The Yale-Affiliated Gastroenterology Program: 1965-1995. A community-university model of collaboration

The Yale-Affiliated Gastroenterology Program (YAGP) originated in 1965 from the informal arrangements of two gastroenterologists, one university based and the other in a community hospital. Conceived at a time when there was little central authority, either on a national or on a hospital/medical school level, its links were forged by the personal relationships of its directors. The process of growth remained informal and flexible enough for the directors to meet the special requirements of their own community and hospital. YAGP provided an important model for improving medical care and education in community hospitals since it addressed personnel needs, contributed to the education of physicians, and fostered clinical research in digestive diseases. YAGP evolved its own standards and its own accreditation mechanism, but faltered when the Accreditation Committee on Graduate Medical Education provided national rather than local criteria. Increased controls by hospitals and medical schools led to more formal ties and programs, and YAGP ceased to matter. Still, there may be lessons from what was in its time an innovation, on a local and state level rather than on a national level.