UNM Neurosurgery Department regains residency accreditation - Albuquerque Journal

UNM Neurosurgery Department regains residency accreditation

The UNM School of Medicine's Basic Medical Sciences building. (Courtesy of UNM)
The UNM School of Medicine’s Basic Medical Sciences building. (Courtesy of UNM)

Copyright © 2022 Albuquerque Journal

The University of New Mexico School of Medicine has revamped its Department of Neurosurgery less than two years after its residency program’s accreditation was yanked over working conditions and other problems.

UNM announced this week that the school has regained its accreditation from the Accreditation Council for Graduate Medical Education, a designation that was lost in June 2020.

It will still take years for UNM to grow the residency program to full capacity, but without that program, it would have been difficult for UNM Hospital to maintain its Level 1 trauma center status, according to the school’s new top neurosurgeon.

Dr. Meic Schmidt, the chair of the department, was hired in February 2020 and given the task of restoring the department’s status. UNM already knew at the time Schmidt was hired that it was going to lose its accreditation.

“I was well aware that there was a huge task in front of us, right? Because there were multiple serious citations … that ultimately led to the withdrawal of the program,” Schmidt said in an interview. “The state of New Mexico wants to have a neurosurgery program, because we need neurosurgeons in this state.”

UNM officials didn’t say how much it has spent to rebuild the department. But there have been many new hires.

Schmidt said that at the time the school lost accreditation, there were five neurosurgeons instructing seven residents.

Now, by July the school will have 11 neurosurgeons as well as 21 advanced practice providers – which are nurse practitioners and physician assistants – to handle much of the day-to-day duties and allow the residents to focus on training. Problems within the department came to a head in 2018, when the budding brain surgeons sent a letter to the accrediting council complaining of the conditions.

UNM never provided the Journal with a copy of that letter, despite a records request. And a spokeswoman for the accrediting council previously told the Journal the agency keeps most of the information about medical programs confidential and it’s up to the program to disclose why it lost its status.

But documents presented to UNM regents show that the ACGME found the residency program lacked structure, faculty weren’t engaged in teaching and feedback, there were inconsistent evaluations, and residents were being mistreated, including by having to work more than the maximum 80 hours per week, among other problems.

When the ACGME provided UNM with a copy of the residents’ letter in August 2018, Dr. Howard Yonas, the then-chair of the department, agreed to retire at the end of the year. The department was placed on probation and then in August 2019 UNM was told by the ACGME that the department’s accreditation was being taken away in June 2020.

UNM was required to send the residents in the program to other neurosurgery residency programs around the country and continue paying their salaries.

Schmidt said he worked to change the culture within the department by essentially building the department from the ground up. He said there are a handful of physicians in the department who were there when he was hired, but the majority of the team is new.

“You can have a brand new stadium, but if you have the same old team, it will make no difference,” he said.

Some of the ways UNM responded after losing accreditation was to monitor and address duty hour violations, ensure confident evaluations and more supervision. They also hired a wellness director, increased the number of meetings the residents have with their program director and created a system for residents to raise concerns, according to UNM documents.

The school also hired more neurosurgeons with different sub-specialties.

The ACGME’s residency review board is allowing UNM to bring in one new neurosurgeon resident per year for the next seven years until the program is full with seven residents, Schmidt said. The school this week selected its first resident, who will start a seven-year program in June, Schmidt said.

Several of the neurosurgeons who were hired had previously worked with Schmidt.

“The very best neurosurgeons are in academic neurosurgery,” he said. “The learners, they challenge you, you really have to be at the top of the game. We really get the best people in the country to go to neurosurgery. They have the best board scores, the average neurosurgery applicant has 18 publications. When they apply a lot of them have M.D.s and Ph.Ds, and these sort of people are top notch, right? So the teacher really has to be on top of the game.”

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