Reflections on a Crisis in Graduate Medical Education

In June 2019, Hahnemann University Hospital (HUH) in Philadelphia became the largest U.S. teaching hospital to announce its closure and the closure of all of its graduate medical education (GME) programs, which displaced more than 550 residents, fellows, and other trainees. In addition to the displaced trainees, the HUH closure involved many stakeholders at both the closing hospital and hospitals willing to accept transferred residents and fellows-program directors and coordinators, designated institutional officials (DIOs), and hospital executives-as well as the Accreditation Council for Graduate Medical Education, the Centers for Medicare and Medicaid Services, the National Resident Matching Program, and other organizations. Given the rarity of such events, those involved had little experience or expertise in dealing with the closure of so many GME programs at one time. In this Invited Commentary, the DIOs of HUH and 4 other area teaching hospitals detail their experiences working to find new training opportunities for the displaced residents and fellows, discussing lessons learned and providing recommendations to prepare for any future teaching hospital closures. Stakeholder organizations should work together to develop a "playbook" for use during future closures so that the chaos that occurred this time can be avoided.