Carilion History: Physician Education Part 1

Roanoke Hospital began training interns and residents in the early 1900s to meet its need for skilled staff to treat patients for free.

For many years, Roanoke Hospital struggled to attract interns to its limited rural facility. Early on, one to three interns worked and trained at the hospital each year. Once interns were acquired, keeping them for a full year was a challenge because benefits were negligible. Interns were hired for one year at $50 a month.

In 1933, at the invitation of Roanoke Hospital’s board, a physician from the University of Virginia inspected the facility, rendering a very complimentary report. It noted that the hospital would “compare favorably with large first-class hospitals.” That year, the American College of Surgeons put the hospital on its approved list. The hospital admitted 1,710 patients and listed only 16 employees on its payroll.

For 13 years, the hospital applied to the American Medical Association (AMA) for accreditation of its intern training program. Finally, in 1946, the AMA granted its approval. In that year, first-year interns were paid $75 a  month, plus room, board and laundry. Second-year interns received $100 a month, plus room, board and laundry.

Medical students in their search for opportunities to experience and practice in real-life clinical situations now included Roanoke Hospital in their list of choices.

Interns were an essential component in staffing the hospital’s outpatient department. Records for 1936 show 60 affiliated physicians and two interns treating nearly 2,000 hospital patients. The hospital was searching for room for overflow patients by 1940.

During World War II, medical professionals were called to active duty, leaving the hospital desperately shorthanded. Oral history recounts only nine doctors and interns left at Roanoke Hospital during the war.

From 1946 to 1948, there was a universal shortage of interns. The wartime effort had emptied medical schools. Returning GIs scrambled to catch up on interrupted educations. However, the Army Medical Corps was still encouraging military service by offering medical students active-duty status and pay, while participating in selected civilian residencies.

By 1949, Memorial and Crippled Children’s Hospital (as CRMH was knows from 1949 to 1955) had more to offer interns. Amenities included excellent library and laboratory facilities, electrocardiographic technology, the crippled children’s ward—and more money. The salary was $90 and $150 for first- and second-year students respectively. Recruiting letters appealed for interns interested in general practice for one- or two-year rotations.

Not unusual for rural hospitals, Roanoke Hospital set out to interest young doctors who would continue to practice in the Roanoke Valley region.

Part of the strategy to keep quality professionals was Annual Post-Graduate Day, a major conference launched in 1950. It was sponsored by the hospital and open to all physicians in the region as well as house staff. It offered up-to-date medical information from nationally known experts This initiative became the foundation of a productive series of lectures, seminars and conferences on specialty topics of interest to the medical community.

Stay tuned for Part 2 of Physician Education history!