,000 each.

Even with a substantial budget increase, it will be difficult for King/Drew to recruit enough surgeons willing to cover trauma shifts 24 hours a day, seven days a week, said Dr. Bruce Stabile, chairman of the surgery department at Harbor-UCLA Medical Center.

He said it’s a “huge concern” that the loss of King/Drew’s surgery program will end up overwhelming surrounding hospitals, including Harbor-UCLA.

Garthwaite said he thought the hospital’s existing surgeons could handle many of the operations now performed by residents.

“What we’re paying the surgeon to stand and look over and supervise the resident, it won’t cost any more for them to perform the surgery,” he said.

But Garthwaite acknowledged that doctors might balk at the added tasks.

County Supervisor Yvonne Brathwaite Burke, whose district includes the hospital, said she had hoped the surgery program would get another chance.

Officials moved quickly to replace the facility’s leadership and correct problems identified by the accrediting council, she said. “I’m very disappointed,” she added.