Orphaned Trainees: A Vulnerable Population in an Inequitable System

Two years ago, Hahnemann University Hospital (HUH) closed, orphaning the largest group of trainees in the history of graduate medical education (GME). Last month, the plastic surgery community learned of the forthcoming closure of two plastic surgical residencies (2.4% of all integrated plastic surgery residencies), while most programs were in the final stages of planning the 2021-2022 academic year. Recounting the turmoil experienced by orphaned HUH trainees and their families, left alone to relocate amidst funding-related legal battles, one cannot help but wonder, how could this happen again? Trainees deserve transparency, funding protection and support when training programs close or lose accreditation. Moreover, applicants deserve to know if a program is on the brink of collapse before they sign their rank list. Applicants and trainees deserve to have their funding protected in the event of a program closure, so their ability to relocate is not held hostage by a sponsoring institution. Trainees deserve to be supported by a central organization that is responsible their relocation in the event of an orphanage. These changes are overdue and their absence has already resulted in academic and emotional adversities for trainees and their families.