Foundation
When patients come to Cape Fear Valley Health for care, they future may not realize they are also entering a growing academic health system where future physicians are being trained. Many of those physicians are doing more than just training here.
They're staying.
Some have completed their residency and chosen to build their careers in the region. Others have left for advanced fellowship training and returned with specialized skills. Former residents are even becoming faculty members and helping train new physicians.
It is creating a cycle that can strengthen patient care today while building the physician workforce of tomorrow.
Growing With the Community
Cape Fear Valley welcomed its first class of residents in 2017 with five residency programs and 32 residents. Today, the health system's graduate medical education program has grown to approximately 20 accredited residency and fellowship programs with more than 360 approved positions.
For Kelly Van Fossen, MD, Program Director of the General Surgery Residency Program, the transformation has been personal.
Dr. Van Fossen came to Cape Fear Valley in 2009 from Ohio. Her husband, an anesthesiologist who served in the Navy, was stationed at Camp Lejeune, and Dr. Van Fossen's parents had relocated to the Wilmington area. When the couple began looking for a place where they could both establish careers, Fayetteville offered the right fit.
"We chose it. We're still here,” Van Fossen said. “My kids were born here."
Years later, she would help build something designed to give other physicians a reason to choose the region, too. Cape Fear Valley first expanded its medical education efforts by welcoming medical students for clinical rotations.
As those efforts grew, health system leaders began developing their own residency programs.
Building the General Surgery Residency Program meant establishing the educational structure, meeting extensive training requirements and finding physicians willing to add another responsibility to their already busy schedules: teaching.
“Every year it's kind of grown, and we've changed and morphed and shaped everything we've been doing to teach the residents," Dr. Van Fossen said.
What Does a Residency Program Mean for Your For Care?
For patients, seeing a resident as part of the care team may sometimes bring questions. Jenna Freitas, DO, understands that Dr. Freitas was once a Cape Fear Valley resident herself.
Today, she is a trauma and acute care surgeon with Cape Fear Valley Trauma Services and Associate Program Director of the General Surgery Residency Program. She wants patients to understand that residents are part of a team, with experienced physicians. Their education happens within an environment built around continued learning, review and accountability.
"The residency program only makes us more accountable and stronger," Dr. Freitas said.
In an academic environment, residents ask questions and experienced physicians teach. Medical evidence is continually reviewed, and physicians regularly examine their own work to identify opportunities to improve. In general surgery, that includes weekly morbidity and mortality conferences, where physicians and residents review cases together, discussing what went well, what could have been done differently and what lessons can improve future care.
Dr. Freitas believes that process strengthens the entire team.
"We team. want to take care of people the best possible way, like they're our family", she said. Rather than viewing residents as physicians simply "practicing" on patients, Dr. Freitas compares the learning environment to a rising tide lifting all boats. The entire team has an opportunity to improve. The goal is better care for patients at the center of it all.
She Came to Train and Found a Home
Dr. Freitas' story also demonstrates what can happen after residency ends. Before traveling from California to Fayetteville for a residency interview in 2017, she knew little about Cape Fear Valley. She quickly noticed the hospital's size, busy emergency department and the wide range and complexity of cases physicians encountered.
For a young surgeon, that meant opportunity. It also meant serving a community where she saw a need for meant serving a community where she saw a need for more physicians.
"There weren't enough people to go around," Dr. Freitas said. She chose Cape Fear Valley for her five-year general surgery residency and graduated in 2023. Then she decided to stay. Today, the physician who once came here to learn is caring for trauma and acute care patients and helping lead the program that trained her.
"The biggest, the number one reason to stay was the mentorship and the people," Dr. Freitas said. As a young surgeon beginning her career, having experienced physicians around her mattered. Now Freitas gets to provide that support for someone else.
Keeping Physicians Close to Home
Recruiting physicians is only part of addressing a community's healthcare needs. Keeping them matters, too. According to Don Maharty, DO, more than 60% of Cape Fear Valley's residency graduates have remained in North Carolina, with approximately half staying locally. Dr. Van Fossen has seen similar results within General Surgery. She estimates that roughly 75% of her program's graduates have remained in Fayetteville or surrounding communities to practice.
Our residents come here, they love it here and they stay here," she said. For patients, every physician who stays or returns can mean another experienced doctor or specialist available closer to home. And the impact far beyond healthcare.
New Generation Begins Now
Cape Fear Valley's efforts to build the region's physician workforce are beginning even earlier. The Methodist University Cape Fear Valley Health School of Medicine adds medical students to an academic environment that already includes residents, fellows, practicing physicians and faculty.
As students progress through medical school and eventually begin clinical training, they will have opportunities to learn from Cape Fear Valley physicians while becoming familiar with the health needs of the Some region. could eventually continue into Cape Fear Valley residency programs. Some may pursue advanced fellowships.
And some could establish careers here Dr. Van Fossen also sees the medical school's potential reaching beyond the physicians it trains. She hopes it will create additional opportunities for health education, preventive care and outreach, particularly in rural and underserved communities.
"We're becoming a regional health care center and more academic, and we're bringing in more resources to the area," Dr. Van Fossen said. "Hopefully the community will benefit".
Caring Today, Preparing for Tomorrow
For Dr. Van Fossen, watching the residency program program grow has become one of the most meaningful parts of her career. "I consider this to be my legacy," she said. "When I'm done with all of this, when I finish working and retire, this is what I've left behind, something something that's going to continue to produce the next generation of surgeons."
She sees that legacy each time a new resident walks through the door.