The reputation of the University of Missouri-Columbia's medical school and its recruitment efforts could suffer after it landed on a short list of programs with serious shortcomings.
The Accreditation Council for Graduate Medical Education placed the doctors' residency program at the school on a two-year probation last month based on an on-site review and interviews from 2008.
Health officials at MU on Wednesday said they were devastated by the downgrade in credentials and look forward to an upcoming report from the council laying out the specific deficiencies.
"We take this very, very seriously, and we will do everything we can to correct the problems," said Dr. John Gay, MU's associate dean for graduate medical education. Gay stressed that the probation doesn't affect the quality of the medical school or patient care.
Probations of entire institutions by the council are rare. MU is one of just five teaching hospitals out of 386 nationwide currently under the disciplinary action. The four others are the Children's National Medical Center in Washington and hospitals in Atlanta, Brooklyn and Puerto Rico.
"It's never a good thing to be on anybody's bad boy list," said Dr. Alan Luger, program director of MU's pathology residency program. Luger called the action a "wake-up call" for the university's leadership.
4-YEAR MEDICAL SCHOOL NOT AFFECTED
The oversight group alerted Missouri officials in December to their concerns, which involved administration of the program, funding and record-keeping. Their more detailed recommendations for full compliance will be sent to MU within 60 days.
The school has two years before its next review to fix the problems or, in an unlikely scenario, risk losing its accreditation entirely. School officials said they will try to get the process expedited.
The probation involves the school's residency training program, not the four-year medical school, which is not affected by the probation. Residency programs are the three to seven years of specialty training and research that doctors practice after graduating from medical school.
Because the probation is at the system level, it also does not currently include any of MU's 39 residency programs, which represent 390 doctors training in specialties from anesthesiology to urology. Those programs are reviewed individually.
Current and future MU residents should not be impacted by the probation. But, if any residency program lost certification, the residents would not be eligible to become board certified in their specialties and could have trouble obtaining medical licenses.
Various specialties within the resident training programs at MU have been disciplined in the past. Credentials for the thoracic (chest) surgery program were withdrawn by the accrediting body in 2007, meaning investigators found a "catastrophic loss of resources."
Residency programs in anesthesiology and obstetrics/gynecology were on probation the same year. The problems were mostly tied to lower patient volumes and reduced staffing, school officials said.
While the medical education council does not release reports from its hospital reviews, its requirements include residents' insurance coverage and work hours. Reviewers also grade hospitals on factors including residents' access to counseling, on-site sleeping quarters and round-the-clock meal availability.
RECORD-KEEPING AN ISSUE
One issue that officials expect to be a factor for MU is a relatively new electronic system for medical record-keeping.
Frank Schmidt, a biochemistry professor in the medical school who works on the pre-clinical side, said he heard concerns that it took too long for residents to input information into the system.
"The accrediting agency does ask if the residents are doing something and learning something - or are they just doing busy work?" he said.
School officials acknowledged the record-keeping system is cumbersome, and like hospitals nationwide, they have grappled with the transition from paper.
Schmidt said the probation could make it harder to recruit medical students to the residency programs at MU. The university typically receives 10 or more applications for every open residency position.
Katie Leonard, a third-year medical student at St. Louis University, said she probably wouldn't apply to a residency program at any institution on probation.
"That's a pretty big deal," Leonard said. "When you're searching for residencies, one of the things they always tell you to do is look and see when they got accredited and when they're up for reaccreditation."