Two hundred and thirty physicians began a new chapter in their lives this month. Most hail from medical schools in 37 states, including Washington, D.C. and Puerto Rico, and 24 come from more distant lands as foreign medical graduates. And they all have one thing in common: they have chosen OHSU as the place where they will receive their graduate residency training, and, in turn, provide essential clinical care to patients in the community.

“Program quality and location were the deciding factors in choosing my surgical residency,” said Justin Meunier, MD, a general surgery intern from Louisiana. “The surgery program at OHSU has a strong reputation that we all know about in my home state. The surgery department embodies a team attitude, and I wanted to be a part of a program with those qualities.”

But for the residents themselves, this time of year is more significant than simply starting a new job.

“The process of beginning a residency program is variably exciting, exhilarating and terrifying,” said Donald Girard, MD, Associate Dean, Graduate Medical Education. “But if there’s one word that sums up why residents are here, it’s ‘education.’”

Primary care specialties – those in internal medicine, family medicine and pediatrics – are extremely competitive and make up the largest group of this year’s incoming physicians, with 98 residents. OHSU’s primary care education program was ranked third in the country this year by U.S. News & World Report.

“Federal health care reform and an aging population underscore the need for primary care physicians in our country,” said Dean Mark Richardson. “OHSU continues to attract residents who want to be part of our efforts to find solutions to health care workforce shortages.”

“I came to OHSU for the first time in September 2009 for a visiting rotation. I learned that the OHSU environment is supportive, places a strong emphasis on teaching, and has a great reputation for clinical care and research,” said Divya Gollapudi, MD, an internal medicine resident. “A few months later, during my residency interview season, I kept reflecting on my great experience and felt that it couldn't be matched by any other institution.”

Out-of-state residents are an important pipeline for Oregon’s physician workforce. Many of these residents – drawn here by the quality of the programs – will stay in Oregon to practice. And the likelihood that the 33 incoming residents who graduated from the OHSU School of Medicine will remain in Oregon to practice is also high. OHSU’s GME program ranks 10th in the nation for in-state retention of residents – more than half of the physicians completing their residencies at OHSU remain in Oregon to practice. One-third of all Oregon licensed physicians, in fact, completed all or part of their education at OHSU.

Pictured: Dr. Mario Villalba, a School of Medicine House Officer in the Department of Surgery, attends a recent orientation session.

Focus on quality Part 1: New interns attend neurosurgery “bootcamp”

OHSU’s Department of Neurological Surgery conducted a two-day training course for 30 western regional PGY1 residents July 9 and 10. Dubbed a fundamental skills “bootcamp,” the training course is part of a nationwide effort by the Society of Neurological Surgeons (SNS) to provide basic clinical, professionalism and communication skills development for PGY1 residents.

Nathan Selden, MD, PhD, Campagna Professor and Residency Program Director, Department of Neurological Surgery, guided the national implementation of the program as Chair of the Bootcamps Subcommittee for SNS. “The bootcamp courses were designed by senior neurosurgical educators committed to patient safety and professionalism,” said Dr. Selden. “We focus on competency-based topics, interactive learning and simulation during the training, and our goal is for continuous evaluation and improvement.”

From medical knowledge to professionalism, patient care to interpersonal skills, the bootcamp touches on all facets of a junior intern’s experience. Day one of the training course is structured in a traditional lecture format, while day two puts participants in operating rooms, recreating bedside neurosurgical procedures.

Six courses took place in regional centers nationwide during the month of July to maximize neurosurgical intern participation. Over 90 percent of incoming PGY1 residents from ACGME accredited programs participated in the inaugural 2010 courses. OHSU’s two neurological surgery residents were joined by 28 colleagues for the Portland training; 13 faculty from OHSU, the University of Washington, UCLA, UCSD, UCSF and UC Davis led the course.

Pictured: Dr. Nathan Selden provides hands-on guidance to PGY1 residents during a neurosurgery “bootcamp.”

Focus on quality Part 2: Starting on day one in Emergency Medicine

Before they even arrive on campus, incoming residents in the Department of Emergency Medicine receive a letter from Professor and Chair O. John Ma, MD. The letter articulates the department’s emphasis on a “culture of always” and is part of a long list of service excellence initiatives implemented since Dr. Ma’s arrival in 2007.

“I promise that our department will always do whatever is necessary to provide you with a first-rate medical training and that you will graduate with all the necessary skills to practice as an outstanding emergency physician,” writes Dr. Ma in the letter to residents. “The patient always comes first in the OHSU emergency department. Providing high quality and safe patient care is always our number one priority.”

The impact of the letter goes beyond OHSU; academic health centers from around the country have requested copies for implementation in their resident orientation.

The department’s culture of quality is thoroughly instilled in a resident’s educational experience. Residents participate on the ED Service Excellence Committee and are encouraged to follow AIDET principles, which emphasize heightened communication with patients. In fact, each resident shadows one patient throughout the course of their ED visit – from waiting room to discharge – in order to experience an ED stay from the perspective of a patient.