Each year, about 1,000 OHSU students and residents/fellows participate in rotations at the Portland VA Medical Center, and it all stems from a decision made at the end of World War II when the Veterans Administration (VA) partnered with the nation’s medical schools to jointly support patient care, research and education.
This pioneering decision by General Omar Bradley, head of the VA at the time, changed the face of medical education almost overnight, as VA medical centers welcomed a top-notch workforce, and medical schools had a new venue to train physicians and students.
Six decades later, the VA-medical school affiliation thrives on Marquam Hill.
Located across the sky bridge, the Portland VA is one of OHSU’s most important collaborative partners in medical education and research.
“VA physicians are committed to educational excellence,” said Donald Girard, MD, Professor, Department of Medicine and Associate Dean for Graduate Medical Education (GME) and Continuing Medical Education (CME). “Many have important teaching responsibilities on campus. They are centrally involved in every aspect of medical student, resident and fellowship training at the school.”
Jeffrey Kirsch, MD
"At the time of graduation, our medical students consistently cite their experiences at the Portland VA to be amongst the most valuable components of their training."
Since the relationship began in the 1940s, the Portland VA has grown to become the largest provider of external clinical training for the OHSU School of Medicine’s trainees. In 2010, more than 750 OHSU resident/fellow physicians in 73 Accreditation Council for Graduate Medical Education-accredited GME programs rotated at the Portland VA. These rotations occur multiple times over a resident’s three to six years of training. Internal medicine is the largest of the programs, training 96 residents last year, followed by psychiatry and general surgery. Residents also fill core rotations in many of the medical subspecialties, such as geriatric medicine and transplant hepatology.
Setting the national standard for patient safety initiatives, the Portland VA offers trainees invaluable experience working with veterans who may have unique and complex health care needs that require a high level of care coordination.
“While caring for patients with a broad spectrum of medical conditions, the VA has also focused on certain patient populations and disease entities, such as addiction psychiatry and geriatric medicine,” said Patrick Brunett, MD, FACEP, Associate Professor, Department of Emergency Medicine and Assistant Dean for Graduate Medical Education. “The availability of expert training in these and other specialized disciplines enhances the educational experience of residents and the overall quality of the GME program.”
It’s a mutually beneficial relationship. According to a 2009 Blue Ribbon Panel report on VA-medical school affiliations titled, Transforming an Historic Partnership for the 21st Century, “trainees make up a substantial portion of the VA’s overall clinical workforce. The 33,000 medical residents who receive training in VA annually participate intimately in almost 40 percent of VA’s medical care overall, and in an even higher percentage of inpatient care.”
The educational relationship also extends to medical students. In 2010, 20 percent of all OHSU student clerkships occurred at the Portland VA, with 50 percent of fourth-year MD students fulfilling electives there.
Brian Garvey, a third-year student, is currently participating in a VA Internal Medicine rotation. “I have been so impressed by the spirit of service that pervades the VA – both among providers and veterans alike,” he said. “It creates a learning environment for students that is fulfilling and meaningful, and reminds us of the importance of fostering these values in our future practice of medicine.”
“At the time of graduation, our medical students consistently cite their experiences at the Portland VA to be amongst the most valuable components of their training,” said Jeffrey Kirsch, MD, Professor and Chair, Department of Anesthesiology & Perioperative Medicine and Associate Dean for Veterans and Clinical Affairs. “Without doubt, this is just one of many reasons why VA staff are regular recipients of teaching awards from trainees at all levels.”
With VA Medical Centers helping to train over 100,000 medical professionals each year, the experience gained by these trainees will continue to impact the strength of health care across the United States for many decades to come.
Pictured above: (top) the Skybridge and OHSU hospital; (bottom) Brian Garvey, MS3