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SLU medical school gets $6.6 million to boost primary care training

A view of Saint Louis University Hospital, taken 02/23/15.
Durrie Bouscaren | St. Louis Public Radio
A view of St. Louis University Hospital.

Citing the projected demand for primary care physicians in underserved areas, a California-based foundation is donating $6.6 million to Saint Louis University’s School of Medicine.

The donor, the Everest Foundation, is the charity arm of a Los Angeles-based consulting firm for medical students called Residents Medical Group. Over a 10-year period, the gift will fund a visiting research fellowship program, five residency positions and a scholarship for family physicians returning to pursue a master’s degree. Of the seven positions filled annually, the donor would select the candidates for one of them. 

The visiting fellowship program is designed to help medical school graduates develop skills to be better prepared for acceptance into the residency program he or she wants. Saint Louis University will select the fellows from a pool of candidates provided by the Everest Foundation, according to SLU spokesperson Nancy Solomon. The fellowship winners will then be paired with specific research projects, Solomon said in an e-mail.

“Saint Louis University carefully researches the foundations with which we have relationships,” Solomon wrote in an emailed statement Monday morning. “As with all of our graduate medical education programs, candidates for positions made possible because of the grant are evaluated on the basis of their own merits.”

Read SLU’s full statement here.

Consulting firms for medical students hoping to increase their chances of finding a position after graduation are not unheard of; nor are consultants who establish charitable foundations. But the donor’s influence over the candidate choices is unusual.

“It is rather uncommon. Pretty rare, actually,” said Michael Nilsen, a spokesperson for the Association of Fundraising Professionals. The level of donor influence that’s acceptable is often a gray area for nonprofits, Nilsen said, and he often counsels them against accepting gifts that come with too many strings.

“Organizations need a strong and thorough gift acceptance policy,” Nilsen said.

In addition to the visiting research fellowship, the gift will fund five new residency positions for medical graduates. Residencies are intensive, post-graduate training required for new doctors that last three years or more, and are chosen through the National Resident Matching Program. Often funded by hospitals or through the federal government, the number of available residency positions has not grown in step with the increasing amounts of students graduating from medical school. 

Dr. David Schneider, the chair of Saint Louis University’s Department of Family and Community Medicine, said these new positions will expand SLU’s program training new doctors to care for the underserved by about 50 percent.

“Countries with well-developed primary care health-care programs provide a much higher quality of care at a much lower cost,” Schneider said. “If we in the United States are going to get a handle on health-care costs skyrocketing, it’s going to be through strengthening our primary-care delivery programs.”

Of the five positions, two residents would complete three-year family medicine residencies through SLU. Another three would be one-year preliminary residencies focusing on internal medicine.

The third part of the gift, the new Everest Fellowship, would pay for family physicians to pursue a master’s degree in public health. Schneider said the fellows will conduct research to find out how primary care can be delivered more effectively — a field often overlooked in favor of flashier, more specialized research.

“Much of what we research in primary care is how to prevent disease in the first place. (What this will fund is) the type of research we need to be able to show how to provide primary care in the best way possible for our patients,” Schneider said. 

Schneider said the first fellow, a SLU resident currently working at St. Elizabeth’s Hospital in Belleville, will start this July.

What is the Everest Foundation?

Scant information about the Everest Foundation is available online. Everest Foundation spokesperson Greg Heffernan said it was established by family members of the late Edwin Everest, a doctor and humanitarian who died in 2008. His wife, Bimla Everest, is identified as CEO on tax documents.

According to its website, the Everest Foundation donates to "medical institutions, hospitals, and residency programs to build expansive research programs and sustainability." Donations in 2013 went to the University of Southern California, Children’s Hospital Los Angeles and San Joaquin General Hospital in French Camp, Calif.

Residents Medical Group is listed as the Everest Foundation’s only contributor on its most recent IRS filing; the company transferred $251,558 to Everest in 2013. The firm offers help to medical students, often from foreign countries, to prepare their residency applications.

In 2010, a member of the Everest family pled guilty to forging documents and offering bribes to a New York-based hospital, with the intention of placing prospective medical residents who had paid his consulting service $100,000 or more, according to the Manhattan district attorney’s office.  That company is no longer in operation, and Everest Foundation spokesperson Greg Heffernan says the individual is not affiliated with the foundation or Residents Medical Group. 

The dawn of med-school consulting services

Though enrollment numbers for American medical schools have increased in recent years, the number of available residency positions has not grown in step with demand. That means more graduates, laden with student debt and high anxiety, are competing for the same number of jobs.  

The competition for residencies is fueling the growth of firms that specialize in helping medical students find a residency match, similar to college application counselors or tutors for graduate school entrance exams.

“We’re getting to a point here in the near future where we may have some very talented medical school graduates come out of medical school but not find positions in a residency,” said Dr. Samir Desai, a professor at the Baylor College of Medicine.

Realizing his students weren’t always getting the level of mentoring and advise they sought from faculty members, Desai began writing books about how to apply for a residency. He established a consulting firm of his own called MD2B in 2003.

Desai said the quality and price to hire consultants can vary considerably, and a student’s ability to vet a potential consultant may be limited. Desai said, “There are some very strong promises that are made. You have to be very, very careful.”