By:Carrie James
Finishing up his final year as a resident in the radiology department at Nassau University Medical Center, Dr. Marcio Curvelo has plans take his specialty one step further by studying interventional radiology, a combination of radiological diagnosis and minimally invasive surgery.
Like many of his fellow radiology residents at the East Meadow hospital, Curvelo said he could attend any of the top hospitals in the country, including Harvard, to finish his studies.
"I'm applying now, and I'm shooting for Harvard or Yale," Curvelo said. "I need one more year of fellowship for interventional medicine. I know I am going to one of the top-10 hospitals in the country. It's because of the hands-on experience I got here. That is what's important. You do things at a higher level here."
Curvelo is not alone in his accomplishments. Across the board at the medical center, just under 300 residents in more than 20 different specialties get the supervised experience they need to succeed as doctors, said Christos Carvounis, director of academic affairs. Each year, the hospital takes on 100 new residents, starting this year at the beginning of July.
At least a quarter of the doctors that practice in Nassau County received at least some training at the hospital, and a majority of residents stay in the New York metropolitan area and Long Island, he added.
The residency program at the medical center has been in place for decades, and has a total of 22 accredited training programs, including anesthesiology, internal medicine, general surgery, pediatrics, ophthalmology and physical medicine/rehabilitation. The residency programs give graduates from medical schools the experience they need to get their medical licenses, Carvounis said.
"After you finish medical school, in order even to practice, you need at least one year of training [as an intern] to get a license," he said. "Many doctors choose to get a specialty, so they go into an approved residency program that averages between three and five years [but can go to seven years]."
Regardless of the department or what year of residency they are in, though, every resident and intern is supervised by the full-time faculty staff of doctors at the hospital, which number about 250.
Each resident is supervised differently, depending on the program and how many years they've been in residence, said Barbara Ramirez, house staff coordinator for the department of academic affairs.
A first-year resident in internal medicine, for example, would have little or no decision-making abilities. He or she would have to report findings to the supervising physician, and they would discuss diagnosis and treatment options.
"Most of the attending physicians' time outside of patients is spent with residents," Carvounis said. "Residents are not making decisions on their own. They are all made with the supervising physicians. Everything they do, every significant decision or every action, is closely supervised."
A third- or fourth-year resident, however, would still be supervised, but have a little more autonomy to make diagnoses and treatments.
"Every year of your residency, you get a little bigger responsibility, but at all times you are supervised," Curvelo said.
In many cases, Carvounis said, it is possible that admitted patients could have up to three doctors caring for them - a first-year resident, a third-year resident and the attending physician.
First, the first-year resident examines the patient, usually for a good hour, getting symptoms. That doctor then goes to the third-year resident and discusses his findings and gets feedback. In a similar way, the third-year resident meets with the patient and makes a diagnosis, and both doctors then confer with the attending physician, who also meets with the patient. A final diagnosis is then decided.
The medical center also offers internships to doctors of osteopathy, a study of medicine that involves treating the whole body. Doctors of osteopathy typically participate in a rotating internship in which they get a feel for many hospital departments.
"We do this to give them a diverse picture of medicine," Ramirez said. "Instead of going into a specialty, they go into a year of this first."
Dr. Martin Ferrillo, one of many osteopathy interns at the hospital, is participating in the traditional rotating internship before he goes into his residency for physical medicine.
"I get to work in almost every service," he said. "It gives you a real good view of what goes on here. I came here because this facility offers extensive cultural and medical diversity, from which I can take with me onto residency with the overall goal of being the best physician I can be."
Some doctors of osteopathy, however, elect to do their one-year in a particular field. Dr. Scott Meisel, who, like Ferrillo, attended the New York College of Osteopathy, is doing an internship in surgery.
Even though he has only been at the hospital two weeks, already Meisel has been asked to see patients, of course with supervision, to make diagnoses and give treatments. Recently, he saw a patient with a hernia and was able to give the patient the necessary care he needed.
"I spent about 15-20 minutes getting to know the patient as well as the disease, and thank goodness I was able to alleviate his concerns," said Meisel, who plans to go into plastic surgery. "I hope to learn how to be a compassionate and skilled physician and surgeon."
An uncommon aspect of Nassau's residency program, Carvounis said, is having residents' quarters located behind the hospital, enough to accommodate roughly 160 residents and their families.
The hospital rents studios, one-, two- and three-bedroom apartments well below the market rate. A three-bedroom runs about $900 for residents. The housing program not only provides the doctors with a temporary home, but it gives the hospital a plethora of doctors within walking distance of patients.
"There are not that many hospitals anymore that offer this," Carvounis said. "In fact, though, that is where the word resident came from, because they lived at the hospital. It is a great advantage, but it is not common. In the span of 30 years, this is the only hospital I've seen that has it."
It's an advantage in that any number of specialists can be called upon if an emergency comes into the hospital, Carvounis added.
Unfortunately, only about half the residents can live on the hospital's campus. The rest, the Department of Academic Affairs gives an allowance to help pay for housing in nearby communities, Ramirez said.
Regardless of where they live, the doctors participating in the internships and residency programs at Nassau said they have good experiences working there.
"You see a lot of different things here that you won't see in a private hospital," Ferrillo said. "You see people who have good health care and take care of themselves to those who don't have good health care or don't care for themselves. The spectrum of medical exposure is great."
Many of the doctors who leave Nassau go on to be highly successful in their chosen specialty, Curvelo said.
"When you leave here, frankly residents can go anywhere," he said. "They all pass their boards. It's a very high passing rate. Overall, the level here is pretty good."
