The 1960s was a time of transformational changes in medicine. In the wake of World War II, dramatic societal shifts left many communities impoverished and millions of aging Americans in nursing homes that were ill-equipped to serve the growing population. As more physicians chose to focus their practice on a specialized area, the need for dedicated specialty training programs increased, and the number of general practitioners decreased.
A promising new idea emerged to help reverse that decline while providing more rigorous training to help practitioners keep apace with the rapidly advancing medical field: Make family medicine a specialty of its own, with physicians focused on delivering comprehensive health care while building meaningful relationships with patients of all ages and backgrounds.
Penn Medicine Lancaster General Hospital’s Family Medicine Residency Program began in 1969 – the same year that family medicine was officially recognized as a distinct specialty in the United States. Under the direction of Nikitas Zervanos, MD, program director emeritus, the program was one of the first to train the next generation of physicians in the new specialty.
Now celebrating its 50th anniversary, LGH’s pioneering residency program remains one of the most consistently top-ranked among more than 500 programs focused on family medicine across the country. About one-third of the program’s 523 graduates have gone on to practice medicine in Lancaster County, many serving in leadership roles at LG Health.
J. Kenneth Brubaker, MD, who graduated with the residency program’s first class in 1973, went on to co-found LG Health Physicians Family Medicine Norlanco. He recently retired from LGHP Geriatrics after a long career that included such varied experiences as doing mission work in Puerto Rico and seeing patients in Lancaster County Prison.
“I especially appreciated the residency program’s emphasis on caring for the whole person, namely the physical, mental, social, and spiritual well-being,” he said. “I was blessed to train with colleagues who were enthusiastic and passionate about family medicine and had a clear calling that was driven by their faith.”
LGH residents gain broad skills, training in inpatient, outpatient, rural, and urban settings, with a special emphasis on obstetrics. Pamela A. Vnenchak, MD, a 1993 graduate who recently succeeded Stephen Ratcliffe, MD, as the program’s third director, remembers being on-call by herself in rural Quarryville.
Patients would call or knock on the door with ailments that ranged from broken bones and lacerations to chest pain, she said. While it was rather terrifying to never know exactly what was coming next, having to solve the problem by herself, she says, also gave her a lot of confidence.
The promise of diverse clinical experiences attracts many future residents. Christine M. Stabler, MD, LG Health vice president of Academic Affairs, had no plans to leave her native Philadelphia until, as a third-year medical student, she heard Zervanos speak.
“His speech resonated with me,” said Stabler, a 1983 graduate. “He put my feelings about continuous, comprehensive care into words and more importantly, actions. I knew then that Lancaster would help me become the physician I envisioned.”
While program graduates practice in such far-off locations as Africa, Alaska, and Hawaii, many put down permanent roots in Lancaster during their three years in residency. In recent years, about 60 percent of graduates have joined LG Health Physicians practices.
John C. Wood, MD, medical director, LG Health Physicians, and a 2004 graduate, said the residency program’s comprehensive training prepares graduates to confidently pursue any career direction they choose. The emphasis on providing comprehensive care helps many to feel at home in a full-spectrum family practice, but more than a dozen areas of concentration allow other graduates to dedicate their careers to more specialized areas, such as sports medicine, geriatrics, hospital medicine, or HIV care.
The program also trains physicians in the key competencies of leadership. Graduates have gone on to become LGHP regional medical directors and managing physicians, department chairs, program directors, medical school deans, Family Physicians of the Year, and leaders in national professional associations.
Michael R. Ripchinski, MD, chief clinical officer at LG Health, who graduated in 2006, said LGH was his top-ranked residency program, due to its reputation, his experiences during medical school rotations, and the caliber of faculty, residents, and the hospital. His interest in leadership and the administrative aspects of medicine originated during residency.
“I developed a calmness under pressure for anything I do now in my current role as a result of experiences leading hospital codes, performing procedures in our rural office and delivering over 100 babies during residency,” he said. “I absolutely believe that my formative years in residency directly contributed to my abilities to engage and lead others to improve our patients’ outcomes.”
Zervanos, who served as director until 2002, attributes the program’s continued success to administrative and clinical staff support, a dedicated faculty and the residents themselves. Admission to the program is highly competitive, with 150 physicians applying for 13 openings each year.
“So many times on an interview day, I felt so inspired by the young people applying,” he said. “Some didn’t end up coming to our program, but thankfully, a lot of them did.”