Residency programs aim for top local service

Grant D. Crawford | Daily Press

Dr. Beth Harp speaks with a patient during a visit at W.W. Hastings Hospital in Tahlequah.

TAHLEQUAH, Okla. — Not all rural communities have ample health care services these days, but doctors in Cherokee County are being trained every day through residency programs to provide care those who need it.

Northeastern Health System, Cherokee Nation Health Services, and Oklahoma State University partner to offer physicians-in-training - called "residents" - the opportunity to learn from specialists in a variety of areas. The residency system not only offers aspiring doctors quality education, but helps address health issues in Northeast Oklahoma.

While students could apply for residency in larger, more urban settings, there's an advantage to training in a rural area. According to Christine Jankas, vice president of physician services at Northeastern Health System, residents in a rural setting have the opportunity to see far more types of disease and lines than in urban settings.

"Often, physicians who have trained in rural settings are more confident upon completion of training to treat more illnesses than urban-trained peers due to experience," said Jankas. "Another advantage to rural training is what is commonly referred to as 'undiluted' experiences. Often, rural training comes with opportunities for one-on-one training and ability to treat patients directly; there is no competition to treat patients, as there are enough to go around, so to speak."

The local family practice residency is also different from other rural programs, because it offers several areas for learning and practice, such as cardiovascular surgery, cardiology, nephrology, gastroenterology, and neurology.

Dr. Doug Nolan, Family Medicine Residency program director, said many residencies based in a rural area can only treat so much.

"Basically, they would treat them to a certain point, and ship them to a larger facility, so they lose that follow up," he said. "Here, we have the specialists, so they actually train one-on-one with specialists and they're able to learn how a specialist treats particular disease processes in the rural setting. So it's very beneficial."

Since it began in 2010, the residency program has had an impact on the city and people who live in it. One of the purposes of the program, said Nolan, is to provide competent physicians to underserved areas. After a recent review of graduates, administrators noted a little over 80 percent have begun working in rural, underserved portions of the state.

"During their training, they provide a lot of care to the patients we have," said Nolan. "They perform sports physicals for a lot of the community schools - that's free of charge. At Tahlequah High School, they provide coverage for athletes who are injured on the sidelines at Friday night football games."

The program has also helped recruit specialist physicians, and due to the training atmosphere, both patients and doctors stay up to date on the latest medical offerings.

Jankas called it "a wonderful, almost unexplainable, phenomenon."

"Because resident physicians are studying immediately the most recent information available, patients can rest assured that atypical illnesses can be identified and treated well," she said. "Resident physicians, because they are learning, must use multiple resources to verify diagnoses and treatments, which benefits patients. The resident physicians nearly always spend far more time with patients than attending physicians, who must adhere to a more restricted schedule. Many patients like that."

Aside from the Family Medicine residency program, NHS also uses an Internal Medicine residency. Its physicians treat many of the same diseases and conditions, but in different settings and for different ages. Jankas said most Internal Medicine physicians treat ages 18 and older, unless they're Pediatric Internal Medicine trained, and they work primarily in a hospital-based setting.

"Internal Medicine physicians specialize in treating disease involving the internal organs, such as treating those with pancreatic disorders like diabetes," said Jankas. "Again, it's not that Family Medicine cannot treat this; however, more complicated issues are usually referred to Internal Medicine physicians. By the same token, Internal Medicine physicians frequently treat 'primary' issues, such as offering flu shots, physical exams, and more."

The Cherokee Nation is going further in its mission to educate more doctors. In May, the tribe and OSU Center for Health Sciences broke ground on the new OSU College of Osteopathic Medicine at the Cherokee Nation and is slated to have its first 50 students in 2020.

Nolan said former Principal Chief Bill John Baker and current Principal Chief Chuck Hoskin Jr. have, in a strategic move, been working on "growing our own," so local students interested in studying medicine will have a route to treat their own friends and family.

"For those medical students who want to do primary care, there's a good chance they'll want to stay in our program," Nolan said. "They would basically establish their home and their family within this area while they do four years of medical school and then three years of residency. So the natural inclination would be that they want to stay here, because this is home."

Nolan grew up in Tahlequah and said he never thought there would be a medical school and residency program all located in town. He added that for parents whose children are interested in a health profession, it's the perfect city for keeping them close.

"They can stay and they can take care of their family, friends, and give back to this area," he said. "I just think it's an exciting time, and it's going to be beneficial for Cherokee Nation, Tahlequah, and all of Northeastern Oklahoma."

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