SUNY Downstate Well being Sciences College, Brooklyn.
Photograph courtesy SUNY Downstate Well being Sciences College
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There was a lot dialogue about how the deliberate closure of SUNY Downstate College Hospital will drastically compromise healthcare companies in Brooklyn — and depart greater than 400,000 sufferers handled there annually with out instant entry to very important, life-saving care.
However little has been stated about how Downstate’s medical faculty — and significantly its residency program — will probably be affected if the hospital is shuttered.
In a press release issued in early March, 16 division chairs at Downstate’s medical faculty and hospital aired main issues concerning the medical faculty’s potential to offer high quality instruction and experiences for medical college students and residents. The impression on undergraduate and graduate medical training will probably be “devastating” if the hospital closes, they stated.
Downstate medical college students spend as much as 30% of their scientific rotations at Downstate hospital. With out its instructing hospital, Downstate would discover it very tough to position residents at neighboring affiliate hospitals.
There’s a extreme scarcity of residency openings at close by hospitals, particularly in surgical procedure, drugs, obstetrics, gynecology, and pediatrics coaching applications. There could be “inadequate coaching alternatives” at different hospitals for residents and fellows if Downstate closes, the chairs stated.
And that can adversely impression healthcare in Brooklyn and the opposite boroughs. Downstate is a crucial pipeline of medical doctors and medical professions to New York Metropolis; extra physicians have skilled at Downstate than every other medical faculty.
Downstate isn’t the one medical faculty dealing with this problem.
The scarcity of residency applications for medical college students is a serious problem nationally, with vital implications for the healthcare system. It’s an issue that may’t be overstated, because it impacts not solely medical college students but additionally hospitals, sufferers, and communities at giant.
Let’s acknowledge the paradox: We have now a rising want for healthcare professionals, but there aren’t sufficient residency positions to accommodate all graduating medical college students. New York–and by extension Downstate hospital and SUNY public instructing hospitals in Stony Brook and Syracuse– play a pivotal position within the medical residency pipeline.
Based on a research by the Middle for Well being Workforce Options, practically one in 5 physicians working towards in the US obtained graduate medical training in New York. In 2021 alone, New York residency applications skilled roughly 18,000 physicians in its graduate faculties, accounting for about 13% of all physicians skilled nationwide. These statistics underscore the very important position that New York performs in supplying the nation with expert medical doctors.
This scarcity not solely delays the profession development of aspiring medical doctors but additionally leaves many extremely certified people with out the chance to totally make the most of their expertise and data in serving the group.
A significant consequence of this scarcity is the worsening of the doctor scarcity in underserved areas like Brooklyn. With out enough residency positions, medical graduates is probably not incentivized to pursue careers in areas the place healthcare entry is already restricted. This perpetuates disparities in healthcare supply, leaving susceptible populations with out important medical companies.
The truth is, the New York State Division of Well being documented these healthcare disparities in their very own report, which was quietly launched in February. A number of key findings from the report embody:
- Zip codes with the next proportion of Black and Hispanic residents had at the least 20% fewer medical suppliers and staffed hospital beds per capita of their neighborhoods;
- Untimely deaths earlier than the age of 65 are increased in Brooklyn than the opposite boroughs of New York Metropolis and New York state; and
- Brooklynites expertise late diagnoses of a number of sorts of most cancers at the next price than the remainder of New York Metropolis and state.
The bottleneck in residency positions additionally has a ripple impact on medical training as a complete. With restricted spots obtainable, medical faculties might face strain to lower enrollments, decreasing the general variety of future physicians skilled. The Affiliation of American Medical Schools (AAMC) predicts the U.S. may see a scarcity of roughly 122,000 physicians by 2032 as demand is exceeding provide for main care and specialist physicians. This might worsen the already vital doctor scarcity in the long run and hinder efforts to handle evolving healthcare wants.
Addressing the scarcity of residency applications requires a multifaceted method. Elevated funding for residency positions is essential, as it might enable hospitals to develop their coaching applications and accommodate extra medical graduates. Moreover, insurance policies ought to be carried out to incentivize the creation of residency applications in underserved areas, which might encourage physicians to follow in communities that want them most.
One factor is obvious: Closing SUNY Downstate College Hospital could have a right away and severely destructive impression on a borough that’s already experiencing multi-generational healthcare disparities. Relatively than closing SUNY Downstate hospital, the Governor ought to be investing in Downstate to considerably improve the ability to make sure our future medical doctors and healthcare professionals obtain the very best high quality of training and coaching.
