Medical residencies increase in Las Cruces

LAS CRUCES - With more than 160 students expected to graduate from Burrell College of Osteopathic Medicine per year, and the goal of keeping these new physicians in New Mexico, local health facilities are stepping up to meet the need for more medical residencies in Las Cruces.

After medical students graduate, they are required to complete a residency in their specialty in order to become fully licensed physicians. Medical residency programs, also referred to as Graduate Medical Education, can range from one year for general internships up to eight years for certain subspecialties, like neurosurgery, according to a BCOM news release.

“There’s evidence that if you go to medical school and stay and do a residency in the same place, you’re more likely to remain there to practice medicine,” said Dr. Oliver W. Hayes, BCOM senior associate dean for clinical education and a nationally known authority on clinical education of medical students and medical residents.

According to a BCOM news release, studies show that 70 percent of medical students remain in the area where they complete a residency training. And as cited in the release, Tripp Umbach, a national consulting firm, “estimates that each resident in a community-based residency program generates $200,000 in annual economic benefits to their community while in the program, and $1.9 million in economic benefits every year they remain in the area to practice medicine after training, plus nine new jobs.”

More: Burrell boasts diverse inaugural class

Before the establishment of BCOM in 2013 (the newly constructed private medical college officially opened in August last year), the majority of residency training positions were at the University of New Mexico in Albuquerque. At that time, there was only one medical residency program in Las Cruces, at Memorial Medical Center with 18 family medicine positions, according to the news release.

Since then, Hayes has worked with Memorial Medical Center, MountainView Regional Medical Center and La Clinica de Familia, a federally qualified health center, to increase medical residencies by 450 percent in Las Cruces, with 81 residency positions between MountainView and MMC, according to the news release.

Medical residencies receive a certain amount of funding from the federal government (specific to each health facility and its programs) once they are up and running and training residents. However, hospitals and health centers typically have to make a significant internal investment to get the program started. Some of the start-up costs include classroom facilities, offices for teaching physicians, personnel, capital costs and accreditation costs, Hayes said.

“The start-up cost for each medical residency program is a minimum of around $200,000 or $250,000 — often times, more than that,” he said.

Memorial Medical Center

MMC, home to a three-year family medicine residency program accredited by the Accreditation Council for Graduate Medical Education, worked with BCOM to apply for an additional osteopathic accreditation. MMC got approval from the American Osteopathic Association and became a dual-accredited program in 2014, expanding the program to allow for 12 residency slots specifically for Doctor of Osteopathic medicine students, said Dr. John Andazola, director of MMC’s Southern New Mexico Family Medicine Residency Program.

However, these 12 slots have yet to be filled due to lack of federal funding.

“The federal funding for medical residency programs was capped in 1997,” Andazola said. “Since our program opened before that date (in 1996), we have a residency cap, so that limits our ability for seeking more funding and that’s a common problem across the country, and we have been working with the state to find other avenues to increase funding.”

MMC’s medical residency program is “over-capped,” Andazola said.

“We have more residents than our cap, so because of that, the funding we receive doesn’t cover the training for all of our residents, so the hospital subsidizes that difference,” he said.

Fortunately, a new funding opportunity through state Medicaid, recently approved by the federal government, may allow MMC to fund more training positions and begin the process of filling those 12 DO slots, Andazola said.

“We hope by next year to have expanded our residency program because of that,” Andazola said.

To accommodate the expansion, MMC will partner with La Clinica to train residents at La Clinica Central Medical Cervantes Complex, which opened in February, he said.

In addition, by 2020, MMC’s residency program will go into a single accreditation system under ACGME and programs that train osteopathic physicians will no longer be a separate accreditation under the AOA. This will allow the program to provide specialty training for DOs even if the program hasn’t expanded, Andazola said.

Since it’s creation, MMC’s residency program has had a good success rate in keeping physicians in the area, Andazola said.

“In Doña Ana County alone, there are 40 physicians that have graduated from our program,” he said. “This year, we will have graduated 94 physicians and out of that, we have a 67 percent retention rate in the state of New Mexico and that’s above the national average of 45 percent.”

MountainView

MountainView started its Traditional Rotating Internship and Orthopedic Surgery residency in July of last year. This coming July, positions in the specialties of Neuromusculoskeletal Medicine and Internal Medicine will begin, said MountainView Chief Executive Officer Denten Park.

MountainView has spent approximately $1 million on start-up costs associated with the residency. Federal subsidy for the program will depend on expenses, number of residents, number of Medicare patients and more, according to Veronica Peery, director of marketing and business development at MountainView.

“We figured out a way to make it work because it’s so important and so critical,” Park said of investing in the program.

The first year, there were seven people in the medical residency program at MountainVIew and starting in July, there will be 16, Park said.

“If it continues the way it is, we could have up to 47 residents by year five,” he said.

Eric Czer, 26, a resident in MountainView’s Traditional Rotating Internship, a one-year program, said he plans to begin the Orthopedic Surgery residency, a five-year program, next year and then go on to complete an additional one-year fellowship in a specialty. Once he completes his training, Czer, originally from San Diego, said he would like to stay in Las Cruces to practice medicine.

“I pretty much instantly fell in love with the city,” Czer said. “I interviewed here and visited for the first time and have grown to like it more and more the more time I spend here. I feel like it’s a good place to raise a family so I really see no reason to leave.”

Until residents complete the program and, hopefully, stay in the area to practice medicine, the residents provide an extra set of eyes for patients, Park said.

“As a resident, they’ve already been in medical school for four years,” he said. “Residents have a doctor with them; they don’t do it alone, so it’s an extra set of eyes as they come through the system and I’m estimating that will help patients get better access to care and overall care.”

Park said providing these residency programs is a significant investment in the community.

“When it’s all said and done, we’ll probably have over $6 million in payroll alone and 75 jobs created,” he said.

La Clinica and the region

BCOM is also working with La Clinica to create a new residency training program in psychiatry at the La Clinica Cervantes Complex. The four-year program will offer three positions per year and is tentatively planned to begin on July 1, 2018, Hayes said.

In addition to expanding medical residencies in Las Cruces, Hayes is working to develop residency programs in other communities throughout the region. All counties in the state have below the average number of physicians per population compared to the rest of the country, he said.

Increasing the number of physicians in southern New Mexico is especially important.

“Half of all the physicians in New Mexico are located in Albuquerque (Bernalillo County),” he said. “It’s not surprising because Albuquerque is the single largest city in New Mexico, but if you live in Silver City, you still need health care and the option of driving to Albuquerque isn’t (always) a good option.”

The average age of practicing physicians in New Mexico is also one of the oldest in the nation, Hayes said.

“That means physicians in practice now in New Mexico are likely to retire in the near future, so you have to have new physicians to replace them,” he said.

Alexia Severson may be reached at 575-541-5462, aseverson@lcsun-news.com or @AlexiaMSeverson on Twitter.