In what amounts to a temporary and limited reprieve, the state of Michigan has agreed to restore some of the funding it cut from the training budgets of psychiatry residency programs at Michigan State University (MSU) in Lansing and Wayne State University (WSU) in Detroit. The partial restoration of funds should at least allow current residents to finish their training.
The fix is temporary, however, and significant barriers lie ahead for the two programs as Michigan, like most states, struggles with an unprecedented budget crisis.
“We were able to get about $300,000 restored to the budget for this fiscal year—but it’s a one-shot deal,” Christopher Colenda III, M.D., M.P.H., chair of psychiatry at MSU, told Psychiatric News.
The restored funding amounts to about 56 percent of the $535,000 of state funds cut from the department’s training budget in December after an executive order from Michigan Gov. John Engler required across-the-board reductions in state spending (Psychiatric News, December 21, 2001).
The actual funding lost amounted to twice the dollar figures cut in the state’s budget crisis because the state’s funding for the two residency programs was matched nearly dollar for dollar by the federal government. As such, the total decrease at MSU amounted to more than $1 million. The cuts amounted to about half of each department’s training budgets.
The WSU program stands to get back around $1.6 million in state funds of the total of $3.1 million it originally lost, according to Manual Tancer, M.D., interim chair of psychiatry at WSU. However, Tancer told Psychiatric News, at press time WSU had only a verbal agreement with the state for the partial restoration of funding. No formal agreement had been confirmed, and no funds had actually been restored.
The cuts resulted in drastic consequences for both programs. At WSU faculty were cut, and the number of resident positions offered in this year’s match cycle were reduced. In addition, previously funded positions for residents who were already in the program but transferred out were eliminated instead of finding replacement matches.
At MSU, Colenda fought fiercely to preserve the number of slots the program could offer in the spring match cycle. To do so, he had to reduce faculty, raid departmental reserves, and threaten to operate the program at a budgetary loss.
But through strong collaboration between the two programs, faculty, patient advocates, and mental health advocates coordinated through the Michigan State Psychiatric Society convinced state lawmakers to restore the partial funding. For Colenda, the collaboration was especially surprising and rewarding. He told Psychiatric News that a large number of each department’s faculty had never spoken to any of their counterparts in the other program.
“Each of the programs,” Colenda said, “historically has been in its own world, and I have appreciated the opportunity to meet colleagues and work with them.”
The programs, he added, are now exploring ways to reduce expenditures by looking at opportunities for shared didactic experiences and shared clinical rotations. He noted that the two programs are geographically far apart, so such shared solutions could prove challenging.
“We’re not out of the woods yet,” Colenda stressed, “but clearly we think that the process is working on the political side of the ledger as well as working to figure out common strategies for common approaches to training.” ▪