Teachable moments

HCA Healthcare expands its graduate medical education programs that train new physicians

When healthcare industry experts look into the not-too-distant future, one disturbing trend stands out: There will not be enough doctors to meet demand.

A physician shortage of up to 90,000, across all specialties, is projected for 2025. HCA Healthcare is intensifying its efforts to alleviate that shortage by building up its Graduate Medical Education (GME) programs, where new doctors get the supervised, accredited training they need in order to be licensed to practice medicine. These programs include residencies, internships, fellowships and subspecialty training.

“HCA Healthcare has sponsored and participated in GME for quite a while, but generally at a local level,” says Bruce Deighton, PhD, vice president of Academic Affairs/Graduate Medical Education for HCA Healthcare. “What we are attempting to do now is organize all GME programs across the company to provide support, assure best practices are in place, and to see where we can use our scale to reduce costs and improve quality. But the key is to develop new programs and expand the scope of the existing GME programs.”

New physicians tend to stay in the area where they do their residency, so these HCA Healthcare-trained doctors will most likely remain connected with the company. And if they do want to move to another area, HCA Healthcare has opportunities with hospitals all over the country.

“We are training medical staff for the next decade, and want to be sure that each one of our graduates is confident with patient safety and quality care methods and metrics,” explains Dr. Deighton. “So when graduates come on to our medical staff we have physicians who are tuned in to those measures, which are so important for patient care.”

The first organizational step was bringing GME under the Physician Services Group, to best enable coordination and support across HCA Healthcare hospitals as new programs were implemented.

Resident programs support hospital staff

In July 2015 nine new programs, with 276 resident positions, launched. Programs in development will align with growth in many key HCA Healthcare clinical service lines such as neuroscience, women’s services and trauma programs. Many also will focus on specialties where recruiting is difficult, such as psychiatry, pulmonary critical care and general surgery.

“We are starting more new programs than anyone else, by far,” says Dr. Deighton. “The real success in that growth is the high levels of accreditation achieved. On measures such as Intraining exams, scores of HCA Healthcare residents are higher than the national average. Some residents from our new internal medicine program at Aventura Hospital took first place in a research competition for the Florida chapter of the American College of Physicians this year. We have a lot of positive things going for us.”

Though preparing for the future drives the growth of HCA Healthcare’s GME programs, attention also is being paid to the status of existing physician training. Combined with the GME program expansion, residency programs greatly enhance patient care and improve the patient experience. A number of studies show that teaching hospitals provide higher-quality care, for example, most likely because there are more doctors at the hospitals so patients get more time with a doctor.

Any HCA Healthcare hospital incorporating a new residency program will go through a learning curve of how to interact with residents, but they also get more hands on deck to handle cases. On the physicians’ side, the GME programs spend a lot of time on improving communications and professionalism, as well as systems-based practice, so that residents complete their training with both a deeper understanding of how to provide compassionate patient care and a more in-depth bank of medical knowledge.

“They start with us in residency and we want them to partner with us for life,” says Mary Beth Titsworth, GME program director. “Everything in our training model is driven by quality because we expect to retain them for a long time.” 