The Future of Medicine


For more than 85 years now, young doctors from far and wide have been coming to Santa Barbara to continue their training. Offering one of the few graduate medical education programs between Los Angeles and the Bay Area and with a national reputation for high quality teaching, Santa Barbara Cottage Hospital (SBCH) has been successful in attracting the caliber of young physician which adds to the program's standing.


Three medical career paths are offered to a total of 48 residents: 25 in Internal Medicine, 14 in General Surgery, and 9 in Diagnostic Radiology.



Dr. Matti Jansen, left, and Dr. Ashley Thorsell are in their first
year of internal medicine residency. They've been close friends
since attending elementary school together in Santa Barbara.



Many program participants say that one of the strongest attractions to SBCH is the variety of cases that residents have. Dr. David Kolegraff, who completed his surgical residency at Cottage in 1989 and has been busy in its operating rooms ever since, agrees.


"Compared to programs in large university settings, the breadth of experience offered at Cottage was a definite draw for me," he says. "Surgical residents here aren't confined just to general surgery. The variety and volume of cases-including ortho, gyn and other procedures-and the overall operative experience one gets through the Cottage program are a big plus."


Certainly, the training regime is rigorous, although the horror stories of 36-hour shifts without a break are no longer the norm in today's residency programs. Always under the guidance of attending staff physicians, the residents provide medical and surgical care to hospital patients without private insurance or without their own personal physician. They also assist private attending physicians with the care of their patients. And of particular value in the after-office hours, they help admit patients who have been seen by the Emergency Department physician. This translates to immediate response and 24-hour in-hospital coverage for illness and accidents, and it can bridge the time before the on-call specialist or personal physician can get to the hospital.


The residents also take turn staffing the Santa Barbara County Public Health Department outpatient clinics, and as experience increases, can take on more and more responsibility for inpatients and outpatients, eventually becoming involved in supervising and evaluating the newer residents.


Organizing and presenting educational conferences for their physician peers adds another dimension to residency training. Prominent medical and surgical experts-some local, some visiting professors-are invited to lecture at hospital conferences too, and it's generally acknowledged that such events bring academic stimulation to the hospital. Together with collaboration between residents and attending staff, some of whom serve on the teaching faculty as physician preceptors and provide one-on-one learning opportunities to the residents, the environment at a teaching hospital has mutual benefits for teacher and student, and ultimately for patients.


Dr. Andy Gersoff is among those who truly believe this. "It engenders self-examination, academic stimulation, and questions about why we are doing what we're doing, particularly in a time of rapidly changing medical knowledge and technology." And it remains gratifying to him and other members of the established medical staff to watch these young doctors train and develop. "There's no doubt that a teaching hospital challenges existing staff to stay current on the latest developments and ongoing research in medicine," adds Gersoff, program director of Internal Medicine Residency for the past 20 years.


What's also significant is the number of local physicians today who completed all or part of their residency training at SBCH and chose to practice in the community. It could be part climate, part great place to live, but combine those with a caliber of physician that's the envy of any town, and the greater Santa Barbara community has a winning mix.





Read other stories from the Fall 2009 Cottage Magazine here.