For nearly 40 years, future pediatricians from the University of South Florida's College of Medicine have done their on-the-job training — or residencies — at All Children's Hospital in St. Petersburg.
But that relationship faces an uncertain future with the arrival of Baltimore-based Johns Hopkins Medicine, which earlier this month formally joined forces with the 84-year-old pediatric hospital.
Hopkins officials want to turn All Children's into an academic and research powerhouse, and they're envisioning a new type of residency program as one way to help them get there.
USF's residency program at All Children's, meanwhile, is scheduled to end in 2014, which hospital officials say will allow the group of residents arriving this July to finish their three years of training without interruption.
Dr. Charles Paidas, USF's associate dean for graduate medical education, would like to see the program continue, and Hopkins and All Children's officials say they're not ruling out the possibility. A meeting of the parties is scheduled this month "to talk about ways to extend it beyond 2014," said Gary Carnes, All Children's president and chief executive.
One thing is clear: The loss of the program would leave USF without a primary pediatric training site, which over the years has groomed hundreds of pediatricians, many of whom have remained in the area to practice.
"I think that the USF training program would suffer" without All Children's, said Dr. Juan Dumois, who did his residency at the hospital from 1987 to 1990 and now runs All Children's pediatric infectious disease program. "There's just so much learning that they can do here."
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At any given time, USF has about 50 physician residents at All Children's. Residents rotate through a variety of areas within the hospital under the guidance of physicians and participate in daily discussions and lectures.
The 50 slots represent a small fraction of the USF College of Medicine's 700 physician residency positions spread around area hospitals. But they account for the large majority of its pediatric positions.
Paidas described the pediatric residency program at All Children's as superb, and one that has benefited the community in several ways.
Dumois says having a residency program raises the bar at a hospital. "It forces us to really stay up on our game," he said. "Because the attending physicians who are primarily responsible for caring for these patients also have responsibility of teaching the trainees."
As a result, he said, the care patients receive at teaching hospitals is often better.
Paidas said the community also benefits from having physician residency programs at local hospitals because most doctors tend to stay in the areas where they do their residencies.
"Contrary to what people might think, it's not where you go to medical school. It's where you did your residency that will determine where your job is," Paidas said.
That's especially true at USF, where nearly 68 percent of its medical residents have stayed in Florida to practice, Paidas said. The state average is 57.5 percent.
Though hopeful that USF will be able to stay at All Children's, Paidas said the medical school would have to look elsewhere if the pediatric program isn't extended. One possibility would be Tampa General, which houses the bulk of USF's residency slots, but only a few in pediatrics.
Hopkins officials, meanwhile, are in the early stages of designing their own residency program at All Children's. Heading that charge is Dr. Jonathan Ellen, who oversaw residency programs at Hopkins' Bayview Medical Center in Baltimore, and is now physician-in-chief at All Children's.
Ellen said he envisions a residency program that complements a new medical school curriculum recently adopted at Hopkins. The curriculum, called Genes to Society, is the first academic overhaul at the Hopkins medical school in 20 years.
Ellen said the new curriculum will, among other things, help tomorrow's doctors better understand and treat chronic illnesses such as diabetes and asthma, which have skyrocketed over the years.
Asked if he envisions Hopkins' medical students one day doing their pediatric residencies at All Children's, he replied: "That would be wonderful."
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Carnes said Friday that one possibility would be to have two distinct residency programs at All Children's. "It won't be a melded program," he said, explaining that accrediting issues likely would stand in the way of trying to merge the programs.
Such a move would not be unprecedented. Hopkins' other teaching hospitals in Baltimore have affiliations with both the Hopkins medical school and the University of Maryland School of Medicine.
One thing that may work in USF's favor is Paidas, who has a long association with Hopkins, dating back to 1987. He did research and a pediatric surgery fellowship there, and also served on its faculty from 1991 to 2004, when he left to join USF.
Paidas even co-authored a book, The Golden Hour, with Dr. David Nichols, the man who led the curriculum overhaul at Hopkins.
Paidas met with Hopkins and All Children's officials in January, when the parties agreed to extend the USF residency program through 2014.
"This process has been of the utmost professionalism," he said. "And there's no question that we welcome future discussions."
Richard Martin can be reached at firstname.lastname@example.org or (727) 893-8330.