More than 400 friends and family members recently turned out to watch the Barry University School of Podiatric Medicine Class of 2010 receive their white coats in a ceremony held at the Broad Center for the Performing Arts on the Miami Shores campus.

The Rite of Passage ceremony, narrated by David Auguste, president of the Class of 2011, continues a tradition at Barry University for podiatric medical students. The lab coats presented to the students have been recognized as the attire of the medical profession since the 1800’s. Each student was presented with their coat by Ramjeet Pemsingh, Ph.D., chair of basic medical sciences and John Nelson, D.P.M., associate dean of clinics.

The School of Podiatric Medicine currently has more than 200 podiatric medical students with approximately 200 hospital-based externships, a 36-month podiatric medical and surgical residency training program and more than 1,000 podiatric graduates.



The Medicare program reimburses teaching hospitals for their shares of costs associated with direct graduate medical education (GME) and indirect medical education (IME). Payments for residents are based on formulas incorporating such factors as hospital-specific per resident amounts, resident-to-bed ratios and FTE resident “caps”. Federal rules (1) set the standards under which medical residency programs may be established and reimbursed.

One of the effects of the Balanced Budget Act (BBA) passed by Congress in 1997 was to place some controls on the continuing growth of GME positions. The BBA contained several important changes in the GME funding mechanisms, included a cap on total residents funded by Medicare.

Generally, the regulations limit a residency program to the number of residents that the program had for the most recent cost reporting period ending on or before December 31, 1996. However, federal regulations create an exception to the limit for “a new residency training program,” allowing hospitals that did not have residents in 1996 to start new GME programs, if they meet certain requirements.

CMS Regulations define a “new medical residency training program” as a medical residency that received initial accreditation by the appropriate accrediting body or begins training residents on or after January 1, 1995.” (2) While that definition appears fairly straight forward, the Centers for Medicare and Medicaid Services, (CMS) has begun to apply a more restrictive definition.

A recent case that was decided by a Provider Reimbursement Board dealt with the issue in of a provider’s program qualified as a new program under the federal regulations. (3) The board ruled that the language of the regulation does not support a facility specific-based test. Rather, the regulation is specific to the program, not the facility at which it is located.

Furthermore, Medicare holds that the language of the Rule “does not mean that it is the first time a particular hospital began training residents in a program on or after January 1, 1995, but the program was in existence at another hospital prior to January 1, 1995.” (4) Hence, the deciding factor for determining a “new” program for residency training cap purposes is the program, not the hospital.

Accordingly, if a residency program was in existence and certified by the accreditation body (ACGME or AOA) at another hospital, CMS may consider it to merely be a “relocation” to another facility rather than a “new program”. Since existing training programs that are transferred to non-teaching hospitals are not considered “new” for purposes of establishing resident limits, those seeking to establish new training programs must be careful to ensure that the program is not a replacement for a pre-existing program. In the case where the closing of one residency program coincides with the opening of the new program in the same specialty and in the same or geographic area, CMS may consider factors such as:

  • Relationships and communications between the two hospitals.
  • Transfer of residents, from one program transfer to the other program to complete their training.
  • The number of approved slots for the two programs
  • Whether there is the same:
    • Program director
    • Director of medical education
    • Hospital rotations
    • Nonhospital rotations
    • Didactics
    • Sponsoring institution

This ruling may have broad implications for a hospital looking to start a new residency program in proximate time to the closure of a similar program at another facility. Care must be taken to ensure that there are substantive differences in the programs operation. Otherwise, the program may not qualify as a new program.



Florence Poitier, a Family Finders Specialist with Our Kids of Miami-Dade/Monroe, Inc., a non-profit organization created in response to the need for local control and leadership of the newly-privatized child welfare system in Florida, has been named a Shining Star by Miami Youth SHINE.

Florence became a Family Finders team member in March 2008. She has eight years of experience as a Specialized Therapeutic Foster Parent and two years of experience in case management. She holds a Bachelor of Business Administration Management and a Bachelor of Business Administration Healthcare Management.



Homicide rates have increased in Miami-Dade and Broward Counties since 2004 nearly twice the rate of the national average. For the first time these rates are being examined as more than crime statistics, but statistics that have a significant effect on South Florida’s public health.

With the lives of victims, families and communities drastically altered by these acts of violence, homicide should be considered part of any public health prevention agenda argues Dr. Evelio Velis, associate director for Barry University’s master in health services administration program.

His research is an observational study of homicide victims in Miami-Dade and Broward Counties between 2004 and 2007. Data was obtained from the medical examiner’s office in both counties and was compared to identify associations and differences among selected groups.

His findings are bleak. Although Black Non-Hispanics account for 19 percent of the population in Miami-Dade County, 56 percent of homicide victims are in this ethnic group. The same trend can be seen in Broward County, where 53 percent of homicide victims are Black Non-Hispanics although the group makes up only 23 percent of the population. Likewise, Dr. Velis’ research shows that Hispanics faced a greater risk of being a victim of homicide in 2007 than in 2004 when he began his research.

Most startling, however, is the ages of the victims. In both counties, more than 80 percent of the victims aged between 14 and 17 were killed by gun-related injuries. Almost 90 percent died by this type of injury among victims aged 18 to 24.

According to his research, Velis asserts that a substantial portion of homicide victims are considerably young, with median age decreasing during his research. However, Velis hopes his research will bring attention to this issue across professional lines.

“The active participation of public health professionals should be a constant component in any effort aiming to reduce homicide. Addressing socio-economic factors such as poverty and education must be part of any intervention.”



Under a new articulation agreement with Nova Southeastern University (NSU) pre-med students at Jacksonville University (JU) now have a leg up in the medical school admissions process. The agreement establishes a dual admission 4+4 program for students who want to pursue their undergraduate degree at JU and seamlessly enter NSU’s College of Osteopathic Medicine (COM).

“This strategic relationship with Jacksonville University will help to strengthen the higher education environment throughout our entire state, said Health Professions Division Chancellor, Dr. Fred Lippman. “The agreement will provide Florida students with enhanced access to NSU’s outstanding medical school and be instrumental in producing a number of tomorrow’s compassionate, caring physicians.”

NSU will reserve up to five slots annually for JU graduates who have completed undergraduate degrees and pre-med prerequisites. High school seniors seeking dual admission to the 4+4 program will need to apply to JU, and upon acceptance if eligible, apply and be interviewed at NSU. Upon completion of their bachelor’s degree and meeting the prescribed academic requirements, the students will matriculate into NSU’s medical school.