On Jan. 21, the Accreditation Council for Graduate Medical Education withdrew accreditation from West Suburban Medical Center, declaring it would no longer be a sponsoring institution for the Family Medicine Residency Program.
ACGME is a nonprofit that monitors graduate medical education programs to ensure that resident doctors and fellows deliver safe and high-quality care. And when an institution doesn’t meet its requirements, ACGME can put it on probation or withdraw accreditation completely.
About 30 residents in the Family Medicine Residency Program – which has been at West Suburban since 1973 and is the hospital’s only residency program – are navigating continuing their education elsewhere by the time West Suburban’s accreditation officially ends June 30.
Dominic Robolino, a first-year resident, said he wanted to do his residency at West Suburban to help an underserved community. While he said he was disheartened when he discovered West Suburban lost its accreditation, there was a glimmer of hope, too.
“When I heard the news, certainly [there were] mixed emotions,” Robolino said. “But I was honestly relieved in some way to know that somebody did recognize how dangerous of an environment this was, and how inadequate of a learning environment this was.”
After West Suburban’s withdrawn accreditation was announced, the Family Medicine Residency Program’s associate directors and program coordinator helped residents reach out to accredited family medicine programs at nearby hospitals, which said they would create new openings for West Suburban residents. Some residents were interviewing with these hospitals, and some were about to accept offers and transfer.
Medical residents assumed that a new position at another hospital would be funded by federal Medicare money – which institutions receive annually to go toward residents’ education – that travels with them to whatever accredited institution they continue their education at.
But the first week of February, residents said that the Family Medicine Residency Program’s associate directors told them that West Suburban wouldn’t release funding for residents to bring with them to other institutions.
West Suburban CEO Manoj Prasad said no decisions have been made yet about whether Medicare funding will transfer with residents to another institution.
According to the Centers for Medicare & Medicaid Services, transfer of such funding is voluntary.
“My heart kind of broke for the first and second years,” said Harleen Multani, a third-year resident and chief resident, who graduates June 30 when West Suburban’s accreditation ends. “Some people may not be able to complete their training. Some people are going to have to move to another state when they have a family and kids here… or they would have to potentially start their training over again.”
Institutions that were going to take on West Suburban’s residents have rescinded or indefinitely put on hold their offers to five residents, likely because they would have to internally fund the rest of those residents’ education.
Since those hospitals were going to create new spots for West Suburban residents, and there are no open residency spots in the 30-plus family medicine programs in Illinois, many residents are looking to continue their education at an out-of-state institution. Or they can try and reenter the residency matching process, filling open spots after the first round of matching for other resident doctors in March. But that may require transferring into a specialty outside of family medicine.
“Switching to a different specialty may require us to repeat certain parts of our training, essentially delaying the time in which we would actually make a greater salary that would allow us to pay off student loans,” Robolino said, adding that he and many of his peers don’t want to follow that path.
If West Suburban holds onto resident funding, it would only be allowed to use it for another residency program, which it’s not allowed to launch for at least two years after its accreditation withdrawal, according to the ACGME.
Prasad said the hospital may continue to train residents and is in the process of navigating next steps.
“If the institution wishes to continue to train residents, there are options available to continue to do so,” Prasad said in an email, confirming that West Suburban hasn’t yet made a decision about whether to appeal its withdrawn accreditation. “We are in the process of evaluating what is the best pathway for the hospital to pursue.”
But even with the possibility of the hospital appealing the loss of its accreditation, many resident doctors don’t necessarily want to stay.
“I don’t think that anyone is wanting the appeal to go through because this place has just become such a terrible place to get education that staying here for an extra year isn’t going to make you well equipped to go out there and save lives,” Multani said. “I think everyone is just hoping that [Prasad] will release the funds and they can move on with their lives.”
The end of an era
The Family Medicine Residency Program has a longstanding history with West Suburban, one that spans 50-some years. Residents are assigned to one of four sites hosted by the PCC Community Wellness Center, a federally qualified health center.
PCC Dr. Burdick Family Health Center, previously known as the Family Medicine Center, is located inside West Suburban and was accredited in 1972. The PCC Lake Street Family Health Center in Oak Park was accredited in 1994. Chicago’s PCC Salud Family Health Center received accreditation in 1997, and the PCC Austin Family Health Center was accredited in 2010.
But residents will no longer serve at these health centers, as the Family Medicine Residency Program was the last residency program at West Suburban.
West Suburban’s internal medicine residency program lost ACGME accreditation at the beginning of 2022 after 35 years. And in 2021, the Family Medicine Residency Program was put on probationary accreditation but continued its accreditation the following year.
Last April, the Family Medicine Residency Program’s faculty and program directors called for ACGME to return to West Suburban, an unprecedented move at the hospital, to analyze what they call a lack of investment in resident education and worsening patient conditions.
In October, ACGME returned to the hospital for an institution review. That visit triggered another in December to assess the Family Medicine Residency Program. An ACGME review committee will meet in April to assess the program, but the program can only remain accredited if it has a new accredited sponsoring institution.
“Without a hospital to run our program, technically the [program] accreditation is gone,” Multani said, “unless we can find another hospital to take our program.”
The loss of the Family Medicine Residency Program is a defeat for the program’s staff and hospital as a whole, according to residents.
“Data shows that receiving treatment from a teaching team, or at a teaching hospital where there are residents and students or attending doctors,” Robolino said, “results in better care for the patients because there are more people” working to ensure the best care possible.
But the end of the program also affects the community that West Suburban serves on Chicago’s West Side.
“People who train in a certain location are more likely to remain in that location,” Robolino said. So, residents leaving West Suburban without their funding would mean “less primary care doctors on the West Side of Chicago overall, less healthcare and worse healthcare for the people on the West Side, which is already an underserved community with disproportionate rates of illness and healthcare needs.”
