It has been 10 years since the first class of 22 newly graduated doctors entered Eisenhower Health to begin their residency in internal and family medicine. Today, 222 have successfully graduated from the four-year program with an additional 110 currently enrolled.
The program has grown significantly and now includes emergency medicine, pharmacy, advanced nursing, fellowships and even clerkships for active medical school students. Fellowships are offered in pulmonary disease, infectious disease and sports, addiction and geriatric medicine.
But has the program met the ambitious goals that inspired the teaching hospital’s certification a decade ago? According to Chief Medical Officer and Designated Institutional Official Alan Williamson, MD, the answer is “a resounding yes on all fronts.”
Aiding the valley’s primary care physician shortage
When Desert Health first reported on the program in 2013, the ratio of primary care physicians (PCP) to local residents in the Coachella Valley was an astounding 1,476 to 1 versus the national average of 631 to 1, according to County Health Rankings. At the time, Eisenhower identified a deficit of 102 PCPs based on an independent Reuter’s survey. As the national shortage continues to grow, that statistic is now closer to 1,683 to 1 and their target number of PCPs is 200.
Being recognized as a teaching hospital significantly helps in recruiting those doctors. “We tried to recruit PCPs to the valley, but were challenged by the large number of Medicare patients in our community which means lower income for doctors than other communities around the country,” says Dr. Williamson. “Studies show that residents tend to gravitate to the areas where they train, so we made the decision to train our own.”
Out of 222 graduates in internal, family and emergency medicine, 25% (55) have stayed at Eisenhower while more have taken positions at other facilities in the valley. He adds that there is also an increasing number who finish the program and go onto specialty training and fellowships at other institutions before returning to the Coachella Valley. “I am very happy and proud to be in that 25 to 30% retention range which is higher than the national average.”
Attracting high caliber doctors
Offering a residency program not only expands the pool of recruits for teaching hospitals, says Williamson, it also enables them to attract a different type of doctor who values the opportunity to educate others as part of their work environment. “I am very confident that many of our more recently recruited physicians would not have come here had we not had a teaching program.”
Residents and hospitals find each other through the National Residency Match Program (NRMP) which invites both hospitals and residents to rank their choices for confidential submission. Sophisticated algorithms then create the best matches. There are two rounds of this process (similar to a sports draft), before hospitals are able to reach out to “free agents” to fill positions still available.
Newer programs often struggle to fill spots through the NRMP’s first match round; however, Eisenhower has done so since their very first class in 2013.
“Every year, we have been able to fill our available positions with the top 10 to 15% on our rank list,” says Williamson. “We are picking people that we think are the best of the best and only have to go 15% down our list to fill available positions.” That speaks loudly to the hospital’s reputation and the lure of Greater Palm Springs for resident doctors.
Eisenhower now has an established track record of program graduates and where they end up as well. Fellowship programs are very competitive with the vast majority only offering one to five positions each year. “We have a number of residents who have gone into very prestigious fellowship programs at Stanford, Harvard, UC San Francisco and others, often in competitive areas like cardiology, pulmonary critical care and infectious disease,” he adds.
Raising the bar for all medical staff
“Working with smart, inquisitive and eager young minds raises the bar for everyone as they ask a lot of questions and demand a lot of answers,” says Williamson. “In today’s world, ‘because we told you so’ doesn’t go very far. They want to see the evidence-based science behind all our decisions and methods and definitely hold us all accountable for practicing very high-caliber, evidence-based medicine. The enrichment is reflected in the caliber of care we are providing our patients.”
Supporting the underserved
When the program launched, resident rotations included work with Coachella Valley Volunteers in Medicine, a free medicine clinic in Indio for the underserved which is 100% staffed by volunteer doctors and nurses. This area of education has now expanded to include Borrego Health in Coachella and Clinicas de Salud del Pueblo in Mecca, both Federally Qualified Health Centers.
“It is important to continue providing our residents experience in the unique challenges of taking care of the underserved patient population,” says Williamson. “It’s one thing to learn the building blocks of how we practice medicine, but in reality, there is a lot more to understanding how health care systems work and where they don’t work. There are a lot of layers of complexity in dealing with different populations, and it is very important that doctors understand that.”
Williamson, who retired from clinical practice earlier this year, adds that 30% of his time was spent working on socioeconomic issues rather than medical issues. “It is the reality of medicine today and very important that we keep that piece of their education in place; not only to do our part in serving our community and to help provide health care where it is needed, but also to give a really important piece of education to our residents.”
For more information on Eisenhower Health’s residency programs, visit gme.eisenhowerhealth.org. Lauren Del Sarto is founder/publisher of Desert Health and can be reached at [email protected].
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