No one’s calling it mission accomplished, but with 16 medical students scheduled for third-year rotations through Humboldt and Del Norte counties, the plan to “grow-your-own” is taking shape.

“The average age of physicians up here on the North Coast is 54 years old,” said Dr. Stephen Kamelgarn, the half-time director of medical education for Touro University. “Bringing the students up here is the first step in one of our strategies of recruiting and retaining new physicians.”

The ultimate goal: a family practice residency program that trains students after they complete four years of medical school.

“Studies have shown approximately one-third of the physicians who train in a family practice residency will settle to within 50 to 100 miles of where they did their residency,” Kamelgarn said.

“Having a family practice residency up here would offer us a built-in pool of new physicians settling in the area. For those of you who have trouble finding a doctor, this can only be good news.”

“The dean wants it and the school wants it,” said Dr. Kate McCaffrey of the residency program.

As president of the Humboldt-Del Norte County Medical Society, McCaffrey focused on retention and recruitment until her term ended on Monday at midnight.

“The hospitals have all signed affiliation agreements and are looking to the future toward a residency, but one step at a time,” she said. “We have to see how the student program runs this year.

“The university, the medical associations and the hospitals can all want it, but it doesn’t mean anything until the doctors get on board.”

McCaffrey left the county last year to teach at Touro University’s College of Osteopathic Medicine and she worked with Dr. Abe Pera, formerly of Humboldt Radiology, to make the North Coast the sixth rotation in Touro’s four-year program.

Pera is now the Interim Dean for Clinical Education at Touro, which is based in Vallejo and trains 120 physicians a year.

In their third year, the Touro students choose a core clinical location in Southern California, Michigan, Colorado, New York, the Bay Area or Humboldt County.

“There must be 50 people waiting in line to get up there,” McCaffrey said. “In my unofficial poll, 40 to 60 say they wish they’d picked Humboldt. Right now, they say it’s the best-organized rotation we have.”

Kamelgarn is pleased to hear he has them fooled. He became the permanent medical director in April and has been in full throttle juggling the clinical rotation arrangements and paperwork around his 60 percent time base at the Open Door Community Health Centers.

“It’s probably too quick,” he said of being up and running less than four months after getting the March 4 go-ahead. “It sort of reeks a little bit of panic, mostly from me. We’ve had some first rotation kind of kinks and ruffled feathers to be smoothed over.”

Kamelgarn said the bulk of the comments have been positive about the excitement of training a new generation.

Students pick their top three choices for third year placement, then go into a lottery.

On June 23, 12 of the 16 third-year students started their year-long rotation through internal medicine, family practice, general surgery, pediatrics, obstetrics/gynecology and psychiatry.

For Anne Neumann, it’s a chance to return home to Crescent City. After graduating from UC Davis and rowing with the Aggies for three years, she’s looking forward to learning in the redwoods and crewing with the Humboldt Bay Rowing Association.

Kamelgarn said students also choose two additional specialties, rotate through four hospitals in the two counties, and attend a Tuesday lecture series. Kamelgarn spoke yesterday about taking a patient history and conducting a physical.

A physician mentor is assigned for the four weeks a student is on a given service.

“We don’t want to burn the doctors out,” McCaffrey said. “We are walking a fine line because doctors are so incredibly stretched for time.”

The solution has been to put two or three doctors with one student, she said.

But Drs. Deepak Stokes and John Morehead have three in their office, one of whom McCaffrey said delivered a set of twins last week.

“Most third years are thrown into a big university or community hospital with a million interns,” Kamelgarn said. “They spend a year as scut monkeys for interns and residents.

“What students here are doing is much more like a 17th or 18th century apprenticeship. Rather than having the bulk of their training done by someone a year older, they are learning from people who have been out practicing for anywhere from a couple to tens of years.”

McCaffrey said physicians have been going out of their way to make room for the medical students, who were welcomed at a June 18 barbecue in Eureka’s Sequoia Park.

“In Del Norte, I just signed on a third of their medical staff within 24 hours,” McCaffrey said. “They are beyond strapped for physicians.

“The next surprise is Fortuna. They’re coming through big time.”

As for the surgeons, McCaffrey said everywhere she goes, they show up.

“Every time I run into a surgeon it’s ‘Bring ‘em by. I’ll show you how to scrub, show you how to take out a gall bladder.’ They are so great, I’ve been blown away.”

The students rent, mostly in Eureka or Arcata, but that’s not a viable option for their month-long rotations in Del Norte. McCaffrey and Kamelgarn are looking for temporary housing for students heading north.

McCaffrey said a residency requires paying two directors and full-time physician specialty teachers.

“You cannot have a volunteer physician work force,” she said. “The doctors now are being kind and giving back to help with recruiting to the area. It’s a whole other beast when it comes to opening a residency.”

The money to train residents comes from Medicare after jumping through hoops and filling out paperwork, she said.

“They have a 400-page instruction book on how to open a residency program,” she said. “Medicare is extremely persnickety.

McCaffrey said a family practice residency is the most likely with student assignments split between Touro and its affiliate, the University of California at San Francisco.

“Residents would have to spend the majority of their first year in tertiary care centers, the big ones in the city, then their second and third years could be more ambulatory,” she said.

“If the gods smiled on us and a rainbow arc opened up with a residency program here next summer, they’d spent 2009-10 in the city and be up here for the next one to two years,” Kamelgarn said.

“The students are already smitten with the place,” McCaffrey said of the 12. “They’ve taken the place and made it their home. We have a couple who are hoping we have a residency up there.”

McCaffrey said the pro-student attitude of St. Joseph Hospital’s administration and chief of staff, Dr. David Ploss, are big pluses in the bid for a residency program.

“UC Davis was looking at coming up about 15 or 16 years ago, but it was torpedoed for a variety of reasons,” Kamelgarn said. “Then (Assemblymember) Patty Berg’s office made some noise about one-and-one-half years ago, so we’re beginning to explore those avenues again.”