The patient room at Partnership Health Center is full on a weekday morning, the doctors racing about in close conversation with young family medicine residents fresh out of medical school.
But the hurried pace and care given patients is a good sign. One year after launching, the Family Medicine Residency of Western Montana is off and running, and the 10 inaugural residents who made last year’s cut are now a full year into the program.
Dr. Ned Vasquez, the program’s medical director and a clinical associate professor of medicine at the University of Montana, said efforts are now underway to grow the program to 30 residents by 2015, helping Montana gain ground in a service it’s sorely lacking.
“Our residents are capable of becoming board certified in family medicine at the end of their three years, and they’re capable of taking care of people in settings where there may not be a lot of other physicians around,” said Vasquez. “Going to the small towns around western Montana and providing care for people is one of the ultimate goals.”
The program looks to train up-and-coming doctors in a specialty area after medical school. In addition to seeing patients, they work rotations in surgery, adult medicine, obstetrics and pediatrics. They complete the rotation every 28 days throughout their three-year residency.
But it’s here in the clinic where the residents cut their teeth. Behind closed doors and under the supervision of practitioners, they’re helping cure whatever ails the underserved patients of western Montana.
“We want to make sure our residents have a lot of time in clinics while they’re here,” Vasquez said. “That’s where family medicine physicians will spend much of their professional lives.”
The residents are assigned a panel of patients at Partnership Health Center, a major collaborator in the growing residency program. On the job, the residents receive mentoring and oversight by physicians in a process known as precepting.
Over time, the residents will gain more autonomy. The residency for a family medicine practitioner is roughly three years, and the intensity of precepting grows less as they progress through the program.
On Wednesday, the precepting room at Partnership Health Center was a hub of activity. Dr. Brad Ihrig, a community physician, and Dr. Jennifer Robohm, director of the Clinical Psychology Center at UM, reviewed a patient’s records with Dr. Ben Grass, a program resident.
Nearby, Dr. Kerry Haney, an associate professor of pharmacy at UM and a faculty pharmacist at Partnership Health Center, did the same with pharmacy student Haley Cote.
“It’s a stretch for everyone going from having your own practice time and teaching students,” Haney said of the program. “We’re teaching people from all different disciplines. It’s definitely needed in Montana. We need more doctors here and that’s the mission of the program.”
Montana has ranked 50th in the nation for graduate medical education. Before the UM-sponsored program opened last July, the state had just one medical residency program, located in Billings.
With the new program in Missoula up and running, and an internal medicine residency planned in Billings, the state will have three such programs to bolster its roster of doctors. Vasquez said it will eventually help bring medical care to Montana’s underserved communities.
“Because we were 50th in the county in graduate medicine education, our pipeline for physicians in our communities is much smaller,” Vasquez said. “By creating more residency training, it’s expanding our pipeline and providing more doctors.”
While the 10 residents are deep into their residency, the program is gearing up to bring 10 additional residents onboard, followed by 10 more in 2015 to achieve a capacity of 30.
Vasquez said the program received more than 600 applications this year from residents vying for those 10 new openings. Staff interviewed 80 people and will decide by March who the 10 successful applicants are.
The demand for residency training is high, but Vasquez called it a good problem to have. The effort relies upon the time and resources of physicians across western Montana, including those at St. Patrick Hospital and Kalispell Regional Medical Center.
“The rotations of our residents require community physicians to act as teachers,” Vasquez said. “We’ve had surgeons, hospitalists, obstetricians and pediatricians that have stepped up and allowed our residents to come into their medical realm to teach them.”
Sponsored by the College of Health Professionals and Biomedical Sciences at UM, the program is part of the University of Washington’s larger Family Medicine Residency Network.
David Forbes, dean of the UM college, said the program is funded by a variety of sources. Federal pass-through money goes to Partnership Health Center, which also received a $5 million grant to expand its facility on Railroad Street.
Medicare covers the remaining costs of training the residents. The dollars are determined by how many residents the program has, and how many “Medicare beds” exist in communities served by the residents.
“It all came together at once to make a wonderful addition to this community to serve more underserved patients,” Forbes said. “After three years of general practice, 70 percent of family medicine residents practice near the area where they completed their residency. This is a vey important addition to our community.”
Nearly a year into the program, Vasquez looks back on the success and notes the work that still lies ahead. It was a big undertaking to get the program going, and the team is now working on a second-year curriculum as the first-year residents advance to that second stage.
Staff will soon be required to craft a curriculum for the third year, building the program as it grows. The relationship between local hospitals, practitioners and Partnership Health Center is firmly in place, and it has helped the effort succeed.
“The relationship with Partnership is really important as a place that provides us with a body of patients we can use to help teach residents as we take care of them,” Vasquez said. “And by bringing the residency here, we’ve provided Partnership with more physicians to see more underserved patients. It’s a nice synergy.”
Also this month, Barry Kenfield, former chief operating officer of Community Medical Center in Missoula, was appointed the new COO of the Family Medicine Residency of Western Montana.
Kenfield also was appointed director of the Western Montana Area Health Education Center at UM, replacing Larry White, who has directed the program since it began operating at UM in 2008.