title: The effect of a teaching hospital's financial crisis and reorganization on a group of residents.
abstract: OBJECTIVE
  Allegheny General Hospital (AGH) in Pittsburgh, Pennsylvania, was part of a statewide health care system that underwent a financial crisis and operational reorganization between 1998 and 2000. This study assessed internal medicine (IM) residents' perceptions of the effects of AGH's financial crisis on their residencies
  
  
  METHODS
  A confidential, program-based questionnaire was distributed to 75 IM residents at AGH in spring 2000 and included questions on demographic information, inpatient and outpatient medical education, and the hospital's financial crisis. Residents were asked to assess the effects of the financial crisis on their residencies, personal experiences, and attitudes toward health care systems. Outcomes included consideration of transfer, recommendation of the program to a medical student, concerns about fellowship opportunities, opinions about large health care systems, and medicine as a career recommendation.
  
  
  RESULTS
  A total of 71 residents (95%) responded to the questionnaire. Fifty-five (79%) had experienced effects on their residencies due to the financial crisis, but perceptions differed widely. Eighteen (25%) considered transferring from the program, but 44 of 59 (75%) would have recommended the program to a medical student. Because of the financial crisis, respondents reported significant changes in concerns about fellowship opportunities (p <.001), opinions about large health care systems (p <.001), and opinions about recommending medicine as a career (p <.001).
  
  
  CONCLUSIONS
  This study highlights the fact that residents serve as program ambassadors and their experiences may influence recruitment and retention. Thus, programs should consider ways to assess and address residents' concerns during any system crisis or reorganization.
authors.affiliation: Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212-4772, USA. skiely@upahs.org
authors.forename: Sharon C
authors.initials: SC
authors.lastname: Kiely
authors.forename: Kelly Sipe
authors.initials: KS
authors.lastname: Russo
authors.forename: E John
authors.initials: EJ
authors.lastname: Orav
authors.forename: Kelly
authors.initials: K
authors.lastname: McMahon
authors.forename: Richard P
authors.initials: RP
authors.lastname: Shannon
authors.forename: Walter J
authors.initials: WJ
authors.lastname: O'Donnell
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D006784:Hospitals, Teaching / Q000191:economics*; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000191:economics / Q000458:organization & administration*; D008297:Male; D010414:Pennsylvania; D011795:Surveys and Questionnaires