2022/Jan/29 A Resident Reflects on The Closing of Tufts Children's Hospital

 The Tufts Pediatrics Residency Class of 2021, on their last day of intern year, with Rachel Olfson [author] pictured in center.

A Resident Reflects on The Closing of Tufts Children's Hospital (formerly The Floating)

On January 20th 2022, it was announced that Tufts Children’s Hospital, formerly “The Floating Hospital for Children,” would be closing in July of 2022, after over a hundred years of providing care to our community’s children and families.  The news was shocking and heartbreaking, to myself, my resident physician colleagues, attending physicians, nurses, social workers, as well as child-life specialists; but, moreover, it was devastating to our patients and families who identify this children’s hospital as their medical home.

I am a fourth-year resident physician in the Tufts Triple Board Residency Training Program, which is a combined program in Pediatrics, Adult Psychiatry and Child and Adolescent Psychiatry.  Tufts was the only institution in the state of Massachusetts that offered Triple Board training, and one of only nine total programs nationally.

As someone who trained in pediatrics at Tufts, the sense of community and camaraderie among the pediatric residents is unparalleled. For many young physicians, the transition from fourth-year medical student to intern physician is daunting.  I cannot imagine a more welcoming and supportive environment; the pediatric residents are more than friends, and we refer to ourselves as “the floating family.” Such a reaffirming dynamic engendered resilience, a crucial quality in the context of widespread physician burn-out, depression, and other mental health challenges.  Little did I know, back then, how paramount this community would be with the unforeseen, immense challenges of the Covid-19 pandemic.

Throughout the pandemic I served on the frontlines among the pediatric trainees who were treating infants, children and adults with Covid-19 in intensive care units, medical wards, and the emergency room.  In addition, I served on another frontline--the growing mental health pandemic--caring for and treating children and adults in psychiatric crisis, including suicidal patients.  This is critically important work, as suicide is the second leading cause of death among children and adolescents aged 10-24.

Tufts Children’s Hospital was what is known as a Safety Net Hospital, in which a large proportion of children and families seeking care were underprivileged or came from marginalized backgrounds.  Disadvantaged children are more vulnerable to adverse childhood experiences, and these early experiences harbor the potential to contribute to severe psychiatric illness later in life.  To meet the complex needs of such children, Tufts created interdisciplinary teams and training programs like the Triple Board Residency to provide compassionate and personalized care for children in psychiatric crisis.  We recognized the need for training pediatricians to work collaboratively while managing children’s emotional and behavioral health.

By closing Tufts Children’s Hospital, despite our program's interviewing hundreds of applicants, we will not match a new class of resident physicians in Pediatrics or the Triple Board Program.  Thus, our community will be losing twelve pediatricians and two child psychiatrists. These may seem like relatively small numbers but in the state of Massachusetts, there are only an estimated 35 child psychiatrists per 100,000 children.  The loss of these programs is a blow to not just to our Tufts community, but to the many communities served by our trainees when they graduate and establish practices outside of major teaching centers.

I am grateful for having the opportunity to train at such a storied, and compassionate children’s hospital. This experience will forever inform the care I deliver to children and families. I hope that the larger communities of Boston, and the state of Massachusetts, will step up and do more to invest in the physical and mental health of our children, in the wake of this loss.

Rachel Olfson, MD
Tufts Triple Board Resident, PGY4
Pediatrics/Adult Psychiatry/Child and Adolescent Psychiatry