The University of Nebraska Medical Center and Regional West Medical Center in Scottsbluff are improving the health of Nebraska through UNMC’s new UNMC Emergency Medicine Residency Program.
The program means no longer will UNMC, and Nebraska, lose six new residents to other states in order for residents to pursue training in the emergency medicine specialty. A resident is a physician — usually a recent medical school graduate – who spends three to six years gaining required, specialized training in a specific area of medicine.
Already, Nebraska has reaped benefits from the state’s first program, which was launched in 2004 with its first six residents.
Utah native and resident in the program, Marion Bishop, M.D., Ph.D., grew up and lived in rural areas, as well as big cities, including New York City. She went to medical school in Utah, but when she chose to specialize in emergency medicine, she knew she’d have to leave Utah because at the time, the school had no residency program.
One of the sites she applied to was UNMC. During her visit for an interview, she decided she liked Nebraska and its people. She was also attracted to the residency program’s rural rotation component.
“The chance to practice rural medicine was an appealing part of this residency. Some of the most unsung ER practitioners aren’t in big cities. The physicians who do that have a certain kind of skill and know-how that I respect.”
“There is this wonderful work ethic in Nebraska,” Dr. Bishop said. “They’re hard working, but also very friendly. The people are plenty smart, but did their jobs without having to call attention to themselves. I found that very refreshing and different from other places.”
Currently 18 residents are enrolled in the 3-year program. Six residents are accepted each year. Next year, the first class of physicians will graduate from the program.
Mike Wadman, M.D., director of the program and associate professor of surgery, said the program is working well.
The goal of the new program is to provide residents with outstanding clinical and educational experiences in emergency medicine. Another goal is to encourage more board-certified physicians to choose rural practices.
Nebraska stands to gain more emergency medicine physicians, particularly in rural areas. As research suggests, once residents graduate from their residency programs, they choose practices near where they served their residencies.
As part of the program, residents serve two, one-month rotations at Regional West Medical Center in Scottsbluff under the direction of Peter Meyer, M.D., rotation supervisor, UNMC Emergency Medicine Residency Program, and director of the Regional West Medical Center Emergency Department. The remainder of the residency is spent at the emergency department at The Nebraska Medical Center in Omaha, UNMC’s hospital partner, and one month at the pediatric intensive care unit Children’s Hospital in Omaha.
“From the start, Dr. Meyer and the hospital have done everything they can to make this program successful, including helping the residents find housing and relocate for a month. Some have taken their families with them. They’ve done everything they could to make this a smooth transition.”
“It’s important to have more board certified emergency medicine physicians in rural Nebraska. This program exposes residents to the work and life in rural areas,” Dr. Wadman said.
Dr. Wadman said a report card by the American College of Emergency Physicians supports the need for more board-certified ER physicians in rural Nebraska.
“One of the main recommends for Nebraska was to devise a strategy to increase the number of board-certified emergency physicians in Nebraska. There’s a disproportionate number between those serving in urban areas and those serving in rural areas. We recognize that here at UNMC and needed to do something about it,” he said.
Board certified programs set rigorous standards and ensure high quality training. Board-certification requires members to take and pass a written and oral exam.
Dr. Meyer said he likes the fact that when residents first go to Scottsbluff for a rotation, they think they’re going “to the middle of no where.” “But Scottsbluff is the largest community in the panhandle and I think all the residents have been pleasantly surprised. I think everybody who’s been here likes it,” he said.
He said the facility is a Level II trauma center that receives traumas for the region, including parts of South Dakota, Colorado and Wyoming, and treats minor conditions as well.
“We see a lot of patients who should be seen in a family practice setting. It’s difficult for some people to get into the doctor’s office,” Dr. Meyer said. He said unlike the big city, they don’t have anyone waiting in their emergency room. “We get them in and out in two hours. I think the residents are impressed with how fast things can get done out here.”
He said one of the reasons for the efficiency is the good relationship the ER docs have with the medical staff in and outside the hospital. “It’s a small enough center that we know each other. It’s a pretty congenial atmosphere,” he said.
Dr. Wadman said the ER at Regional West Medical Center is a great place to train residents in rural emergency medicine.
“They have five board-certified emergency medicine physicians to staff the ER,” Dr. Wadman said. That’s a rarity for that many to be credentialed considering the size that Scottsbluff. It’s a great thing for Scottsbluff.”
Ben Fagot, M.D., UNMC emergency medicine resident, has completed two rotations in Scottsbluff, one just recently. The York, Neb., native said he has already signed a contract to work at the Great Plains Regional Medical Center when he graduates from residency next year.
“The ER in Scottsbluff can be as busy at times as Omaha, but in general it isn’t as hectic. There’s a more laid back atmosphere. It helps keep the stress level down a little bit. I hadn’t been to Scottsbluff before. I think it’s a really neat community. It has different things to do — more hiking and outdoor activities. The landscape is beautiful. It’s not the hustle and bustle of the big city.”
Dr. Bishop enjoyed her Scottsbluff rotations and is considering a rural practice after graduating from residency. “The town I grew up in had more cows than people. I was excited to be in a rural setting again,” she said. “There’s something about small town life. Let me tell you it’s beautiful there. I had a wonderful time out there.”
Dr. Wadman said efforts are under way to work with other hospitals to serve as residency rotation sites in order to further increase the number of physicians in ERs across Nebraska.
“One of our intentions with this program is also to give residents an insight into what rural emergency medicine involves and hopefully encourage more to seek positions in rural ER medicine. “I think it’s working out the way we expected.”
Class of 2007
Marion Bishop, M.D., Ph.D.
Chad Branecki, M.D.
Brian Cunningham, M.D.
Benjamin Fagot, M.D.
JR Realing, M.D.
Raja Srinivasan, M.D.
Class of 2008
Lori Asher, M.D.
Travis Dierks, M.D.
Phillip Jones, M.D.
Tyler Petersen, M.D.
Thomas Spiegel, M.D.
Kelly Wagoner, M.D.
Class of 2009
Jennifer Carpenter, D.O.
Bradley Hess, M.D.
Cynthia Hernandez, M.D.
Charles Schmier, M.D.
Hillary Ormseth, M.D.
Leighton Singh, M.D.