Controversies in Academic Emergency Medicine: For-Profit Associated Residency Programs

There has been rapid growth in the number of emergency medicine residency positions over the past decade, which includes growth sponsored by more traditional academic health systems as well as that sponsored by faculty groups employed by contract management entities and for-profit hospitals. This latter development has been accompanied by increased scrutiny, particularly in light of prior concerns regarding an emergency physician workforce surplus. However, there has been little cross-institutional dialogue to understand how such programs are structured, and to objectively examine the relative benefits and challenges to training residents in these environments. Accordingly, this interactive didactic aims to foster this dialogue, summarize central critiques and present data and insights on key outcomes, and including the academic experience within such programs.

Presenters:

  • Martin P. Wegman, MD, PhD
  • Jennifer Chapman, MD, MBA
  • Jason An, MD, FACEP
  • Alfredo Tirado, MD
  • Christine Miyake, MD
  • Steven Nazario, MD, FAAEM, FACEP
  • William Angelo Kantrales, DO
Authors

  • Martin Wegman, MD, PhD

    Research Director

    HCA Florida Orange Park Hospital

    Martin Wegman, MD, PhD is a practicing emergency physician, population-health scientist, and research director at HCA FL Orange Park Hospital. He is also the inaugural Senior Research Fellow at the American College of Emergency Physicians where he provides strategic direction for the College's research portfolio, including the annual research conference, research training course and research networks. In these roles, he serves as principal investigator on multiple funded projects. 

    He completed his MD-PhD training program at the University of Florida, with graduate work in epidemiology and healthcare policy. He then completed a post-graduate clinical research fellowship at Yale School of Medicine and his emergency medicine residency training at Yale and the University of North Carolina. He has been published in Lancet Global Health, JAMA, Health Affairs, and Medical Care, and funded by the NIH, FDA, Doris Duke Foundation, and the AMA - with awards totaling in excess of $1M. He has expertise in research methodology, including quasi-experimental design and experience in analyzing large healthcare datasets to inform healthcare practice and policy.

  • Jennifer Chapman, MD, MBA

    Orange Park Medical Center

    My name is Jennifer Chapman MD, MBA and my current professional roles include Program Director of HCA Florida- Orange Park Emergency Medicine Residency Program, Vice-Chairman Department of Emergency Medicine and Assistant Facilty Medical Director of Emergency Department. I attended University of Rochester School of Medicine before completing EM residency at Kings County/SUNY Downstate in Brooklyn. Upon finishing residency, I enjoyed working at Lahey Hospital in Burlington MA, working with Boston Medical College EM residents before moving down to sunny Florida. My family and I enjoy the benefits of living in the Jacksonville area. We are avid football fans and I was thrilled to take on the role of Airway Management Physician for the Jacksonville Jaguars, a position that I share with two of my EM colleagues.

  • Jason An, MD, FACEP

    Riverside Community Hospital

    My name is Jason An and I currently serve as the Designated Institutional Official and Emergency Medicine Program Director at Riverside Community Hospital in California. I am proud to be a part of a department that won the ACEP EM Wellness Center of Excellence award in 2022. My areas of interest in EM include medical education, ED procedures, mentoring, and physician well-being.

  • Alfredo Tirado, MD

    Program Director, Associate Professor Emergency Medicine Residency

    HCA FL Healthcare/USF Morsani College of Medicine GME: Oak Hill Hospital Program

    Original from Puerto Rico, he finished his Medical School and Emergency Medicine Residency Program in the University of Puerto Rico, where he served as Academic Chief Resident on his Senior year. After completion of his Emergency Medicine Residency Program, he went to Providence, Rhode Island, and finished an Emergency Ultrasound Fellowship with the University Emergency Foundation associated with The Warren Alpert Medical School of Brown University. He originally started his career as Ultrasound Director for FL Hospital (current Advent Health) EM Residency Program from its inception in 2007 and practice there until 2018. Within this time he helped implement a robust Ultrasound Curriculum for Residents and Faculty, as well as a Credentialing Process. He also founded the FL Hospital (Advent Health) Ultrasound Fellowship and was Fellowship Director from 2013-2018. From 2009-2018, Dr. Tirado, served as Associate Professor for the College of Medicine of the University of Central Florida, where he helped develop and implement an Ultrasound curriculum for Medical Students for all four years of education. In 2018, he was offered the opportunity, to once again help start a New EM Residency program, with HCA Healthcare sponsored by USF Morsani College of Medicine, and he currently serves as Program Director for this program. He has been appointed Associate Professor for the College of Medicine HCA Healthcare/ USF Morsani College of Medicine GME for which he practices.

    Dr. Tirado, has presented in the Society for Academic Emergency Medicine (SAEM), American College of Emergency Physicians Scientific Assembly (ACEP), American Academy of Emergency Medicine (AAEM) and the World Congress on Ultrasound in Emergency Medicine and Critical Care. He has also contributed to the specialty with research on Bedside Ultrasound for the Non-Invasive Estimation of Central Venous Pressure in Critically Ill Adult ED Patients, as well as has a passion for ultrasound procedures in emergency medicine and Ultrasound Management. Dr. Tirado is also an active member at AIUM, AAEM, SAEM and ACEP, where he has served in different Committees at the Ultrasound Section such as the EUS reporting guidelines and former Committee Chair and Course Director for the Emergency Ultrasound Management Course (EUMC).

  • Christine Miyake, MD

    Valley Health System

    Dr Miyake is a board certified emergency physician currently practicing in Las Vegas NV. She attended medical school at the University of Nevada School of Medicine and completed her emergency medicine residency in 2007 at the University of Rochester. She has 15 + years of experience and has worked at multiple academic centers across the country. She has been actively involved in sepsis quality initiatives throughout her career. Dr. Miyake is program director for the Valley Health System emergency medicine residency program in Las Vegas. In addition Dr. Miyake is currently medical director for short stay reviews for Livanta LLC. She enjoys crafting, reading and spending time with family.

  • Steven Nazario, MD

    Program Director Emergency Medicine Residency

    AdventHealth East Orlando

    Born and raised in Brooklyn, NY he obtained his medical degree from Downstate Medical Center. Having completed his residency in Emergency Medicine at Jacobi-Montefiore in 1997 he stayed on as faculty until 2003. Dr. Nazario then moved to Orlando, Florida and was as a founding member of the EM residency at AdventHealth (formerly Florida Hospital). In the fall of 2019 he became the Program Director after serving as its Associate PD for twelve years. Dr. Nazario serves as an Oral Board examiner for the American Board of Emergency Medicine and as a member of his hospital system’s ethics committee.

  • William A. Kantrales, DO

    HCA Florida Orange Park Hospital

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