Marshall University adds orthopedic residency
8/16/2007
By Jean Tarbett Hardiman
CHARLESTON -- Gov. Joe Manchin announced Wednesday the approval of an orthopedics residency program at Marshall University's Joan C. Edwards School of Medicine.
Manchin, who had knee surgery in Huntington last year, expressed pride and excitement for Marshall, Cabell County and the state of West Virginia.
"A residency program is like a window," Manchin said. "People will come here who might not otherwise have had a reason, and we get to show off."
The approval comes from the Accreditation Council for Graduate Medical Education, which has approved just two new orthopedic programs in the United States in the past 12 years, said Dr. Ali Oliashirazi, chairman of Marshall's Department of Orthopaedic Surgery and the one who performed the surgery last year on Manchin's knee. The other new program is in Detroit.
"Acquisition of an approved residency program in orthopedic surgery is a Herculean accomplishment and the program will represent only the second in the state of West Virginia," said Dr. Charles McKown, dean of the medical school.
Marshall's program will start in June 2008 with three residents, and it will add three residents the following years and grow to 15. It will recruit both Year 1 and Year 2 residents, who will do their surgical work primarily at Cabell Huntington Hospital.
"I think it's going to be a benefit for Marshall students and the community, too," said Marshall medical student Jason Tucker, who is considering orthopedics. "It's going to mean better patient care. They're going to have access to care right here in the community that otherwise might not be available."
Primary care is still a mission for Marshall's medical school, McKown said, but as subspecialty care becomes an expected standard, the school feels responsible to respond to those needs. Orthopedics is the area of medicine that deals with bones and muscles, or the musculoskeletal system.
And there's a growing need for musculoskeletal training, McKown added, as the population ages and needs more joint surgeries.
One of the factors in getting approval for an orthopedic residency program was the particular need in this area. According to figures from the American Academy of Orthopaedic Surgeons, only Michigan ranks lower than West Virginia in the number of orthopedic surgeons for its population: West Virginia has 4.5 orthopedic surgeons for each 100,000 people, far below the national average of 6.2.
At the same time, West Virginia has a disproportionate number of car accidents based on miles of roads it has, likely because of their narrow twists and turns through the hills, McKown said. It also has a lot of ATV accidents, said Dr. Dan Cowell, senior associate dean for graduate medical education at Marshall. Add to that the high-risk occupations (coal mining, timbering and railroad work), the state's high percentage of seniors and its high rate of obesity, which leads to joint problems, and Huntington becomes a perfect place to have a training ground for these doctors.
"To do this, we needed to put Marshall on the orthopedic map," Oliashirazi said.
A joint replacement program was established at Marshall, and over the past few years it has gained recognition from institutions around the country and around the world. Oliashirazi has given lectures at places such as Harvard, and other institutions around the United States and Europe.
Over the years, Marshall grew its orthopedics team. Oliashirazi said he wanted members of the team to be elite, to have subspecialties in orthopedics who would do the same type of procedure all day long, whether it be foot and ankle surgery, hip or spine surgery.
"We wanted people who are good at what they do, but who also can teach it," he said.
And he said he found some. The members of Marshall's orthopedic team are Dr. Charles "Ted" Shuff (adult and pediatric spine surgery); Dr. Zach Tankersley (adult and pediatric surgical podiatry); Dr. Gregory Hendricks (primary care sports medicine); Dr. Andrew Marcus (orthopaedic sports medicine); Dr. Charles Giangarra (chief of Marshall Athletics and Orthopaedic Sports Medicine) and Dr. William Wallace (orthopaedic hospitalist).
"Now we have a faculty truly at the top of their game," Oliashirazi said.
Tucker, a fourth-year medical student who worked with the orthopedics faculty as part of his rotation last year, said all the faculty were willing to take time out to teach while being very proficient in what they were doing.
"Dr. Ali is meticulous in what he does, and I think he's going to attract top quality applicants -- and it will get even better as they get more experience and the reputation will be even better in years to come," said Tucker, a Clay County native.
Consistency is key -- both for the faculty and the residents, Oliashirazi said. The residency program will be modeled after the Mayo Clinic's and will take residents through three-month rotations during which they are paired with just one physician at a time. They first will spend three months with a physician as a junior resident, and then three more months as a senior resident, Oliashirazi said. That way, they get more time to read literature on certain procedures, watch them being done repeatedly and pick the brain of an attending physician. Through that process, they get a thorough knowledge of each specialty, he said.
"It makes you a very different orthopedic surgeon when you come out," Oliashirazi said. "It's a very rigorous academic program."
The physicians on Marshall's orthopedic team are good examples to follow, he added. "We've amassed a faculty that is truly kind and compassionate, and I think that will rub off on the residents."
Cabell Huntington Hospital has had an important role in the development of the orthopedics program as well, he added. It accommodated much of the growth by approving the purchase of expensive surgical equipment and offering salaries that would attract high-quality surgeons. The hospital also covered $600,000 in renovations so that patients could have single rooms rather than doubles. State of mind is important for patients in the healing process, particularly if they are healing from a surgery such as joint replacement. They are not ill, so it's important not to pair them with someone who is ill because that could have a negative impression on their morale, Oliashirazi said.
Cabell Huntington Hospital has worked closely with Marshall in many capacities, said CEO Brent Marsteller. It provides clinical teaching for medical students, the facility is joined physically with the Marshall University Medical Center, creating a medical campus, and it does joint recruiting with Marshall to meet the needs of the community.
When it came to supporting an orthopedics program, the reasons to jump on board were plentiful, he said.
"We are not producing enough specialists and subspecialists in this country," Marsteller said, and the new program could help in recruitment. It's much easier to obtain orthopedic surgeons if you train them, and he hopes some Marshall-trained residents will stay and practice in this area.
"We'll get the best surgeons to come here and practice on you and I," he said. "That's what it's about -- personal care. I want the best people here at Cabell operating on my wife and kids and family."
Jean Tarbett Hardiman is a reporter for The Herald-Dispatch. Comments may be e-mailed to jeant@herald-dispatch.com.
