Pathology program shapes USD’s medical school 60 years later
VERMILLION, S.D. (AP) — The University of South Dakota’s first medical residency program started in 1958 with four open spots.
Without those four spots, Sioux Falls — and the state as a whole — likely wouldn’t have the strong medical workforce it boasts today.
In a word, it’s “poetic” celebrating the 60th anniversary of the pathology residency, said Nedd Brown, USD’s associate dean of graduate medical education.
It’s the program that kick-started decades of growth and made South Dakota a destination for medical students who come to learn and stick around to practice. And it started before USD offered a four-year medical school program.
Today, the USD Sanford School of Medicine is one of the top 10 schools in the nation for its local retention rates, and it all started with pathology, the Argus Leader reported.
“The unique thing about pathology? They see every patient in the hospital,” Brown said. “If you’re a child, you have blood drawn. If you’re an elderly person, you have blood drawn and if you’re a pregnant lady, you have blood drawn. Pathology is involved all along the way, so it’s poetic that pathology was the first one and the rest have grown out of that.”
The pathology residency program only had four spots a year available from 1958 to 2008, Department Chair Michael Koch said. He has been head of the department for the last 15 years, and the program since more than doubled in positions.
“I don’t want to sound corny, but I feel kind of like a proud father,” Koch said about his department’s growth. “It’s very unique and satisfying to see that development.”
Today, the graduate school receives thousands of residency applications each year for eight different medical fields or about 150 spots scattered between Avera, Sanford and the Veterans Administration medical center, Brown said.
If a medical student completes a residency in South Dakota, they have an almost 80 percent chance of staying to practice, Brown said. That makes USD’s medical school the sixth in the nation when it comes to local retention, he said.
And as of April, the medical school graduates a greater percentage of physicians practicing in rural areas than any of the other 145 medical schools across the nation.
“I know when I or my family have been in to see physicians in this community, invariably we’ll bump into a resident,” Brown said. “Whether it’s at a clinic or at the hospitals, they’re around, and they’re providing care.”
Pediatrics alone, one of the school’s newest residency programs, brought in more than 400 applications for six spots this year, Brown said. The school interviews 10 potential students for every open spot it has, making the only medical school in the state highly competitive, Brown said.
But what sets the graduate school apart from other medical schools across the nation is how collaborative the school is with its medical partners, Brown said.
It helps that the school is located in the state’s largest city and often makes for a great economic and educational environment for students’ families to also work in the area, he said.
If USD was only a medical school without residency spots, the retention rate would drop to 40 percent, Brown said.
“It’s a powerful factor, just based on the raw numbers, of keeping South Dakotans here in South Dakota to care,” Brown said.
Neither Mark Huntington, the family medicine program director, or third-year resident Joseph Swedzinski are from South Dakota.
But both came because of the secret to the medical school’s success — a collaborative, adaptive atmosphere not found elsewhere and a variety of opportunities.
Prior to Huntington joining USD’s residency program in 2006, he practiced in a rural community on the border of Minnesota, he said. He’s been the program’s director for the last five years, and said it was difficult leaving what he loved doing.
But Huntington couldn’t turn down the opportunity to help eager students become mature physicians, he said.
“Sometimes, we have residents who come in and struggle a little bit,” Huntington said. “To help them achieve something they might not have otherwise, and getting to see their process of discovery and see it through their eyes. ... We learn as much from them as they do from us.”
What tipped the balance for Huntington was the faculty’s diversity, and how closely the school worked with local health care systems to give students the chance to explore beyond the basics, he said.
“The value placed on education here is second to none,” Huntington said. “It’s not a Sanford Health system or an Avera Health system. Both work together to offer education, while many other hospitals and institutions view education as a liability.”
That educational investment is what drew residents like Swedzinski to the graduate school and what made him want to stay in the area, he said. He did his first years of medical school in Duluth, Minnesota before serving in the family medicine program, he said.
“No. 1 for me was the mission,” he said. “This residency is all about training people for practicing in rural environments, and preparing them for that. It trains family docs to have a broad skill set and be able to do full-spectrum family medicine, whereas some programs will train people with a limited skill set.”
But with his eyes on having a rural practice from the get-go, USD was exactly what he was looking for, he said. When he finishes his residency, he plans to practice in Pierre and eventually do obstetrics, something he said family medicine residency programs don’t often provide a heavy focus in.
Adaptability will be the key for USD’s graduate program to continue shaping South Dakota’s medical workforce another 60 years, said Jennifer Hsu, the internal medicine residency associate program director.
“Nobody knows where exactly that medicine is going in another 60 years,” Hsu said. “It could be completely different, and the approach to medical training could be totally different. Our main challenge is remaining adaptable as new data comes out about how better to train residents, and that we are appropriately adjusting to meet those needs.”
And if Brown were to look back six decades at where it all began, all he can think about is how far USD’s graduate program has come and how much potential it still has yet to embrace, he said.
“My vision would be to continue that philosophy of having physicians who love, love, love to teach, because that’s how they got their skills, and they want to give those skills back to the next generation,” Brown said. “In the state of South Dakota, we have that in spades.”
Information from: Argus Leader, http://www.argusleader.com