Seven months after launching its inaugural residency program in internal medicine, HCA Florida Fort Walton-Destin Hospital is already seeing positive impacts on both patient care and hospital culture.

• The University of Central Florida/HCA Florida Healthcare GME Consortium program, which received initial accreditation from the Accreditation Council on Graduate Medical Education in March 2024, is part of the nation’s largest graduate medical education community.

On National Thank a Resident Day, celebrated annually on the last Friday of February, program leaders and resident physicians reflected on the program’s progress and its effect on healthcare access in the community.

“One of the proudest things I have as a resident director is seeing the almost immediate impact that these residents have had on our community in the continuity clinic,” said Dr. Amanda Finley, program director. “They have been able to provide open access to primary care, which previously had long waiting periods for appointments.  These residents are seeing new patients every week.”

The White Wilson Internal Medicine Clinic, across the street from the hospital and operated by the residency program, is currently seeing up to 16 patients daily, with anticipated availability to serve up to 60 patients daily by 2026.

The three-year internal medicine residency program, which welcomed its first 12 residents with a white coat ceremony in July 2024, expanded medical care in the local area. The program collaborates with over 50 local physicians and has faculty collaboration with the University of Central Florida College of Medicine.

Dr. Jessica Rambharose, one of the resident physicians, emphasized how the program is filling healthcare gaps in the community.

• “In addition to locals, we get a lot of ‘snowbirds,’ but it just shows me also the difference in access to healthcare in smaller cities and rural areas compared to a big city like Boston, Massachusetts,” said Dr. Rambharose, who relocated from Boston for residency. “Now that I know that there’s this gap, I just feel more inclined to try to fill it.”

Enhanced patient care and hospital culture

Finley noted that the program has elevated the level of medical care at the hospital.

“It’s always exciting to bring the element of education, training, research, scientific studies to every conversation,” Dr. Finley said. “It really takes the level of medical care to the next level, and I think it energizes the medical  and the nursing staff.”

The integration of residents has improved patient communication and follow-up care. Residents spend significant time with patients, explaining treatment plans and answering questions.

• “The ability that the residents have to continue that conversation in the hospital, to go back and see the patient every day, is definitely a patient satisfier,” Finley said.

For Dr. Christopher McQuillan-Hicks, a resident physician from Mobile, Alabama, the program has allowed him to take greater ownership of patient care.

“A lot of our attending physicians encourage us to take over the full care for a full 24 hours under their supervision,” Dr. McQuillan-Hicks said. “Just yesterday in the ICU, I managed a patient who was a critical diabetic [diabetic ketoacidosis] and I ensured that they were receiving proper insulin drips.”

Hands-on experience beyond expectations

Both resident physicians said the program has exceeded their expectations in terms of hands-on experience and learning opportunities.

“My first month of residency was my ICU rotation,” Dr. Rambharose said. “I was the first resident in the ICU, and I think it was about three weeks in that I started procedures, central lines, arterial lines, and intubations under the supervision of the APRNs and the attending physicians.” 

Dr. McQuillan-Hicks expressed similar sentiments about his rotation in gastroenterology.

“Just having them put a scope in your hand, being trusted enough to do an upper esophageal scope, in addition to colonoscopies under direct supervision, it’s amazing to get those types of skills  within your first couple of months here in residency,” he said.

The program offers unique training opportunities, including access to simulation equipment and ultrasound training. Residents have access to both low fidelity simulators at HCA Florida Fort Walton-Destin Hospital and high-fidelity simulators at HCA Florida West Hospital, a sister hospital in Pensacola.

• “Here at HCA Florida Fort Walton-Destin Hospital, we have the low fidelity simulators and the ultrasound devices, and so we have our classroom lab where they learn ultrasound-guided techniques to ensure precision, accuracy and safety for all the internal medicine procedures,” Dr. Finley explained.

Research opportunities with wide impact potential

A standout feature of the program is access to HCA Healthcare’s vast research database. The program currently has seven ongoing research and quality projects in collaboration with the national HCA Healthcare Research Team.

“When these residents develop research protocols, we’re using the entirety of the HCA Healthcare organization, which is the world’s largest healthcare organization,” Dr. Finley said. “We can pull data from literally millions of patient encounters.”

Residents are supported by program faculty and a team of national research coordinators who help select topics, provide resources, and guide projects from inception to publication. HCA Healthcare GME programs can leverage data from more than 30 million patient encounters across facilities each year, and residents have access to prominent medical journals and clinical databases.

• This access allows residents to potentially answer significant questions about drug interactions or treatment approaches that “could completely revolutionize that area of medicine,” according to Dr. Finley.

Dr. McQuillan-Hicks is already taking advantage of these research opportunities, working with cardiology faculty to develop a protocol for a retrospective study examining anticoagulation treatment.

Community involvement and physician wellness

Beyond clinical work, residents actively participate in local community events, which has enhanced their experience. The program encourages volunteer involvement with local organizations and participation in local school career fairs. Dr. McQuillan-Hicks volunteered at a ‘Trunk or Treat’ event at The Boardwalk on Okaloosa Island in October, while Dr. Rambharose participated in the Dragon Boat Race for suicide awareness and prevention.

“It showed me a sense of camaraderie between the team, not just in the hospital, but outside the hospital as well, and the opportunity to network and spread the word about our program,” Dr. Rambharose said about the Dragon Boat event.

Residents also engage in 17 hospital and patient care committees to participate in discussions to innovate and deliver high-quality healthcare.

• The program emphasizes physician wellness, recognizing the intense nature of residency training. Residents work 80-hour weeks while studying and taking regular tests to check their knowledge across the 12 internal medicine subspecialties.

“The idea of physician wellness has become incredibly important,” Dr. Finley said. “HCA Healthcare really takes that as the core of our resident training.”

Looking to the future

As the program continues, Dr. Finley has plans for expansion.

“Not only is our program going to grow to 36 by 2026, but we’re looking at a transitional year program, which would be another residency program and possibly other categorical programs where we train in other specialties besides internal medicine,” she said.

The program is part of HCA Healthcare’s extensive graduate medical education network. Nationwide, HCA Healthcare offers more than 300 graduate medical education programs across 79 hospitals in 16 states, with over 5,100 residents and more than 300 specialty fellows.

• The HCA Florida Fort Walton-Destin Hospital program maintains affiliations with two nearby medical schools: Alabama College of Osteopathic Medicine and the Auburn campus at Edward Via College of Osteopathic Medicine. Approximately 20 medical students per year train alongside the residents.

For the resident physicians, their goals extend beyond their own training. Both expressed interest in becoming effective teachers and mentors for future residents.

“I want to become the best resident physician teacher to my interns and second years. As I become a third year, I want to be able to become a mentor as well,” said Dr. Rambharose, who hopes to pursue a cardiology fellowship after residency.

Dr. McQuillan-Hicks, who has developed an interest in cardiology during his time in the program, echoed this sentiment: “I’m really excited about growing as a resident doctor and being able to communicate quality patient care to the people that are coming in next with us.”

• Upon completion of the program, graduates will be prepared to obtain certification with the American Board of Internal Medicine and the American Osteopathic Board of Internal Medicine, demonstrating they have the clinical judgment, skills and attitudes essential for delivering excellent patient care.

For those considering applying to the program, the current residents offer high praise.

“Our program is a hidden gem. Our attendings are exceptionally trained and their knowledge is so vast and they’re willing to teach,” Dr. Rambharose said. “They’re excited to teach and this is going to become a great teaching program.”

National Thank a Resident Day holds special significance for the program in its inaugural year.

“I love the idea of an intentional day where we can be thankful,” Dr. Finley said. “Thankfulness often brings about joy in what we do, whether we’re the one thanking or the one receiving the thanks.”

The program is currently recruiting its next class of 12 residents for July 2025.