Ask any rural surgeon: practicing in rural Oregon requires a different set of skills than most surgeons receive during their training at urban academic health centers. In a rural practice, cases vary from the mundane to the radically offbeat; available technology may be decades behind what new surgeons experienced at medical school; and, the dearth of specialists in a given area means that a rural surgeon must have a wide array of skills at hand.
For the past eight years, the School of Medicine’s Department of Surgery’s General Surgery residency program and Affiliate Faculty in Grants Pass have jointly flourished from the Grants Pass rural program. The program allows for OHSU General Surgery residents to live, learn and work in Grants Pass for one of the six years of a surgeon’s residency training.
According to Mark Deatherage, MD, Affiliate Professor, Department of Surgery, Grants Pass Surgical Associates, the Grants Pass program has proven to be mutually beneficial to both the OHSU residents who have completed the rural program and the surgical faculty in the rural town of around 33,000 people.
Since the inception of the program eight years ago, every surgeon in Grants Pass has come together to work with OHSU residents, giving the residents an opportunity to work with surgeons of varying surgical specialties while also providing a sense of renewal and rejuvenation for the surgical educators of Grants Pass.
“The Rural Surgery Program gives residents an experience like no other,” said Terah Isaacson, MD, General Surgery resident. “You get to be involved in the care of the surgical patient as a whole and realize the importance of each step including pre-operative evaluation, operative planning and post-operative management.”
According to Dr. Deatherage, the introduction of OHSU general surgery residents into the Grants Pass surgical scene has added an overall “positive boost” to the practice of surgery there. For OHSU residents, the Grants Pass rural program sheds light on a new way of experiencing and providing healthcare. For many of the residents who complete the program, a one-year opportunity in Grants Pass develops into a desire to begin a career in rural health.
“Our year in Grants Pass was an incredible experience,” said Alexis Alexandridis, MD, General Surgery resident. “We were immediately welcomed into the surgical family at Three Rivers Community Hospital and hit the ground running. The operative experience is amazing, no doubt, but it was the ‘whole package’ – the real continuity of care, the relationships with our patients – that really opened my eyes.”
Pictured: Mark Deatherage, MD
Want to learn more about the Grants Pass residents program?
Read the following article, originally published in October 2008.
Workforce Spotlight: Surgical residents learn how to practice in rural communities
10/22/08 Portland, Ore.
Mark Deatherage, MD, knows the disconnect between training and rural practice firsthand. He graduated from the OHSU School of Medicine in 1976 before heading to his residency in Bakersfield, California, and still felt lost when he joined a rural surgical practice in Grants Pass, Oregon later. “The first 10 years of your practice, you stumble around a little,” he said.
So in 2002, when OHSU resident Garret Vangelisti, MD, approached Dr. Deatherage about the possibility of serving part of his residency at Three Rivers Community Hospital in Grants Pass, he quickly agreed to work something out.
For some time, Donald Trunkey, MD, and Karen Deveney, MD, of the Department of Surgery, had been looking for possible solutions to a trend increasingly noted by colleagues in the Oregon Chapter of the American College of Surgeons. Despite their growing and desperate need, rural surgery practices were struggling to recruit and retain new surgeons.
“In small communities that are quite remote from Portland, they have small hospitals whose survival depends on the presence of someone who is qualified to take care of a broad range of surgical emergencies and non-complex surgical problems,” Dr. Deveney, Vice-Chair, said. “The problem is that most individuals are trained in urban areas rather than rural areas, so they don’t feel comfortable handling a wide variety of acute surgical problems in a variety of related specialties.”
John Hunter, MD, Chair of Surgery, had long held an interest in the problems faced by rural areas in attracting and retaining surgeons. He proposed a possible solution: what if academic centers could offer their residents a lengthy stay at a rural practice? This would allow residents to “try on” a rural practice for size during their training.
Just as Drs. Hunter and Deveney began to feel out possible locations for a rural residency experience, something unexpected happened – Mark Deatherage contacted them about hosting Garrett Vangelisti for a year of his residency. OHSU and Three Rivers worked together to set up the parameters of a rural residency program.
“We needed something that had a rural feel, but was not so rural that it didn’t have an appropriate case load,” Dr. Deveney said. Grants Pass fit the bill. With a population of just over 30,000, Grants Pass is larger than many rural towns. Three Rivers Community Hospital, a Level III Trauma Hospital, provides a range of common and complex surgical services.
So far, the School of Medicine has found that the now implemented rural track training rotation has impressive operation logs. And the American College of Surgeons agreed; beginning last year, one resident per year may now count their Grants Pass experience toward residency requirements.
“We teach our residents many things they don’t get the chance to learn on Marquam Hill,” Dr. Deatherage said. “When they finish with us, they have the tools to function easily in a small community.”