Column: Medical fellowships and residencies elevate care at Barton Health

SOUTH LAKE TAHOE, Calif. – Behind the scenes at Barton Health is a thriving culture of teaching and learning through specialized fellowship and medical residency programs. Just as Lake Tahoe attracts visitors from around the world, these programs attract doctors from around the world to gain experience in their medical specialty. By facilitating a constant exchange of experience and new practices, fellowship and residency programs elevate the clinical environment for Barton physicians and enhance quality care for patients.

Barton Health offers two fellowships annually in orthopedics and sports medicine, which are two of the most desired fellowships in the country. Being a smaller hospital known for its high level of orthopedic care, and quality service lines such as the Level III Trauma Center and new Barton Center for Orthopedics & Wellness creates competition amongst the brightest physicians entering the medical field. In 2017, 94 applications were received from orthopedic surgeons for the two available positions offered by the Lake Tahoe Sports Medicine Fellowship.

Dr. Keith Swanson leads the Barton Health Graduate Medical Education (GME) Department and Sports Medicine Fellowship, which began in 1988 at Tahoe Fracture Clinic. In 2009 Barton Health agreed to sponsor the fellowship. Barton Health Sports Medicine Fellows now practice at the new Barton Center for Orthopedics & Wellness. Dr. Swanson is additionally a Clinical Associate Professor at University of Nevada School of Medicine and facilitates medical education seminars and institutional reviews of best practices between Barton Health GME and the university.

“At Barton Health, we believe that the community deserves a hospital with top doctors using the latest tools, treatments and technology to provide the highest quality of care in the safest environment,” said Dr. Swanson. “We have a commitment to innovation that is the basis for our teaching programs.”

A fellowship is designed for the graduate of a residency to focus on a subspecialty of clinical practice, education or research. In addition to fellowships, the residency experience at Barton Health prepares a physician to become a board-certified clinical specialist. Residents are doctors in training who have a medical degree and who practice under the supervision of board-certified attending physicians.

From January to July, 2018 Barton GME rotated 30 residents and medical students rotating across several departments including emergency medicine, general surgery, obstetrics, and orthopedics.

Dr. Clayton Josephy, a Barton Emergency Medicine (EM) physician directs the EM residency program at Barton Health and its teaching physicians, called Attending Physicians. Because of the many residents now at Barton Health, patients entering the Emergency Department (ED) may see a resident when they first arrive. Attending ED physicians are continuously supervising the residents as they participate in patient care.

Residents who rotate through the Barton ED find much more than a standard facility. Barton Health’s ED is home to Lake Tahoe’s only Level III Trauma Center and has the ability to provide prompt assessment, resuscitation, surgery, intensive care and stabilization of critically ill and injured patients.

Residents and Fellows participate in all areas of patient care, from treating patients in out-patient clinics and in-patient hospital settings, as well as assisting in the operating room. Medical students and residents from UC Davis School of Medicine, UNR School of Medicine, UC Irvine, among others routinely spend time at Barton Health under the supervision and instructions of its medical staff.

“Patients love it,” says Dr. Josephy. “When residents introduce themselves as a doctor from UC Davis, the patient understands they are receiving the latest in care from a trainee from a high-quality graduate medical institution.” UC Davis School of Medicine and UC Irvine are two institutions Barton Health offers a pathway for. Physicians have come to Barton Health from as far as Tasmania to participate in the GME Program.

Of the fellows and residents that train at Barton Health, many stay on to practice here in South Lake Tahoe. Dr. Terrence Orr was one of Barton’s early fellows and is here today as a leader in the health care system’s Orthopedics Department. Many Barton Health physicians were residents in its GME Program, including Dr. Sandra Taylor, Dr. Kim Evans, and Dr. Amy Anton. Previous Sports Medicine Fellows that practice at Barton Health include Dr. Scot Southard, Dr. Steven Bannar, Dr. Robert Rupp and Dr. Kyle Swanson.

Fellowships and residencies in the U.S. are accredited by the Accreditation Council for Graduate Medical Education (ACGME). The ACGME ensures that residents and fellows train in educational environments that support patient safety, resident and fellow education, and physician well-being. Not all hospitals are accredited by the ACGME. Barton Health has been an accredited hospital for ten years and continues to expand its Graduate Medical teaching programs. The ACGME requirements determine the clinical learning environments for development of skills, knowledge, and attitudes necessary to take personal responsibility for the individual care of patients. The requirements also ensure an environment where residents and fellows can interact with patients and the community under the guidance and supervision of qualified faculty members who give value, context, and meaning to the interaction.

Barton Health, a growing teaching hospital in California, continues to expand in medical education offerings for residents, fellows and medical students. For more information about the Graduate Medical Education at Barton Health, contact Jennifer Gaston, GME Coordinator, at 530.543.5781.