A DYNAMIC PARTNERSHIP

A DYNAMIC

PARTNERSHIP

TOURO UNIVERSITY AND ST. JOSEPH’S MEDICAL CENTER MAKE SIGNIFICANT PROGRESS IN EXPANDING RESIDENCY TRAINING

BY JO ANN KIRBY

St. Joseph Medical Center’s flourishing evolution as a teaching hospital, in partnership with Touro University California, is bringing more specialists to San Joaquin County and training the next generation of doctors while creating better health outcomes for our medically underserved community.

The mission is threefold: To continue to build up SJMC as an educational institution, to increase the number of medical professionals that practice in our underserved community, and to offer service lines for specialties that are either scarce or nonexistent, so vulnerable patients don’t have to travel out of the area for care.

“We now have six accredited residencies. We have 95 residents currently.,” Don Wiley, CEO and president of SJMC, said. “It attracts physicians we might not have attracted because they want to teach. Service lines are being stabilized and strengthened in specialties.”

In addition to the initial residencies SJMC started in emergency medicine and family medicine, St. Joe’s has since added residencies in anesthesiology, internal medicine, psychiatry, and transitional year. And SJMC is also pursuing accreditation for residencies in orthopedic surgery, neurology, urology and interventional radiology. Once established, there would be room for 220 residents overall. Graduate medical education — GME — is a hospital-based training program for doctors who have finished medical school and earned an M.D. or D.O. degree. GME includes residency, internship, fellowship, specialty, and subspecialty programs. Becoming a teaching hospital isn’t something that was undertaken overnight. It requires a significant amount of commitment, time, and preparation.

An effort by SJMC board member Baraj Singh to help her daughter, who was a medical student at Touro University, land a clerkship in Stockton to complete her clinical rotations was just the spark.

A clerkship program for third- and fourth-year medical students to learn from our community’s physicians designated SJMC as a teaching site for clinical rotations and the committee formed to make that happen decided there was more work to be done. Dr. Ben

Weiderhold, director of SJMC’s emergency room department, had been advocating for a residency program in emergency medicine. After the success of delving into undergraduate medical education with the clerkship program, the group began to explore the possibility of expanding into graduate medical education. It was an idea that gained traction and Touro came on early in the journey as educational consultants.

Dr. Richard Riemer, a Touro associate senior dean said because its Vallejo medical school doesn’t have its own hospital, it looks to form partnerships where its students can complete their clerkships and residencies. “When putting together a strategic plan for St. Joe’s … the idea was to develop programs that fit the need of the community because this is a health provider shortage area,” Dr. Riemer said.

The idea was to grow our own physicians in the community that could fill the gaps in shortage, Dr. Riemer said, and even more ambitiously, to grow physicians in areas of specialties where there had been none at all.

Accreditation for two residency programs, one in emergency medicine and one in family practice, brought 15 residents to

Stockton in its inaugural year back in 2018. “It’s really incredible. We’ve got a really good team here and we’ve added professionals who have experience in teaching. We are most proud of our goal of being able to serve our community and strengthen our ability as a health care provider,” Wiley said. “We want to train and increase the number of physicians in the Central Valley. It’s really important.”

The residency program is dedicated to training highly skilled physicians in a community where patients, many of whom are enrolled in Medi-Caid or other public insurance, might not have the basic means to travel out of the county for specialized care. A well-documented shortage of primary care physicians and specialists makes the program even more important.

The partnership with Touro and their investment in our community has brought more physicians who are practicing medicine here, teaching residents, making San Joaquin County their home, and raising their families here.

Touro University Medical Group, an affiliate practice of Touro University California College of Osteopathic Medicine, opened its clinical office in Stockton and is home to physicians who are part of the St. Joe’s staff and teaching in

“It’s really incredible. We’ve got a really good team here and we’ve added professionals who have experience in teaching. We are most proud of our goal of being able to serve our community and strengthen our ability as a health care provider. We want to train and increase the number of physicians in the Central Valley. It’s really important.”

DON WILEY, CEO AND PRESIDENT OF SJMC

its GME programs. “It is the university faculty practice where we recruit and staff the residencies for internal medicine, psychiatry, neurology and urologic surgery,” Dr. Riemer, who is a neurologist, said. “Our faculty are here in our clinic, we have privileges at the hospital, we have teaching faculty appointments within the residency programs. … and with that we are sort of linked at the hip if you will as we’ve integrated ourselves into the community and St. Joseph’s.”

The medical group gives residents the opportunity to see patients in an outpatient setting and it continues to grow to fulfill the teaching needs and the community needs. Their offices are now in several locations in Stockton and the plan is to move all their divisions, within to two to three years, into new construction at University Park. Dr. Howard Feinberg, also a dean with Touro University, said the medical practice stepped up in partnership with the hospital to build up a clinic system to provide services to the community as well as provide teaching and training to students and residents in the community. As the residency programs grow and as SJMC gains accreditation for more, Touro continues to recruit additional doctors to grow its faculty. The partnership is an ambitious effort with a big payoff. “We are a community hospital and the typical community hospital that starts a residency might do family medicine or emergency medicine and that’s hard,” Wiley said, explaining that the accreditation process is arduous and painstaking. “What we are trying to do, become a teaching hospital, is very highly unusual. This is very ambitious. It’s incredible for a little hospital like us.” Already, a half dozen doctors who completed their residencies in emergency medicine alone have stayed to continue their careers here. And that medical student looking for a clerkship in Stockton? Well, Dr. Jasmine Singh started her own psychiatry practice here in Stockton.

California ranks second in the United States in retention of physicians who have gone to medical school and trained here, Dr. Riemer said, adding that “if we can get a person to Stockton, there’s an 80 to 90 percent chance that they are going to remain in California and a high percentage will remain in our area.”

The symbiotic partnership between SJMC and Touro has not reached its full potential. Dr. Reimer sees potential for continued growth in GME over the next three to five, especially with SJMC’s plans to add more hospital beds. And Wiley has plans to do even more.

“Once we are fully built out in 2025 or 26, we will turn our eye to fellowships,” Wiley said, adding that is a logical consequence to growing as a teaching hospital and fulfilling the community’s health needs for specialists.

HOW IT STARTED HOW IT’S GOING

A MOTHER’S DETERMINATION PAYS OFF

BY JO ANN KIRBY

Dr. Jasmine Singh was attending medical school at Touro University when it was time for her to start a clerkship. There was a need for clinical rotations that wasn’t being filled locally and Dr. Singh’s mother was determined to change that.

The result? “My daughter was the first student from Touro to do rotations in Stockton,” said Balraj Singh, a former clinical scientist who is serving as a practice manager for her husband’s medical office in Stockton.

Getting there took persistence that paid off, she said. “I was going to keep on asking everyone until I went down the list,” she said, describing how she went through all her contacts to gauge interest and support. Her husband, nephrologist Dr. Jagjit Singh, arranged a meeting with St. Joseph’s Medical Center President and CEO Don Wiley. Dr. Gregg Lund, who was a dean at Touro University at the time, was among those who attended the initial pitch.

“The meeting was supposed to be an hour. I’m so happy and grateful that he listened to us and we formed a committee,” she said of Wiley’s enthusiasm.

Balraj called on doctors and even delivered applications that would get them on board as Touro assistant professors. She stayed with the mission until it was completed. “She’s one of a kind and I’m not just saying that because she’s my mom,” Dr. Singh said.

As a student in her third year of medical school, Jasmine felt right at home completing her rotations in St. Joe’s. “I remember it was so surreal because this is a place my father has worked for 30 years and my mother was on the board,” she said. “I would meet dad for lunch in the cafeteria when I was a kid.”

She recognized her father’s colleagues in the hallways and knew the layout of the hospital. It felt like home. After she started, she bumped into her dad one day who was momentarily surprised to see her until he remembered she had begun her clerkship.

After graduation from medical school, the psychiatrist completed her residency at UCSF Fresno because there wasn’t a program in place for someone in her field here. That would change with time as an effort to start rotations for medical students here blossomed into a concerted push to establish graduate medical education programs.

“Balraj was instrumental and had an interest because of her daughter,” said Wiley. “And Dr. Ben Wiederhold, director of our emergency room department, also urged us to do this.

For her work, Touro honored her with its Dean’s Recognition Award to thank her for her “ongoing help which has been instrumental in forging and continuing the relationship between TUC and St. Joseph’s Medical Center.”

She said she is very thankful that Wiley took the time to listen to her dream. “Everyone can make a difference in the community,” she said. “You just have to be passionate, persistent and hardworking and never take no for an answer.”

The effort to host rotations was a seed that, once planted, bloomed and grew. The homegrown effort also paid off in bringing Dr. Jasmine Singh back to Stockton and those involved educating doctors here hope more specialists who serve their rotations and complete their residencies in San Joaquin County will see the benefits and stay as well.

“I’m on the committee for the residency programs and if I can’t convince my daughter that doesn’t look good,” Balraj Singh said, laughing.

Turns out, her daughter didn’t need much convincing.

“I went to L.A. to try and make it on my own. The biggest thing I missed is there was no sense of community. I returned because I missed my people, especially during the pandemic. And professionally, I had a dream of opening my own practice,” Dr. Singh said.

Professionally and personally, she has never been happier, adding that the support of her community means the world to her. And practicing here allows her to be part of a bigger support group. “Psychiatry is very underserved. To be in a place where people really want to get better mentally is very gratifying,” she said. “To bring the expertise here and be valued is very gratifying.”

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