UCF and Nova Southeastern host two diverse residency programs at HCA Kissimmee campus

KISSIMMEE—Osceola Regional Medical Center is ramping up its first-ever Graduate Medical Education (GME) program, substantiating a new chapter of becoming a prominent teaching facility and once again proving its dedication to investing in the local community.

In July, the HCA West Division hospital launched two very different residency programs at the Kissimmee campus via the University of Central Florida (UCF) and Nova Southeastern University, aimed at capturing the pipeline of doctors through residency programs and retaining them in Central Florida.

Trailblazing Program

With the advent of Osceola Regional’s new OB-GYN residency program, approved by the American Osteopathic Association and sponsored by Nova Southeastern University, comes the first-of-its-kind in Florida – and the southeastern United States.

The program began with such demand that Osceola Regional OB-GYN residency director Mark Palazzolo, DO, received 120 applications for three openings in 2014.

“We were initially approved for eight total residency slots, but because it’s such a popular program and the volume is there, we’ve moved our accreditation to 12 slots, accepting three first-year residents every year to the four-year program,” explained Palazzolo, who completed medical school at Michigan State University and residency at St. John Health System in Detroit. Even though studies show that nearly two of three residents practice medicine where they complete their residency, Palazzolo relocated to Central Florida in 2007 to pursue the opportunity to grow and develop the hospital’s women’s health department. It’s now the largest of its kind in Osceola County, with three offices and seven OB-GYNs affiliated with the hospital.

“We have such an intense need for OB-GYNs in Central Florida,” he said. “And while there’s no contract, agreement or understanding in place that a position will be available for residents when they complete the program, we look favorably on their desire to stay in Florida, more specifically the Central Florida region, when we go through our screening process for residency applicants.”

The residency program follows a nationally-recognized curriculum that includes rotations in obstetrics, gynecology, maternal-fetal medicine, and ultrasonography.

“All subspecialties have been catching the residents’ interest,” said Palazzolo. “It’s a nice balance.”

Every week, residents work a half day in continuity clinic, a practice that continues throughout the four-year program. The trio also has protected educational time through morning didactics.

The residency program has an unexpected bonus – spiritual medicine training – via a small grant that Palazzolo secured. “It was important to me for residents to have exposure to as many different facets of the specialty as possible,” he said.

New Health Economy Class

In July, Osceola Regional also launched a three-year internal medicine residency program approved for 60 residents through a partnership with the hospital, the UCF College of Medicine, and Orlando VA Medical Center.

“It’s a big program with 20 new residents a year,” explained Ejaz Ghaffar, MD, director of the internal medicine residency program at Osceola Regional. “By choice, we decided to take 16 this first year, to make sure we’re doing everything exactly right, and it’s all going great. So far, no major hurdles. We’ve very happy with the results and we’re looking forward to the next batch of residents.”

Ghaffar also bucked the trend by not remaining where he completed residency training. After graduating from Khyber Medical College in Pakistan, and completing his internship and residency at LaGuardia Hospital-Cornell University in New York, Ghaffar entered private practice in the upper Midwest, where he also led the Department of Medicine at Dakota Medical Center and served as clinical assistant professor at the University of South Dakota. A warmer climate and the opportunity to grow Central Florida’s internal medicine practice helped the Winter Park-based HIMS Hospitalist Group recruit Ghaffar to Central Florida in 1998. In addition to his role as site director of Osceola Regional’s internal medicine residency program, he also serves as medical director for Keystone Rehabilitation and Health Center in Kissimmee and assistant professor at the UCF College of Medicine.

“One aspect of this program that I really like is … instead of noon conferences, which traditional residency programs have, we’ve set up an academic half-day for didactics,” he said. “When I was completing my residency program, we had noon conferences that were constantly interrupted. We (residents) still had patient duties and were often paged to leave the conference, go out, and come back again, only to get paged again. Every Thursday, residents here are free of their ward duties – the faculty takes over those duties – so they can focus entirely on what’s being discussed.”

Internal medicine training, by nature, makes it more difficult to accurately determine the number of residents who may remain in the area, said Ghaffar.

“Some residents may choose internal medicine in practice, while others will go on to specialties such as oncology or cardiology, which require further training,” he said. “Certainly, some will stick around and we’re pleased with the potential.”

The internal residency program follows the 4 + 1 Block Schedule model. Every resident alternates a week of continuity clinic with four weeks of an inpatient rotation, outpatient rotation or elective.

“The 4 + 1 schedule minimizes conflicting inpatient and outpatient duties, and allows residents to focus fully on one educational aspect at a time,” said Ghaffar. “It optimizes each learning experience, and enhances the continuity clinic experience by allowing for better familiarization with the clinic setting, which becomes an educational home throughout the program.”

Ghaffar pointed out the residency program’s “tremendous support” from Osceola Regional faculty. “They’re all eager to teach residents,” he said. “Because Osceola Regional has grown steadily with new services and programs, it was obvious we needed to bring everything to the top of the line. We’re no longer the small community hospital.”

Full Circle

Even though the internal medicine residency program is based from UCF, it’s open to all successful MD graduates, noted Deborah German, MD, founding dean of the UCF College of Medicine, while also pointing out that not all interns are based or will be based from UCF.

The second year of interviews began last month for the next cohort, which includes several hundred possible candidates from all over the nation and the world, including UCF, she noted.

“We’re delighted with our first residents and their dedication to caring for our community,” said German, also vice president for medical affairs at UCF. “This new program is a testament to the power of partnership. Osceola Regional and the Orlando VA Medical Center are working with the UCF College of Medicine to create an outstanding internal medicine residency program that will bring more qualified physicians to our community. This new partnership provides residents with a diverse group of patients, including military veterans and residents of Osceola County, one of Florida’s most diverse and fastest-growing counties. Our residents are gaining experience in caring for everyone. This experience is vital for tomorrow’s healthcare leaders.”