A UB medical degree is losing some of its luster as one of the residency programs is at risk of losing accreditation, leaving some aspiring doctors in certification limbo.
The School of Medicine and Biomedical Sciences is in danger of losing its radiology program largely due to poor reviews from the Accreditation Council for Graduate Medical Education.
On probation since 2003, the program has a proposed termination date of July 2007 unless it can improve its residency program, which has been under fire since problems with its curriculum came to light in 2001.
"The program has 16 residents, and these residents are people who have completed medical school and are at the beginning of a four-year training program in radiology," said Dr. Roseanne Berger, senior associate dean for Graduate Medical Education.
Like other residency programs, the students learn by caring for patients under the supervision of medical professionals. Berger said part of the problem is that available radiology staff and facilities are hard to come by.
"UB enrolls over 700 residents in 53 residency programs. Both full-time physician faculty and volunteers supervise residents training in clinics and hospitals. Diagnostic radiology, more than other residencies, is dependent on participation of volunteer faculty," Berger said.
And while these students should be practicing what they learn as the core of their residencies, the accreditation council found that in some cases UB's radiology students were merely observing, according to The Buffalo News.
The council also found the written curriculum to be inadequate and evaluation of residents with experienced radiologists inconsistent.
"One of the things they had some concern with was that we don't have a single university hospital that is affiliated with the university, or owned or managed by the university," Berger said. "(Instead, the hospitals) are managed by their own board. The residents in our program work on the radiology staffs in many different hospitals."
Berger said the council was concerned that the radiologists overseeing the residents were not coordinated in their feedback and communication.
"The term they used was 'cohesive faculty,' " she said, "and in fairness, there is some truth to that. There is a separate group at Kaleida Health, and a separate one at Roswell Park."
Other sites that are a part of the radiology residency include the Buffalo General Hospital, Women's and Children's Hospital of Buffalo, Millard Fillmore Gates Hospital and South Buffalo Mercy Hospital.
Low scores from radiology students on the American Board of Radiology's written certification tests have also tarnished the program in recent years.
"People who graduated here were not achieving high-enough board scores," Berger said. "Over the past two years graduates have improved in their board scores, to the extent that they exceeded the standard."
According to Berger, program administrators are responding to each of the council's concerns.
"It is very challenging for radiologists to simultaneously meet the demands for patient care and teaching at the same time," Berger said. "The challenge is to have enough faculty so there are people who can do the work of taking the demands in the hospital and still have enough people who are free for teaching the residents."
At their next scheduled meeting in April, the Accreditation Council for Graduate Medical Education's Diagnostic Radiology Residency Review Committee will review the school's response.
"If the decision to withdraw accreditation is sustained, residents enrolled in their last two years of training can complete their training here," Berger said. "Residents in their first two years of training will transfer elsewhere."
Expertise, technology, and patients - all elements of a strong radiology program - are elements that are all existent in UB's program.
"We all have a common idea of what makes a good program. If it's feasible to provide that, then that's what we'll do," Berger said. "If we can't provide the balance for teaching and service, and (are) providing a second rate education, that's not something that we would be proud of, and that's not something that UB would be proud of."
Photo: Courtesy of Matthew Messina, from the RMBERS' Instagram page
