Dear Howard University Community,
I have recently received several questions from our constituents, students, residents, alumni and community leaders regarding a follow-up to the East End Hospital bill that was passed in December 2018 by the City Council that charged Mayor Muriel Bowser with finding a way to include Howard University College of Medicine (COM) in continuing its academic mission of training medical students and residents by way of an academic affiliation agreement. Outlined below are questions I have received and corresponding answers.
Q: What is Howard University seeking from the Universal Health System/GW deal being negotiated by the City?
A: Howard University seeks to ensure that it can continue to pursue its academic mission for training medical students and residents by guaranteed access to the new East End hospital. This access would be described in an Academic Affiliation Agreement that would allow the students and residents to be trained in multiple specialties to satisfy the requirements of the regulatory organizations. These specialties would be managed by Howard University COM faculty.
Q: What is an Academic Affiliation Agreement and why is it needed?
A: An Academic Affiliation Agreement (AAA) is a contract between the operators of a hospital and the Howard University COM. An AAA would include components that:
- Ensure the educational requirements of the residents are met regarding their governing bodies (ACGME);
- Ensure a shared governance structure that outlines an agreed upon number of residents in advance, and requires that the agreed upon number be developed by an agreement of both parties;
- Include duration and renewal terms for the AAA; and
- Further address the number of Howard faculty who would have responsibility of training and teaching the Howard University residents.
Q: What medical specialties is Howard University COM seeking to participate in at the East End Hospital?
A: To meet the projected educational requirements we are seeking participation in Internal Medicine and related subspecialties, including Surgery, ObGyn, Psychiatry, Family Medicine, Orthopedic surgery, Ophthalmology, Dermatology, Oral and Maxillofacial Surgery.
Q: Approximately how many of Howard University COM residents would need to be accommodated at the new East End Hospital?
A: To meet the needs for training as well as duty hours, it is anticipated that 50 residents would be assigned on a rotating basis.
Q: Can the new East End Hospital accommodate both Howard residents and George Washington University (GW) residents at the same time?
A: Yes, definitely. It is anticipated that the new East End Hospital will service 150–200 patient beds. For decades, Howard University COM has accommodated the training of 188 residents at the Howard University Hospital using 134–150 patient beds. Howard has 11 medical and surgical specialties, and six medical subspecialties for resident training. We believe there are more than enough beds in the new East End Hospital to accommodate Howard COM’s request.
Notably, the East End bill as passed allows an additional 171 patient beds to be constructed at the GW University Hospital site. In fact, the GW University will have over 300 additional patient beds in which to train residents. The thought that Howard University COM residents could not be accommodated at the new East End Hospital while GW has essentially two new hospitals for their training seem to not be logical.
Q: Will Howard University COM doctors cost the East End Hospital more by practicing there?
A: The Howard University COM faculty doctors will admit patients to the new East End Hospital and will bill insurance companies for the service provided to patients. The doctors are not seeking separate compensation from the operators of the hospital nor the city for patient services. By admitting patients and performing surgeries at the new East End Hospital, Howard University COM doctors will be working with the hospital operators to bring multiple services directly to the southeast DC community closer to the places where they live and work.
Q: Will Howard University Hospital be closing?
A: Howard University Hospital currently serves the training needs of the medical students and residents. The request to accommodate training at the new East End Hospital only covers approximately 25 percent of the COM residents. Howard will still need to accommodate the remaining trainees.
Q: Where is Howard in the negotiation with the City Council?
A: Howard has had one face-to-face meeting with the Mayor’s office. It was positive, and we await further discussions. It is not lost on us; however, that this matter is time-sensitive, and that the Mayor has already presented a budget in this regard. Additionally, other City Council meetings will occur before we have another formal meeting. This is based on the outline from the Mayor’s office testimony to the Council.
While there are many more questions that still need to be addressed, this update represents the latest status and current framework for discussion with the DC government.
I would take the opportunity to again thank the DC community, council members, alumni and others who have stood in support of the mission of Howard University COM and its role in providing the much-needed supply of black physicians across the nation. The future landscape for training minority physicians is becoming more challenging, especially as the number of medical schools grow, and existing medical schools expand their numbers. It has become more difficult for minority physicians to secure opportunities and places to train. It is also of critical concern that we are still experiencing a decline in the number of black males who are entering medical school.
We are committed to keeping everyone informed of the developments in our negotiations with the DC Government. We are hopeful of a successful outcome while remaining very vigilant of the many moving parts involved in this complex process.
In Truth and Service,
Hugh E. Mighty MD, MBA
Dean, College of Medicine and
Vice President of Clinical Affairs
Howard University College of Medicine