TEACHABLE MOMENT
Landmark Medical Center welcomes resident doctors in teaching partnership
WOONSOCKET – Walk the halls of Landmark Medical Center these days and you may run into a new staffing addition at the longtime community hospital – resident doctors participating in Landmark’s new teaching program with New York Medical College.
The New York Medical College/Landmark Medical Center Internal Medicine Residency Program starting last July is headed by Landmark’s past chief of the medical staff, Dr. Glenn Fort, MD, as the program director, and Paula Goncalves, a veteran healthcare administrator, as its program coordinator.
Landmark had wanted to start a residency program for several years and since its parent company, Prime Healthcare, operated one at its St. Michael’s Hospital in New Jersey with New York Medical College, Landmark sought to create a similar residency with the medical college in Woonsocket, Fort explained on Friday.
Landmark CEO Mike Souza helped draft a written proposal and protocols that were submitted to the New York Medical College,” Dr. Fort explained.
“They approved it,” Dr. Fort said while explaining the plan then had to gain a go ahead from the Accreditation Council of Graduate Medical Education (ACGME) which must approve hospital teaching programs under a set list of standards.
“And we found out in April of last year that we were accredited to start a residency program on July 1, 2021,” Dr.
Fort said.
The Landmark-New York Medical College program is approved for seven interns or residents in each of its three years of post graduate internal medicine instruction and training, according to Dr. Fort.
Due to the timing of its approval in July, Landmark opted to only begin the program for two cohorts of 17 medical school graduates, the first and second years, and set adding the third year for the following year of the program.
The initial group also included three preliminary residents, or interns, who have not yet decided what discipline they will follow whether that is medicine, radiology, dermatology, or some other specialty, and will have their first year to help firm that up, according to Dr. Fort.
The program is education based, and while the interns and residents get paid to work at the hospital, they also have conferences and lectures with Landmark’s attending doctors such as Dr. Fort, Dr. Syed Naqvi, the program’s associate director, and other Landmark staff.
“Some of them spend the night and admit patients overnight, some of them admit patients during the daytime and take care of the patients during the day on a our wards,” Dr. Fort explained.
“They can also do what we call electives where they can work in the emergency room, they can work in an office of an endocrine doctor, the office of a cardiologist, so they can get their experience of what it would be like to be a cardiologist,” Dr. Fort said.
“Ultimately at the end of the three years, some will decide they want to sub-specialize, go into cardiology or hematology oncology, some will want to become hospitalists, where they work only in the hospital environment, and some may want to become primary care physicians like we traditionally use and have an outpatient practice,” Dr. Fort said.
For Landmark, the program is also helpful by expanding its medical staffing, especially during the COVID-19 pandemic, Dr. Fort explained.
“There are shortages of everything right now because of COVID, shortages of case managers, nurses, but we didn’t have a shortage of doctors, so between our hospitalists who are very dedicated and none of them left, we also had the residents who could also help with the burden of having a lot of COVID patients,” Dr. Fort said.
“So, they have been very helpful through that period to make sure that we could accommodate the inflow of the patients that came in, especially last month which was a very busy month,” Dr. Fort said.
Dr. Elidona Mirashi, a second year resident in the program originally from Albania and now living in Rhode Island, said she is finding her time at Landmark very well spent.
“Actually, it is going really good,” Mirashi said.
“I did the first year in Brooklyn, which was also during COVID, and it was not an easy year,” the resident explained.
“This time around, I’m in the same position I’d say, but with more responsibilities and I have grown so much and learned so much,” Mirashi said.
The best part of the program has been working with the attendings and doing rounds, and Mirashi said that is where most of the learning occurs.
“It’s a growing and learning process, and very, very good,” Mirashi said.
Thus far, Mirashi has worked in the ICU, worked in nephrology dealing with kidney disease, and also rheumatology, something she hopes to gain a fellowship in so she can continue to study in Rhode Island.
“I really do like Rhode Island, I also have a family so it is a very family environment and I really do like it,” the resident said.
Dr. James Parra of New Jersey, another second year resident, said he held suspicions he would like Rhode Island coming from New Jersey since it was a small state in the Northeast, and those suspicions have proved true.
“The thing that I am enjoying a lot is working in a small community hospital,” Parra
said.
He has already rotated through the ICU, and is currently working the floors, Parra noted.
“I’d love to stay here I think this place is great,” the resident added.
“I get the sense of actually feeling like I’m really delving into being a part of the community here. We see a lot of the same people over and over again and I often feel like we are getting the chance to make a difference,” Parra said.
That may be because Landmark wanted to generate that feeling, according to Dr. Fort.
“We deliberately designed our program to be smaller because we are a smaller hospital and we wanted it to be more of a community, more a tight-knit family, and to have that feeling that you belong,” Dr. Fort said.
“You are not just an employee, and we are going to treat you like a student and we are here to educate you and train you to be both a knowledgeable physician as well as an ethical physician,” Dr. Fort said.
The residents also can provide
continuing care to their patients thru the primary care set-up that Landmark put together for the residents and their attendings in a medical office near Landmark, according to Dr. Fort.
Goncalves, who previously worked with Memorial Hospital’s residency program and followed its doctors to Kent Hospital when Memorial closed, said the goal in her new role with Landmark’s program is to help its participants achieve their future success.
After their three year residency is completed, Goncalves said the new doctors must take their boards to become certified, a necessary step in moving onto practice.
“Our goal is to make sure they graduate and pass all their boards,” Goncalves said of Landmark’s teaching program.
Dr. Gabriel Salk of Jamestown, an intern with the program, said his first year has gone well so far.
“I get here bright an early around 6 a.m., round on the patients and then present them to the attending on our daily rounds,” the intern explained.
“I’m enjoying it a lot so far, it is an incredible learning experience,” Salk said.
Salk said he has learned much faster as a intern than he did all the time he spent in med school.
“It feels that its not fair how much faster that you learn on the job like this,” Salk said.
Although in operation for more than 130 years, Souza does not believe Landmark has ever been a teaching hospital for doctors until now.
“I think it’s great, Prime is very supportive of residency programs and they have more than a dozen I would say throughout the hospitals in the Prime system,” Landmark’s CEO said.
“From Landmark’s perspective, we did it for a few reasons.
As Dr. Fort mentioned, I think it changes the culture in the hospital to a more education-teaching-learning type of culture which I think is great for everyone,” Souza said.
“Second it gives us, the hospital, a piece of educating these future physicians that will take care of us and be in
the community for years to come,” Souza said.
That is the goal at least, Souza offered, that “some will stay whether they stay in primary care, hospital care, or go off to specialty care,” Souza said.
“And, maybe they will stick around whether that is in Rhode Island somewhere or up here in Northern Rhode Island,” the CEO said.
Another factor is that Northern Rhode Island doesn’t have that many primary care options beyond organizations like Thundermist Health and that means local residents often lack having a primary care physician.
“As a part of the residency program there is an outpatient clinic, their continuity care clinic, which is located at the 20 Cumberland Hill building behind the hospital where the residents and interns rotate through that clinic along with the attendings that supervise the clinic,” Souza said.
“And patients can choose to have their primary care done there, so it expands right away primary care in this area which is definitely needed,” Souza said.