When you think of medical training, learning to "be nice" might not be one of the first skills you'd think would be in the curriculum. But it's a term that's used proudly by physicians who go through the KU School of Medicine-Wichita's family medicine residency program at Wesley Medical Center.

"You're trained to have good medical knowledge, to make the right decisions, but you're also trained to be a doctor who's listening and caring," said Dr. Francie Ekengren, Wesley's chief medical officer and a graduate of the program. "That's probably just as important as your knowledge skills."  

"There was a lot of compassion shown by folks in the KU program," agrees Dr. Steve Waldren, another graduate who now works for the American Academy of Family Physicians in Kansas City. "There was this notion of camaraderie or at least professional support. You felt like you could talk with the faculty. It wasn't that you should just 'suck it up.'"  

The approach can be traced back to the residency program's pioneering founder, Dr. G. Gayle Stephens, who influenced the course of family medicine not just in Wichita but across the United States.  

Pioneer in family medicine  

In the 1960s, Stephens was one of the first doctors in the country to be interested in the emerging specialty of family medicine. At the time, Wesley offered a one-year residency for general practitioners (as the forerunners of family physicians were called). "You would finish medical school, do a year (in residency), then go out and learn on the job," said Dr. Gretchen Dickson, the program's director since 2013. "Gayle's thought was we need to train people before they go out."  

In 1967, he got an offer from Roy House, then an administrator at Wesley. If Stephens would see that physicians were available to staff the hospital's emergency room, Wesley would provide the financial support to start a family medicine residency program by donating space and referring patients. Stephens would move his own practice into the program.  

The collaboration put the program on the cutting edge of the new specialty. Although the historical details have not been recorded, the KU School of Medicine-Wichita's residency program at Wesley was one of the first four in the country, and the first one based in a community hospital.  

There were two residents in the program's first year. One of them -- Dr. Conrad Osborne, Jr., who eventually established his practice in Wichita -- was the first graduate of such a program anywhere.  

Stephens designed the program's curriculum. It was based on the key principles of continuity of care, delivered within the context of the family. To deliver that, residents had to get experience in a hospital as well as clinic setting, delivering babies and performing C-sections (an emphasis that was not present in other programs across the country, Dickson said), working the emergency room and intensive care unit, and performing other procedures. They needed to have all the skills to operate a model practice -- and often to do it alone, in a rural setting without the medical resources of a city such as Wichita.  

Stephens included behavioral and mental health training into the program from the beginning. In the early 1970s, as the program began its affiliation with KU, Stephens became the first professor of family medicine on the Wichita campus.  

A new roadmap for family medicine  

According to Dickson, many of Stephens' ideas spread because he was not shy about sharing them at meetings of the American Academy of General Practitioners, which today is known as the American Academy of Family Physicians.  

"Gayle liked to talk and write," said Dickson, who today mirrors Stephens' enthusiasm for the program. "He would lay out the Wesley model."  

The program was in the first batch of family medicine residencies to be accredited. Stephens was consulted frequently by other schools and hospitals looking to start their own program. Today, there are more than 400 family medicine residency programs across the country.  

Stephens tweaked aspects of the program through the years before leaving to chair the Department of Family Practice at the University of Alabama, where he worked until his retirement in 1988. He died in 2014. Two of his nephews -- Drs. Todd and Mark Stephens -- practice in Wichita.  

The KU program quickly expanded to admitting up to nine residents a year. Of the latest crop, half graduated from KU's Wichita campus, which is about average. "We like our KU students," Dickson said. "We like all our residents. It's a good mix."  

A resident's perspective  

A current graduate of the Wichita campus, Chad Stewart, is in his third year of the residency program. He picked the KU program because he felt like it would prepare him for practicing in his native southeast Kansas, which he plans to do in Pittsburg starting next year. "I knew I would walk out as a well-rounded physician," Stewart said. "I felt like it would prepare me the best to go back to southeast Kansas."  

Like many residents, Stewart chose to live near the hospital and clinic with his wife and young daughter so that he could deliver babies on call. "The first year, the majority of what you do is in-patient care," he said. "You live in the hospital, which goes along with being called a resident."  

Over the next two years, residents spend more time at the clinic located across the street, which sees about 100 patients a day.   

Residents complete 13 four-week rotations each year in fields such as cardiology, trauma, pulmonology, and pediatrics. Residents also perform their rural family medicine rotation and help supervise newer interns. Stewart noted that the program has a psychologist on its faculty who trains residents in doctor-patient relations, such as overcoming their own biases, delivering bad news and dealing with patients with mental health problems.

"The KU/Wesley program has had that history of training not just good physicians, but compassionate and caring ones. I'm happy with my choice," Stewart added. "I get to play all kinds of roles, as well as the big factor of being the initial contact for the patient. If I can't take care of it, I find out who can."  

The program keeps up with the times and now trains residents to work closely with pharmacists and social workers to provide better care.  

"The emphasis on doing it all, that hasn't changed," Dickson said.  

By the time they're done, residents have performed all types of procedures, from simple skin excisions to delivering babies to colonoscopies. "It really sets them up for the life of a family doctor who does it all," Dickson said. "They are still that model resident Gayle was training."  

Faith - and Spider-Man  

Residents are expected to honor the faith patients have placed in them. "When they're at their most vulnerable, they let you into their life," Dickson said. "We want them to come in here and have a great experience."  

There's room for a little levity, too. In one room where residents attend to paperwork or just decompress between calls, a life-size Spider-Man doll occupies one chair.  

"He's lived in the team room for years," Dickson said. "Nobody will let me throw him away."