Formed more than eight years ago, the psychiatry residency program at Pine Rest Christian Mental Health Services has been paying dividends by helping to ease an acute shortage of providers and expand services.
Of the 17 psychiatry residents and fellows who completed their training at Pine Rest this year, 16 opted to remain in West Michigan to practice. Nearly two-thirds accepted a position at Pine Rest after completing their residency, while the others opted to practice at another care provider in the region.
The retention rate is about twice the amount that physician residency programs typically experience, said Pine Rest Chief Medical Officer Dr. Bill Sanders.
Bringing more mental health professionals into the market was Pine Rest’s goal when starting the psychiatry residency program in 2014. The results have easily exceeded expectations and have enabled Pine Rest to expand mental health care service, including the opening of a psychiatric urgent care center three years ago.
The program’s retention rate for new psychiatrists is “almost unheard of,” Sanders said. Pine Rest was “really struggling in the past to get physicians to come to West Michigan,” he said.
“There is no way we could have predicted just how well things were going to go. When we started the program, we were thinking, ‘Boy, we’d be lucky to train six residents a year.’ Now it’s 12 a year just in terms of the general residency program, and we have sub-specialty residency programs on top of that,” Sanders said. “It has just enhanced the behavioral health care for patients, not only here at Pine Rest, but the whole community. Our residents rotate at a lot of different sites. To see the elevated health care in the community has just been impressive.”
Shouldering the burden
Beyond the Cutlerville urgent care center that served more than 13,500 patients and recorded nearly 17,300 visits to the center over its first three years, Pine Rest has used psychiatry residents to expand care in areas such as treating children and adolescents and in substance use disorder. As well, the psychiatry residents enable Pine Rest to do more integrative care, providing consultation to primary care doctors, federally qualified health centers and community mental health agencies.
Pine Rest recently added a rural residency track in Traverse City to train psychiatrists in Northern Michigan where the psychiatry shortage is even more acute.
Psychiatry residents have better enabled Pine Rest to respond to significantly high incidence rates during the COVID-19 pandemic for conditions that include anxiety and depression and substance use disorder. At any given time, more than 50 residents and fellows now work at Pine Rest.
“That’s a lot of physicians to help shoulder the burden,” Sanders said.
“It’s weird to think: In eight short years, where would we be without the residents? Where would we be without them?” he added. “They’ve become an invaluable part of our service line.”
Students graduating from medical school who choose to specialize in psychiatry serve a four-year residency, plus another year or two in a fellowship if they go into a sub-specialty such addiction, forensics, children and adolescence, or geriatrics.
Pine Rest just completed its third psychiatry residency class. Since the program’s formation through a partnership with Michigan State University’s College of Human Medicine, 50 psychiatry residents have completed their training at Pine Rest, a “significant number” of whom chose to remain and practice at Pine Rest or in West Michigan.
The 51 psychiatry residents now at Pine Rest came from 18 different states to serve their residency.
“Michigan’s kind of a net exporter of doctors after they finish their training,” Sanders said. “So to be able to get individuals to stay here in Michigan is really a pretty big shift and is really good for West Michigan and our community. It kind of tells us that they’re having a good experience practicing here in West Michigan and the state of Michigan.”
In some instances, the residency program allowed new psychiatrists to do their training after medical school near their hometown.
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That’s the case with Dr. Dan Tuinstra, an Allegan County native who just completed a four-year residency and is now doing a one-year sub-specialty fellowship in addiction psychiatry before going to work at Holland Hospital.
The program enabled Tuinstra, a 2018 graduate from MSU’s College of Human Medicine, to serve his residency close to home.
“I definitely wanted to stay in this area,” said Tuinstra, a father of three young children who was heavily recruited around the country. “I have strong ties to the area and this is what I always called home.”
Pine Rest’s program started with seven psychiatry residents in the first year and has grown to 17 annually, which is close to a cap on slots that qualify for federal funding. Pine Rest would like to expand the program further and train more sub-specialists in addictive, forensics and geriatric psychiatry where “there’s a huge need,” Sanders said.
Pine Rest can apply for additional residency slots, but it would not qualify for more federal funding. Still, as the need continues to rise for new psychiatrists, Pine Rest could pursue further expansion without the added funding, Sanders said.
“At some point, it might get to the point to expand it even if we’re not getting funded if the residents and fellows are able to provide care,” he said. “That’s a calculation that a lot of programs do.”