Maria Persianinova sat down at a computer in the emergency department at Kennewick General Hospital, leaning in to get a good look at the CAT scan image displayed on screen.
Dr. Joe Loera, one of the lead physicians in the department, stood over her shoulder.
They talked about the image together.
Persianinova is a doctor too. But she's still learning -- in her first year of an intensive, three-year training period known as a residency.
She started this summer, along with two other young physicians, Minh-Triet Vo and Shahla Walizada. Together, they make up the first class of medical residents at KGH.
Hospital officials say they're off to a strong start, with the director of medical education describing them as "phenomenal" and an energizing force.
The young doctors said they're learning a lot.
Residency is a busy time in a physician's life, with plenty of long hours. But it's exhilarating too.
The feeling you get when you help a patient -- "that's what made me go into (medicine)," Persianinova told the Herald. "It makes me feel good, that, yes, I helped this person ... You wait for that moment."
Unique in the Tri-Cities
A residency is the next step after medical school. It's required to become board-certified.
KGH's two residency programs -- one in internal medicine and the other in family medicine -- started in July and are the first of their kind in the Tri-Cities.
Kadlec Health System in Richland is working with the University of Washington to join its family residency network. That program will be put in place in the next 18 months, with up to 18 residents once the program is fully operational.
At KGH, Persianinova is specializing in internal medicine, which deals with adult diseases. Vo and Walizada work in family medicine.
The residents work rotations in a variety of departments and specialties and see their own patients in a clinic setting. They're overseen by supervising physicians.
They also attend lectures and participate in other academic activities as part of the programs.
Although the KGH residency programs are new, the hospital has welcomed medical students from Pacific Northwest University of Health Sciences (PNWU) in Yakima for several years. KGH officials help facilitate their rotations in the community.
Not enough doctors
Experts say the aging Baby Boomer population and other factors are contributing to a looming physician shortage nationally.
The Association of American Medical Colleges forecasts a shortage of more than 130,000 physicians by 2025.
As a result, medical schools are expanding and more are starting up. And that means more residency programs are needed.
Dr. Heather Phipps, an orthopedic surgeon and director of medical education at KGH, said a community hospital like Kennewick General is an ideal place to train residents.
Many physicians end up in a community setting, and "(residents) really do learn how to be good community physicians by working at a community hospital during their training," Phipps said.
And it doesn't hurt that many residents choose to remain in the community where they trained.
"From a leadership standpoint, one of the big things for KGH -- one of our motivators -- was just that," said KGH spokeswoman Lisa Teske. "There's a doctor shortage coming and so one of the things that we saw the opportunity to do was be contributing to this community by training doctors who will hopefully stick and stay."
"We're looking for our successors," Phipps added. "We're willing to train the next generation of physicians as our succession."
What's it like
The three KGH residents are now about 11/2 months into their first year. They're all new to the Tri-Cities and said they're learning the lay of the land -- when they have time, between rotations, clinic hours and lectures.
They all said they were drawn to the KGH programs in part because of the surrounding community. Vo described watching a movie in the park while visiting a friend in the Tri-Cities.
"(The place) looked really comfortable, it's really warm and accepting. I thought, this is a nice place to be," he said.
Vo attended the University of Washington as an undergrad and PNWU for medical school.
Persianinova spent her undergraduate years at the University of California at Davis and Cosumnes River College in California, and went to medical school at A.T. Still University-Kirksville College of Osteopathic Medicine in Missouri.
Vo and Persianinova are in their early 30s. Walizada, who went to Boise State University and then to medical school in Yakima with Vo, is 38 years old, with two young sons.
She's fulfilled a longtime dream by becoming a doctor. She said she was drawn to medicine in part because it's challenging, and also -- like Persianinova and Vo -- because of a desire to help people.
Vo said it's hard to describe the feeling of watching a patient improve and get better because of care you've provided unless you've experienced it yourself. But it's a feeling that makes all the hard work worth it.
KGH's residency programs are approved by the American Osteopathic Association, which is the primary group that certifies osteopathic physicians and the agency that accredits osteopathic medical schools.
The hospital may expand its residency offerings in the future to include more specialties.
It will welcome a new class of first-year residents next year. Walizada said she looks forward to working with them and helping them as they follow in her footsteps and those of Persianinova and Vo.
Walizada noted that she and Vo were some of the first medical students to train at PNWU, and that was fun. She's also enjoyed blazing a trail here.
"I like to be a pioneer," she said.