OHSU Residency Programs at Local Hospitals Catalyze Community Awareness
Growing up in rural Yakima, Washington, Esteban Garzadoctor, made it his goal to become a doctor because he saw the difference he could make. Curious and intelligent, outgoing and fluent in Spanish and English, he envisioned using his medical training not only in the clinic, but also in the community to improve health.
He was accepted into the 2021 class of OHSU medical school and, after graduating last summer, landed a residency in the new family medicine residency program at Hillsboro Medical Center (HMC) in OHSU – a dream come true. Residents are new physicians who hone their skills before working independently. Although a major Portland suburb, Hillsboro’s deep roots as a farming community remain, and for Garza, the large Latino community was an added draw.
Now, when he’s not seeing patients at the HMC, Garza has begun leading health education sessions with members of the Spanish-speaking community through a partnership the residency program has developed with Adelante Mujeres, an organization nonprofit providing holistic education and empowerment opportunities to low-income Latinas and their families. .
As OHSU expands residency programs across the state and works to further diversify the medical workforce through the 30-30-30 initiative, which was funded by the US Legislature Oregon in the spring of 2022, HMC’s family medicine and internal medicine residency programs are examples of the positive impact residents can have in a community.
Both Brian Ricidoctor, director of the HMC Internal Medicine Residency Program, and Kay Nordlingdoctor, director of the HMC Family Medicine Residency Program, chose their inaugural classes for the trainees’ willingness to see and overcome obstacles, as well as the desire and ability to connect with patients and families.
Nordling first met Garza while on a family medicine rotation as an OHSU medical student. With his sharp skills, community spirit, and easy-going, compassionate nature, she knew she wanted him in the new residency program. His ability to communicate fluently in Spanish with patients was a bonus, considering that approximately 24% of Hillsboro’s population identifies as Latino/a/x. Four of the 16 residents in the first cohorts of the family medicine and internal medicine residency programs speak Spanish, and the programs provide access to an online medical Spanish course for all residents.
“Creating a new residency program with interns who reflect the community creates a connection that encourages them to take on projects they are passionate about and positively impact the lives of patients,” says Nordling.
Ricci adds: “These are huge benefits for the community. Part of learning medicine, which is essential, is to recognize all the social and structural factors that influence a person’s health. With this awareness, there is so much more space to be creative and use a larger purpose and for residents to focus on the areas that mean the most to them. »
More residency programs open in Oregon
OHSU’s medical school is in the midst of a 10-year expansion of medical residency programs in Oregon. It started with the Hillsboro programs, and this summer is adding its first cohort of transition-year residents, who are training in specialties such as radiology, radiation oncology, dermatology and anesthesiology. Hillsboro Medical Center is part of OHSU Health.
A partnership with St. Charles Health is expected to see its first residency program in central Oregon — in family medicine — starting in 2024, with first-year resident training at OHSU and then an expedition to Madras during the second and third years. Other programs in partnership with St. Charles Health are expected to follow, says Jim Anderson, MD, director of the Statewide Graduate Medical Education Initiative at the OHSU School of Medicine.
OHSU is also a partner with the University of California, Davis in a $1.8 million American Medical Association-funded project to bring hundreds of medical students and residents to train with faculty and community physicians in rural and underserved communities in Oregon and Northern California.
The goal is to build on the success of the family medicine residency program at OHSU and Sky Lakes Medical Center Cascades East, founded in 1993. It trains 24 family medicine residents in Klamath Falls each year.
Why not entrust them with our services?
Nguyen olivesdoctor, a first-year resident in the inaugural class of the HMC internal medicine program, recalls attending a hepatitis C testing clinic a few months ago and noticing how few people showed up for get tested.
Walking out of the hospital’s main doors that day, Nguyen realized that the Washington County Jail was only a block away. Adults in detention are at higher risk of contracting diseases like hepatitis C, which is contracted through blood-to-blood contact, such as sharing injection equipment. Hepatitis C is a viral infection that affects the whole body, especially the liver, and often leads to cirrhosis – irreversible liver damage – or liver cancer.
So Nguyen posed the question to program officials: Why not bring Hepatitis C education and testing services to prison?
“It’s a silent disease that doesn’t show up with all its complications until years later, until it’s too advanced,” says Nguyen. “You have to do extensive training to explain it. Being able to pass this knowledge on to adults in custody so they can make informed choices about getting tested and, if positive, treated, could be very powerful. Hopefully it would improve their health down the line.
Now Nguyen joins Hunter SpencerDO, assistant professor of medicine (general internal medicine and geriatrics), OHSU School of Medicine, who also sees patients at HMC, to study the feasibility of a partnership with the prison.
“It’s a great example of having residents in a community hospital just activating that energy,” Spencer says. “They’re not as aware of all the obstacles and the slowdown in the system, and they think things can just happen easily and with that you get the catalytic force to accomplish something that hasn’t been done before. “
Mayra Hernandez, health and nutrition coordinator for the nonprofit Adelante Mujeres, who partnered with family medicine resident Garza during the health education session in Spanish, described the benefits.
“Having the support of a medical expert in our health and nutrition sessions is so valuable to our program and its participants,” says Hernandez. “Dr. Garza’s expertise and culturally appropriate way of presenting impacts the work we do on health equity.
Gloria Lopez, a community member who participated in the session, took away some action steps.
“I learned how important nutrition is in preventing diabetes, cancer, and hypertension,” Lopez says. “Small daily changes like picking up fresh fruits and vegetables, lean meats, brown rice, and limiting processed foods and salt will benefit my whole family.”
And for resident doctors like Garza and Nguyen, it’s not about lecturing patients. It’s about learning from them.
After the training session, Garza met Hernandez and Lopez on a sunny April evening at the Forest Grove Farmers’ Market hosted by Adelante Mujeres. They toured the produce stalls and gave him an impromptu lesson in how to prepare rapini, a leafy green vegetable with yellow flowers, all of which can be eaten.
“The opportunity to be part of starting a partnership that will help us get to know community members, hear their stories, and better understand their needs is so powerful,” says Garza. “Just visiting the farmer’s market and understanding what kinds of foods community members have access to helps me when making dietary recommendations for my patients. And having Gloria and Mayra share their expertise on cooking rapini, which I have never tasted, was a bonus!