Hospital Reneges on Training Positions

Seven months ago, four doctors hoping to become radiologists received notice that they had been selected for coveted training spots at Martin Luther King Jr./Drew Medical Center beginning on July 1, 2004.

But the hospital didn’t have the slots to offer.

Officials sent out the acceptance letters knowing that the radiology residency program would be forced to shut down the day before the new trainees were to report for work.

Now, the health director for Los Angeles County, which owns King/Drew, said it appears that the hospital committed an inexcusable error.

“Obviously, if you admitted somebody to a program that’s unaccredited, I can’t defend that,” said Dr. Thomas Garthwaite, director of the Los Angeles County Department of Health Services. “That’s stupid. ... There’s no reason to do that.”

The controversy comes as the future of physician training is in jeopardy at the hospital in Willowbrook, just south of Watts.

On Friday, King/Drew was informed that it would have to close its surgery training program on June 30, 2004 -- imperiling its ability to function as a trauma center and leaving 30 residents without positions.

At the same time, the Accreditation Council for Graduate Medical Education, which regulates the nation’s training of medical specialists, is conducting an overall review of King/ Drew’s oversight of its 18 residency programs. In addition to closing the surgery and radiology programs, the council has warned or issued probation to four other programs.

King/Drew received an unfavorable rating after its last overall review in 2000. A second such rating permits the accrediting council to strip the hospital of its ability to train residents.

Meanwhile, 30 surgical residents and 15 radiology trainees -- including the four Garthwaite says should not have been admitted -- need to find new jobs.

So far, they say, King/Drew has done little to help them.

In recent interviews with residents from both programs, some said they have yet to work up the courage to tell their families. Others felt the hospital leadership gave them false hopes that their livelihoods would be saved.

“I’m pretty scared,” said Dr. Courtney Carter, a second-year radiology resident.

At a recent meeting, she said, residents were told that they may have to choose different specialties or even leave medicine altogether.

“That’s the most disturbing thought I could imagine,” she said. “They don’t understand that this is our lives that they’re playing with.”

Many said that King/Drew was more than a training program -- they saw it as part of a mission to serve poor, minority communities. They worry who will fill the void when they leave.

Several surgery residents said the hospital’s prolonged inattention to problems in their program does not give them confidence that King/Drew officials will find acceptable placements for them.

“We do not trust and have faith in our current leadership,” said Dr. David Rodriguez, a third-year surgical resident. He called for outside experts to be appointed to assist in finding trainees new jobs, hopefully at other Los Angeles County hospitals.

Garthwaite, the county health director, said the county would devote additional resources to the task of placing the residents and might agree to pay the residents’ salaries to other institutions as part of the deal.

On Monday, county health officials said they were still trying to reconstruct why King/Drew’s doomed radiology program accepted four new residents set to begin work after its closing date.

An additional resident was accepted at the same time but began training this summer.

In an October 2002 letter sent to King/Drew, an accrediting council official wrote that “no residents may be newly appointed to the program” unless the revocation of accreditation is appealed. King/Drew did not appeal.

Dr. Theodore Miller, interim chairman of radiology, said he does not believe that the program violated the rules by accepting the four additional residents because the hospital did not give them legal contracts. He said those four residents were informed repeatedly -- both before and after their selection -- that the program may not exist by the time they were to start their training.

Miller conceded, however, that it was “an inadvertent violation of the rules” to appoint the one resident who began training this summer.

Although Miller said residents were clearly warned of King/Drew’s troubles, e-mails sent to potential residents in December 2002 from the program’s director gave applicants reason to believe the program’s fate was not sealed.

In a postscript, Dr. Janis Owens said that although the program’s accreditation had been withdrawn, King/Drew was planning to have the council reevaluate it prior to the closure date.

In fact, by the time Owens sent her e-mails, the date already had passed for the program to appeal the withdrawal.

Garthwaite acknowledged that the appearance of ignoring the rules of the accrediting council doesn’t help the medical center.

“It obviously doesn’t show that overall controls are strong,” Garthwaite said. “This is a time when we really were working hard to get everything in place and tighten things up.”