S.J. General surgery residency on probation

FRENCH CAMP — Recently heralded as among the top medical residency training centers for aspiring surgeons, the surgery residency program at San Joaquin General Hospital was placed on probation last month by its national accreditation organization.

As a result, three medical residents have decided to resign and have made arrangements to continue their surgical training in other programs.

A letter sent to The Record outlining the residents’ concerns stated: “The quality of our training and our surgical career as safe, well trained surgeons has been severely damaged. ... The responsibility for the disruption of our training is lost. Faculty, program director, hospital managers are all blaming one another for the downturn of our program from top to bottom. We are just the victims.”

The letter was signed “Surgery residents in San Joaquin county hospital — Names cannot be signed for fear of retaliation.”

Hospital CEO David Culberson said San Joaquin General “is taking this very, very seriously” while noting that the problems cited by the accrediting agency that got the training program into trouble will not be difficult to fix.

In a letter dated May 13 addressed to the surgery residents and incoming interns, program director Dr. Nathaniel Matolo — brought in to lead the program Oct. 1 after serving as its director more than a decade earlier — shared eight areas not in substantial compliance with requirements established by the Accreditation Council for Graduate Medical Education.

Those areas were cited as the basis for the adverse action. They primarily deal with the administration, curriculum and supervision of the program and the ability of the program director to “maintain an education environment conducive to educating the residents in each of the ACGME competency areas,” Matolo wrote.

None of the citations involve the work of the residents, their interactions with patients or the quality of their surgical practices.

Matolo told the residents that the citations are correctable.

“Some of them have already been corrected. We will work diligently to correct the rest of the deficiencies in the near future,” he stated.

Culberson agreed, noting that despite the resignations of the three residents effective July 1, their slots have already been filled by transfers from other surgery residency programs, maintaining the San Joaquin General program at 15 residents.

As far as patients are concerned, Culberson said the current status of the residency program should have “no impact on hospital operations,” either with the trauma program staffed by four double-board-certified surgeons in critical care and general surgery, or the general surgery needs of the hospital.

Both the Accreditation Council for Graduate Medical Education and the Association of American Medical Colleges declined comment for this story, citing similar policies that they do not discuss accreditation issues specific to one training program.

Culberson said that the overall quality of the surgery residency program can be restored and maintained, noting that two of this year’s three surgeons graduating in July have already been accepted into prestigious fellowship programs.

He also noted that the program will have a full-time director on board by June 1.