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When Billings Clinic welcomed 11 new resident physicians Thursday morning, it represented not only a new crop of faces but a major step for its young residency program.

With the White Coat Ceremony officially bringing the new residents into the fold as its third-ever class, the clinic's Internal Medicine Residency program has now for the first time filled out each class in the three-year program.

"This is the last White Coat Ceremony only because next year we'll be doing a White Coat Ceremony along with a graduation ceremony for our very first class of residents," said Dr. Nicholas Wolter, Billings Clinic CEO.

The 11 new resident physicians come from a wide range of backgrounds — each graduating from a different medical school, including schools in Brazil and Ireland, and four were born and grew up in foreign countries — and will spend the next three years training in and around Billings Clinic.

Residency is a required step and the final stage of a physician's graduate medical education before they go into practice and involves training and working under the supervision of an attending physician.

Each of the new residents received the white coats commonly associated with doctors in a ceremony that represents their careers' transition into physicians.

"Really, it's a symbol of medical authority and a symbol of the doctor-patient relationship," said Dr. Robert Ficalora, program director.

After the residents received their coats, all of the other physicians in the room stood and recited the Hippocratic Oath with them.

Dr. Lauren Thom, who grew up in Canada, recently finished medical school at the University of Limerick in Ireland. She said the care and attention the staff in Billings Clinic's residency put into the students appealed to her, as did the chance to be among the first students in the program.

"When I met the directors, I got the sense they were really invested in the careers of the residents," she said. "I love that it's a smaller program and that it's just starting. That's part of the reason I chose it. I love that I'll be able to have input on how it forms."

The ceremony also held a little extra significance for Thom, who had to hustle to Billings from Ireland to start up her residency.

"I never got a graduation (ceremony) from medical school," she said. "I had to get here. It has a double meaning as a graduation and an introduction here."

Ficalora told the resident physicians that, with the now-full program, in joining the residency they'll be part of the largest primary care practice in Montana.

The first class saw 12 physicians, and 10 residents joined in the second class.

With all three classes now in place, it will allow the experienced third-year physicians to take on more of the teaching duties and serve as senior residents with the newer residents, freeing up the faculty to work in a more academic role.

That's something Ficalora said he and other staff have been waiting on for four years.

"We're going to have people walking here who are confident and know what they're doing," he said. "I don't see you guys as brand-new interns who are nervous. I know what you're going to become."

One of the senior residents, and a member of what will be the program's first graduating class, is Dr. Sierra Gross. She's looking at practicing general and primary care upon finishing her residency and hopes to stay in Montana to do so.

She said that having a multi-specialty team to train her and other residents has provided invaluable experience as they figured out together how the residency program would work.

"It's been a real compliment for these first years to help grow and develop what the program will look like," Gross said. "We've had a lot of ups and downs and a lot of bumps in the road, but we've been able to address them all quickly thanks to the help from the staff here."

The residency program is designed in part to help address physician shortages across Montana and in underserved areas. National statistics show that around 70 percent of physicians practice near where they completed their residency.

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