After six weeks of tense negotiations, a health system that planned to shutter its emergency medicine (EM) residency program came to an agreement with the local county hospital district to keep the program open.

In Corpus Christi, Texas, the Nueces County Hospital District (NCHD) Board of Managers unanimously voted on December 12 its final approval of an agreement to keep the EM residency program at Christus Spohn open for the next six years. The EM Residency Program is actively recruiting 12 residents for the 2024 Match.

On October 13, the Christus Spohn hospital system, part of the larger multi-state Christus Health system, announced plans to gradually phase out its 36-member EM residency program, launched in 2007 in partnership with Texas A&M University, by 2026—when the last group of currently enrolled residents graduates. But public outcry against the move led to local government hearings and meetings with the NCHD, which authorized negotiations with Christus Spohn aimed at saving the program. NCHD is a county government entity whose mission is to arrange for indigent health care services for county residents.

On Nov. 8, local television station KRIS 6 reported a tentative agreement with the hospital to preserve the program, based on additional financial support from NCHD in the amounts of $1.4 million for 2024, $2.8 million for 2025, and then $4.25 million annually thereafter. NCHD already pays the hospital to provide indigent medical care to local residents through its Nueces Aid program.

But the NCHD voted not to give final approval to the proposed solution in a meeting on Nov. 14. KRIS 6 reported that doctors testifying at the meeting said the tentative agreement “isn’t enough.” Emergency physician John Herrick, DO, FACEP, the residency program’s associate program director, said the residency “needs to be transitioned to a program that does want us.” After hearing this testimony, the NCHD instructed its director to continue working on the plan.

J.D. Cambron, DO, an associate director of the Texas A&M-Spohn residency program, and a graduate of the program, told ACEP Now by phone from outside the board’s meeting room that it is obvious that the NCHD and the community have the residency program’s survival in mind. “This is a strong program with a cohesive vision to provide great care. I am hopeful that a long-term solution can come to life,” he said.

Why Was it Being Closed?

Christus Spohn has stated that the hospital’s emergency services would remain intact at all of its local hospitals. “It will not impact patient care at all,” said hospital CEO Dominic Dominquez. But as the residency program’s future was placed in doubt, numerous questions were raised in the local community about the potential impact on the hospital, the physicians, and the community itself.