Hopkins residency program re-accredited

Decertification came in August after group found work violations

December 20, 2003|By David Kohn | David Kohn,SUN STAFF

The Johns Hopkins University's largest medical school residency program has been re-accredited after spending several months in limbo.

The program, which has 106 residents, lost accreditation in August after an oversight group found several violations, including failure to limit residents' work schedule to fewer than 80 hours per week.

"I'm personally overjoyed, and I think that reflects the feelings of everyone here. We worked very hard to solve this problem. Everyone pulled together," said Dr. David Nichols, vice dean of education at the medical school. He was heavily involved in the changes the program made to comply with rules laid down by Accreditation Council for Graduate Medical Education.

Since the decertification, Hopkins has examined its residency program, Nichols said, adjusting work schedules and emphasizing to faculty and residents the importance of adhering to the rules.

"We've adopted a zero-tolerance policy," he said. "We've had great cooperation from faculty and residents."

After losing accreditation, the university created what Nichols termed an "emergency group" of six to eight people who worked full time to make sure that the internal medicine program complied with ACGME standards.

Nichols said Hopkins hired an outside consultant to review the program, and, in an attempt to decrease demands on residents, added more physician's assistants and nurse practitioners to the surgery department.

He said Hopkins' 75 other residency programs re-examined their practices also, and were in total compliance "to the extent that it is humanly possible." The decertification did not halt the internal medicine program, because the university had until July next year to correct the problems.

Ingrid Philibert, ACGME's director of field operations, said that Hopkins had been granted probationary accreditation in October. She said the July violations were so severe that the group wanted to re-examine the program before granting it full accreditation.

An ACGME review committee took another look at the Hopkins program and lifted the probation this week.

Hopkins was the first institution cited for violating work restrictions that went into effect July 1. The rules were meant to solve long-standing concerns about exploited doctors-in-training and the risk to patients being treated by sleep-deprived physicians.

Hopkins had said the primary complaint was that several first-year residents worked almost 90-hour weeks in July.

Some observers suggested that ACGME was making an example of Hopkins, to show legislators and critics that the new rules work.

Since August, several residency programs at other medical schools have also lost accreditation, Philibert said. But only Hopkins has been cited for violating the 80-hour rule.

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