Teaching Tomorrow's Physicians
- April 2004
- Français
The success of the Niagara Health System's Clinical Teaching Program is paving the way for a Chief Residency position, something very rare in a community hospital. Dr. Ram Rammohan, Vascular Surgeon and Medical Director of the Clinical Teaching Program for the NHS, says this is "a coup for the NHS. We have worked hard for the last four years and are building on our own success, thanks to the efforts of a lot of people."
Last year, the NHS received designation as a Surgical Clinical Teaching Unit from McMaster University Medical School, and "we were the first hospital outside Hamilton they approved. To achieve designation, the NHS had to maintain consistently high standards, be rated highly by students who trained here, and assure the university that the curriculum needs of students would be met." Up to now, the Clinical Teaching Unit has offered surgical training for students, residents and fellows from McMaster University. The program is being expanded to include surgical elective opportunities in Niagara Falls and Welland.
The Surgical Teaching Program offers training opportunities to students who are in their second year of training to become a Medical Doctor. These students are participating in a ‘clerkship'. Once students have achieved their MD status, they can pursue specialty training. General Surgery takes five years of ‘residency'. Residents in their second to fourth year come to St. Catharines General Site for surgical training.
New Core Programs
Building on that success is a new program starting in April. St. Catharines General Site has been assigned a Chief Resident, a rare occurrence for a community hospital, says Dr. Rammohan. "To my knowledge this is one of the first times a Chief Resident has been placed in a community hospital, rather than a teaching hospital. This is proof that we are doing a good job with under-graduates and that McMaster University has significant confidence in our resources and teachers to also work with post-graduates."
The Chief Resident is Dr. Tara Mastracci, currently in post-graduate year four of specialty training, highly skilled and only one step away from being a specialist surgical consultant. As well, ‘fellows' who have achieved specialist status and are working on a sub-specialty, such as vascular surgery for two more years, will receive surgical training at St. Catharines General site. Dr. Mastracci will supervise the junior residents, which will take some of the teaching load off already-busy surgeons in Niagara.
With the endorsement of McMaster, planning is currently underway at St. Catharines General site for the Internal Medicine Clinical Teaching Unit, slated to begin in the summer of 2004. "It is very unique to run two core programs in a community hospital, and it is our eventual goal to become a Clinical Education Campus for McMaster," says Dr. Rammohan.
Expanding Clinical Teaching
To support the expansion of the clinical teaching program, Niagara Falls Ear, Nose and Throat specialist Dr. Helen Caetano, Welland General Surgeon Dr. Fady Moustarah, and Port Colborne Family Physician Dr. Jeff Remington have taken on the unpaid role of Medical Education Co-ordinators.
Medical Education Co-ordinators – Surgical
"I've always enjoyed the teaching element in medicine and have always been involved in teaching," says Dr. Caetano, who has been practicing in Niagara Falls for two years. "What Dr. Moustarah and I will be doing is co-ordinating the surgical opportunities for the two-week elective period of students' eight-week stay in Niagara. I will co-ordinate their needs with any surgical specialty at Greater Niagara General site and act as go-between for our surgeons and the students." Some of the surgical specialties the students will be able to work in include gynecological, orthopaedic, and internal medicine. "This program will increase the number of students coming to our hospitals. We want students on a regular, continuous basis."
Teaching in Niagara hospitals has been happening for many years, but what the Clinical Teaching Program does is provides more options for medical students and gives them a flavour of what medicine here is really like, says Dr. Moustarah. "The medical education co-ordinator positions are exciting because they are new for Niagara, and we want to see teaching grow to include internal medicine, geriatrics, radiology and more. As clinicians, I believe we have a responsibility to improve the quality of health care to our community. It takes commitment to keep medicine cutting edge."
Dr. Moustarah, newly graduated as a General Surgeon, came to Welland one year ago with the intention of making medical education a priority. "It is positive for the community to have inquisitive minds around. It means the patients will be getting the best care there is and we also hope that when the students are making their career selection they have us in mind. The expansion of our teaching program will put the NHS on the map as far a clinical education and that can only take us forward."
Medical Education Co-ordinator – Family Medicine
In Port Colborne, Dr. Remington is now a Medical Education Co-ordinator for Family Medicine. "I've had about 20 students in my practice since I started in 1997, and I see it as a natural extension that the NHS takes on a bigger role in organizing educational opportunities for medical students," he says. "Having students around keeps me on the ball. They question things, bring the latest information and are constantly challenging."
A new addition to the roster of students at Port Colborne will be the addition of a Family Medicine Resident, coming in July for a four-month rural placement. "This is the final stage of their training, and the Resident will be able to care for patients in the office practice, in home visits, at community clinics and in the hospital," Dr. Remington says. "Teaching leads to recruitment, and this is a very important part of our physician-recruitment plan."