DATE: Friday, February 28, 1997             TAG: 9702280566

SECTION: LOCAL                   PAGE: B1   EDITION: FINAL 

SOURCE: BY DEBRA GORDON, STAFF WRITER 

                                            LENGTH:   72 lines

NAVY CUTS 7 TRAINING PROGRAMS AT HOSPITAL 87 POSITIONS AT PORTSMOUTH NAVAL TO BE AFFECTED

Portsmouth Naval Medical Center will lose seven of its 12 physician training programs over the next five years - or nearly half the doctors the hospital trains - as part of a Navywide cut in graduate medical education.

Overall, the Navy is erasing 122 training positions, 87 of them at Portsmouth Naval.

But the loss will be invisible to military service members, dependents and retirees who depend on the hospital for their medical care, spokeswoman Lt. Merritt H. Allen said, because the Navy will replace the residents with military or civilian doctors.

Residents are licensed doctors who have finished medical school and are learning a specialty by spending another two to five years in training. About 70 percent of their time is spent caring for patients.

Portsmouth Naval, which typically has about 200 residents on its floors, will lose those in obstetrics and gynecology, pediatrics, urology, psychiatry, pain management and anesthesiology, along with residents training in ear, nose and throat care. Pediatrics and OB/GYN, with 20 residents each, will be the hospital's most-affected departments.

Training programs in internal medicine, surgery, emergency medicine and orthopedics will remain.

That's important, said one expert on graduate medical education. ``The two key areas, the most critical, are medicine and surgery,'' said Dr. Paul Griner, a director with the Washington-based Association of American Medical Colleges. Many teaching hospitals don't have training in ear, nose and throat, anesthesiology and pain management, he said. ``So it's possible to retain most of the strength of a teaching hospital with the programs that are being retained.''

But losing such a large number of its medical training programs will require ``a total revamping of the way patient care is delivered'' in those services at the hospital, he said.

Portsmouth, for instance, will probably have to rely more heavily on nurses and other ancillary staff to provide many of the tasks previously performed by residents, he said.

On the plus side for Portsmouth, Griner said, it may see direct medical costs reduced because residents tend to order more tests than attending physicians.

With 360 beds, Portsmouth Naval is the third-largest hospital in South Hampton Roads, and the centerpiece of medical care for the region's vast military population. In 1994, it hosted 1.75 million outpatient visits and treated an average of 238 inpatients a day.

The cuts are part of the Navy's overall downsizing drive, said Jan Davis of the Navy's Bureau of Medicine in Washington. The Navy plans to reduce its medical staff from 4,050 to 3,376 over the next five years, she said.

Reducing training positions is part of that strategy. Cuts in residency slots are also planned at the service's hospitals in San Diego, Bremerton, Wash., and Bethesda.

Most specialty training programs among the Army, Navy and Air Force will be consolidated at Navy hospitals in San Diego and Bethesda, and Army hospitals in San Antonio and Tacoma, Wash., she said.

The move should have no impact on other hospitals in the region. Although about 10 Portsmouth pediatric residents a year rotate through Children's Hospital of The King's Daughters, ``we don't rely on them as part of our contingent,'' a spokeswoman said.

Eastern Virginia Medical School in Norfolk doesn't run any of its residency programs at Portsmouth Naval, said Linda Archer, assistant dean for graduate medical education.

However, the school sometimes sends residents to the Navy hospital for special training. These sessions last no more than a month, she said.

She said she's not sure yet what effect the end of the programs might have on EVMS's programs, but she expects it will cause few problems for the Norfolk school. MEMO: Staff writer Marie Joyce contributed to this story.

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