Butler Memorial Hospital's goal of having its first ever class of medical residents in 2023 is ambitious, but the doctor in charge of running the residency program is embracing the challenge.

“I like challenges,” said Michael Fiorina, who was recently named vice president of medical education by Butler Health System. “I think it's doable. It's going to be a challenge.”

People who graduate medical school are considered physicians upon graduation, but they can't obtain certifications in specialties until they complete three to eight years of residency at a hospital, Fiorina said.

BMH hopes to have five or six residents who want to specialize in internal medicine and family practice in the first class, but planning the residency program, creating pipelines with medical schools and recruiting residents comes first.

Family practice and internal medicine doctors are in the highest demand locally and nationally, and the residency program for those specialties will last three years, Fiorina said.

The program will require them to work one-month stints with attending physicians in cardiology, gastroenterology, emergency medicine, intensive care and outpatient care. The next rotation will be in different departments, and, eventually, residents will have experience in all the departments. They will also take electives in geriatrics, palliative care or other fields, he added.

Getting program certification from the Accreditation Council for Graduate Medical Education (ACGME) would be the hospital's next step.

ACGME requirements for residency hospitals include proof that they have the resources to support a residency program and room for housing residents.

Residents commonly work 36-hour shifts and need places to sleep, eat and shower.

“It's almost like you're living at the hospital,” Fiorina said.

A resident's day begins by reporting to the attending physician with whom he or she is working, making rounds with the physician, attending lectures from staff and then making rounds again or working in a clinic. Fiorina said half of the class will go home after completing a shift and the other half will stay overnight at the hospital.

The transitional care and skilled nursing floor, which is not in use, will be residents' home away from home.

Another goal of the program is to encourage the residents to make the county their permanent homes after they become certified physicians. It's a goal shared by most training hospitals.

“They were very effective in getting people to stay in the area,” Fiorina said, recalling his residency at a hospital in Altoona. He said he and two others from his class of eight left Altoona following their residencies.

“If you have a good residency program, people are inclined to stay,” he said.

Residency programs are a proactive way to replace retiring doctors, Fiorina added.

Gradually, BMH wants to expand the program to other specialties and have larger classes of residents.

Clarion Hospital, which is part of BHS, has a family practice residency program.

A future goal is for BMH to offer fellowships, which require two or three years of work in a specialty after residency, Fiorina said.

Recruiting residents with compassion and good communication skills is one of the more immediate goals.

“I want the best residents I can get. These residents are going to be a reflection on me and the health system,” Fiorina said.

He said he wants to build relationships with medical schools in Pennsylvania, West Virginia and Ohio for recruitment.

“I think most will come from the region, but I'll take others if they're interested. They must be the right fit. To be a well-rounded physician, you must be able to communicate and have empathy,” he said.

A crucial program benefit to BHS is the information residents will bring from medical schools.

Fiorina said medical students learn the latest in medical technology and medicine in medical schools and will share that information with staff.