By BOB ALBRECHT

H&N Staff Writer

 

 

Nestled in the shadow of Sky Lakes Medical Center is one of the nation’s premier rural residency programs.  Each year, eight residents from some of the most prestigious medical schools in the country move to Klamath Falls for at least three years of hands-on training.

 

The program is one of a few that emphasize rural and family practice medicine, often setting doctors up to practice in cities such as Burns, Lakeview and Tulelake. Medical residents start their days with hospital rounds, visiting patients and answering questions from mentors. They spend weeks at a time learning medical specialties and see up to 20 patients in a single day during clinic hours.  

 

Residents practice medicine in the Cascades East Family Medicine Center at the edge of the Sky Lakes campus, and in the hospital.  “We’re such an integral part of this hospital and the medical community here, but we’re kind of invisible,” said Dr. Robert Ross, the program director. “It would be hard for us to disappear. I think things would fall apart.”

 

In some years, Cascades East has received as many as 1,200 applicants for its residency program.       That figure dropped to 380 this year, largely the product of more specific admission requirements, Ross said. Nearly 80 residents have graduated from the program since it started in 1994.

 

The program is a collaboration between Sky Lakes Medical Center, which owns the clinic, and Oregon Health and Science University, which pays the faculty and the physician-residents.

 

Ross said Oregon’s recession has not impacted the program, which receives about $2.5 million each biennium from the state Legislature.

 

“All in all, the residency costs the hospital some money, or breaks even, or makes a little money — it just depends on the year,” Ross said.  Residents spend blocks of time learning medical specialties, including surgery and cardiology, and work stints in the emergency room. Residents also treat patients suffering from severe illnesses, like complex cases of heart failure brought on by diabetes.

 

The curriculum prepares residents to be the lone, or one of only a few doctors, in small towns like Reedsport or Ontario.  Dr. Brandon Chase, a second-year resident, spent a six-week elective in Burns, practicing medicine in a community with a population   under 10,000, which qualifies it as a rural community.  “You are the ER guy, you’re everything,” he said.

 

About 43 percent of the 78 physicians who have gone through the program have started their medical practices in Oregon.  But most leave Klamath Falls for one-stoplight towns.  “Residents have preferred to go elsewhere because they want to practice in smaller places,” Ross said.

 

In recent years, as Klamath Falls has struggled to fill the gap left by physicians retiring and leaving the area, the program has shifted gears, increasing efforts to keep resi   dents in the Klamath Basin.

 

But a readied doctor who leaves the area is as big a success for the program as one who stays.

“The shortage of physicians is everywhere,” Ross said. “It’s going to be in urban and suburban America as well. It’s just starting out in rural areas because that’s where it has always been difficult to recruit.  “We help with that.”

 

Students from Duke University, University of North Carolina and the University of Minnesota have participated in the program, said Dr. Ralph   Eccles, who added that the medical program at Minnesota is on par with Harvard.

 

“The training here is more intense, and we work with a lot sicker patients than most residency programs,” said Eccles, a member of the program’s faculty.

 

Primarily, the idea behind the program is to train residents and send them back to the small communities they came from, places that typically have trouble attracting talented doctors.  “When people in the East wanted to practice in a small town, they said, ‘Go to Klamath Falls and get your training,’ ” Eccles said.