Healthcare practitioners celebrated their attempts Friday at trying to keep homegrown doctors in Louisiana, which they said can be a tough sell when medical students are being courted by residency training programs in other states where healthcare isn't such a constant feature on the budgetary chopping block.
The number of Louisiana's medical school students staying in-state for their residency has ticked downward over the past few years and become a concern of health care and higher education leaders, as doctors are likely to stay over the long term where they receive residency training. But when clinicians at Our Lady of the Lake's Regional Medical Center discovered Friday which newly minted doctors would be joining their residency program next year, they were especially excited with their success in recruiting Louisiana students.
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Nearly all of Our Lady of the Lake's internal medicine residents will be graduates of LSU's medical schools in New Orleans and Shreveport and about half their emergency medicine residents are from Louisiana. Their other residency programs — psychiatry, general surgery, otolaryngology and pediatrics — will also include at least one doctor trained at an LSU medical school.
"We were very proud this last match season, we definitely felt some increased energy," said Laurinda Calongne, the chief academic officer for Our Lady of the Lake.
But, still, LSU New Orleans saw a slight increase in the number of its students choosing to leave Louisiana, with 49 percent remaining in-state for residency. It's only the difference of a few students, as 51 percent of their students chose in-state residencies last year. But the number was as high as 63 percent in 2012.
Steve Nelson, the dean of the LSU School of Medicine in New Orleans, said he is not surprised that the numbers continue to drop. Year after year, his students rank their choices of hospitals for residencies at the same time that the state's political leaders announce midyear budget cuts, he said.
But Nelson is also proud that out of his students staying in Louisiana, 78 percent of them will train for residencies through LSU Health New Orleans programs at Our Lady of the Lake and in New Orleans, Lafayette, Lake Charles and Bogalusa.
Nelson and Associate Dean for Academic Affairs Charles Hilton praised the public-private partnerships that replaced the state's charity hospital system that previously served the poor. The $1.1 billion University Medical Center that opened in 2015 in New Orleans, with its first rate facilities and technology, also has persuaded students to stay there for training, they said.
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"One of the benefits of these public private partnerships has been their ability to recruit the workforce," Nelson said.
And Medicaid expansion in Louisiana, which has given the federal and state-funded insurance to more than 394,000 poor people in the state, has been a positive reason for students to stay here to serve the less fortunate, they said. It also enriches their education as they see more and more types of patients, Nelson said.
At Tulane University School of Medicine, 27 of the 205 students graduating matched for residencies in Louisiana — the same number of students that are from the state, according to Marc Kahn, senior associate dean of student affairs at Tulane School of Medicine.
Both Tulane and LSU New Orleans saw high numbers of students pursuing primary care, which leaders at both universities say is desperately needed in Louisiana and across the nation. LSU New Orleans' class had 51 percent of graduates choose primary care residencies, and Tulane saw a record number of 44 percent of their class choose primary care residencies.
Tulane also offers residency programs, and 28 percent of those who will enter them are graduating from medical school at Tulane or LSU.
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“Upon completion of their residency in three to five years, it is estimated that Tulane will produce 25 physicians who are alumni from Tulane and LSU medical schools," said Jeffrey Wiese, associate dean of graduate medical education at Tulane. "But importantly, it will also produce another 50 physicians who, having done their medical school training elsewhere, would not have otherwise come to practice in Louisiana."
Other Baton Rouge hospitals that will receive residents include Baton Rouge General Medical Center, Woman's Hospital and Ochsner Medical Center.
Baton Rouge General will take in 18 residents in internal medicine and family medicine programs, all of whom attended medical schools in other states or other countries. Woman's Hospital will have four residents in obstetrics and gynecology, three of whom are graduating from LSU New Orleans' medical school.
Ochsner has its own medical school program in partnership with Australia's University of Queensland. Of their graduates, 33 percent are remaining in Louisiana for residency training.
Ochsner Health System will take in 55 new residents, with half coming from a combination of Louisiana medical schools and their program between Ochsner and Queensland.
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Brittany Wagner, one of Our Lady of the Lake's rising chief residents in pediatrics, is one example of a doctor who came to Louisiana for residency from another state. A West Virginia native who graduated from Edward Via College of Osteopathic Medicine in Virginia, Wagner recalled the nervousness of hoping to match for a pediatrics residency.
She found herself in unfamiliar territory in Baton Rouge, but said she has grown to love the culture and that she would consider returning after she completes a fellowship in pediatric emergency medicine, which Our Lady of the Lake does not offer.
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She and others crowded into a lecture hall at noon on Friday at Our Lady of the Lake to watch presentations of those will join them next year. One element that Wagner and Calongne suspected helped them match with quality students this year is a Pathway Innovators program through the Accreditation Council for Graduate Medical Education.
Our Lady of the Lake is one of eight hospitals across the country that was selected for the initiative where they will try new methods for residency training that will then be replicated at other teaching hospitals. Calongne said the program will start with Our Lady of the Lake's pediatrics residents, and a big part of it will be teaching residents how to work in conjunction with physician assistants, nurses, pharmacists, social workers and others instead of simply by themselves.
"All these disciplines have been teaching in silos," she said. "Our project really blows up that silo and we're going to teach people how to be a treatment team."