In Residency: Doctors-in-training already making a difference

By Jamie Durant
Morning News Health/Environmental Reporter
Published: July 24, 2008

FLORENCE—The interns of “Grey’s Anatomy” and “Hopkins” have nothing on the residents of the McLeod Family Medicine Residency Program.

Though they are not on a constant surgical rotation or enduring the high-energy pace of an emergency room rotation with massive traumas every five minutes, they do work in the trenches of family medical care, treating real people living in the Pee Dee. Sometimes they even make house calls.

Dr. William Hester, director of the program, said his residents come into the program as interns, but they leave as family medicine doctors — ready, willing and able to treat thousands suffering from a wide variety of illnesses.

“The residency program is an educational institution that provides both education and a service,” Hester said.

The program began with only two residents in June 1980. Hester said a computer program matches prospective residents with residency programs based on how the residents rank their favorite programs and the programs rank residents. If the McLeod program puts a medical student on its list and that same student has the McLeod program on his list, then the program would designate them as being compatible and the student would be offered the chance for a place in the program.

The residents sit in on lectures each week and see patients, as well.

Dr. William Powell of Hartsville is a third-year resident enrolled in the program. Hester said Powell has a group of patients who come to see him specifically, and they either will opt to follow Powell once he establishes his own practice or have their care reassigned to the remaining residents in the program.

Hester said the program, while not free, is pro-rated to meet the payment abilities of the patients.

“We have patients constantly enrolling to come here, but we can’t take all of them,” Hester said.

“We take care of about 15,000 patients here,” he added. “There are guidelines on how many patients the residents should see, and we have faculty and supervisors overseeing the remaining patients.”

Hester said the majority of residents trained through the program make the decision to remain in South Carolina.

More than 160 residents have graduated from the program thus far, and 65 of those have stayed in the Pee Dee. Ninety-three residents have stayed in South Carolina, which is a 59 percent retention rate, he said.

Hester said a focus on rural medicine requires that the residents learn how to treat chronic diseases such as heart disease, diabetes, high blood pressure and tuberculosis, that are prevalent in South Carolina.

“We teach preventive medicine, too,” he said. “You give them education, and they assert it.”

Dr. Gerald Jebaily, associate director of the residency program, said he thinks the high number of residents who remain in the area is reflective of the high quality of medicine being practiced in the Pee Dee.

“Many of them stay, if not in the Pee Dee, in the state,” Jebaily said. “We have the highest retention rate of any residency program in the country. They come here, they like the climate, they like the doctors, they like the hospital, they like the way of life.”

Jebaily said there are 23 residents training in the program right now. The residents get three years of training after medical school to prepare them to become board certified doctors.

“This is the way young family doctors are trained throughout the country,” he said.

Powell said the residency has given him the actual chance to practice the skills he has learned during his time as a medical student. While most of the things he has seen have been common medical conditions, he said there have been a few oddities.

“I’ve seen a couple cases of sarcoid of the brain (hardening of the brain),” he said. “Usually it presents in your lungs, but it can be anywhere. We see it fairly often in South Carolina, but very rarely it can present in your brain.”

Hester said although the residents do compete with each other, it’s not in the same way played out on television medical dramas.
“In the residents lounge, there is a white board, and it is filled with bizarre and extreme findings, like the highest blood sugar, which was 1,200 or 1,500 — something like that,” Hester said.

He said they’ve also recorded the busiest day they’ve had, as well as the slowest.

“It was a block of about six hours one Christmas several years ago. We got down to one patient,” he said.

Powell said after he graduates from the program, he hopes to set up a practice in his hometown of Hartsville, but Hester and Jebaily both said they hope he chooses to remain at McLeod.