On June 30, Dr. Herb Garrison retired as the associate dean for East Carolina University’s (ECU) Brody School of Medicine Graduate Medical Education (GME), after serving in that role for the past 11 years and after serving ECU and ECU Health for 29 years. He leaves a legacy of growth and success for the GME program, including the formation of the Rural Family Medicine Residency Program, as he looks forward to his next adventure.
The Charlotte native said his interest in health care began in part because of a “genetic predisposition.”
“My dad drove an ambulance and my mom was a nurse,” Dr. Garrison said. “Growing up, I was intrigued by fire trucks, and I was interested in first aid. I took a first aid class in high school because I wanted to be sure I knew what to do if something bad happened to someone.”
Dr. Garrison also worked in a nursing home as a high school student where some of his co-workers encouraged him to attend nursing school. “It was a diploma program, so we were thrown into the clinical aspect pretty quickly,” he recalled. “I liked it and had an aptitude for it, but I wanted to do what the doctors were doing.” Someone suggested he go back to school to become a physician assistant (PA), so he went to the Medical University of South Carolina. Still, his itch wasn’t scratched; he wanted to be a physician. “I applied to the University of North Carolina (UNC) at Chapel Hill, but my grades weren’t good enough to enroll as a pre-med undergraduate.”
Undeterred, Dr. Garrison went to Wingate Junior College for two years to complete his pre-med classes, and he earned all As. He transferred to UNC Chapel Hill to get his undergraduate degree, but he didn’t get into medical school the first year he applied. During that interim year, he worked as an evening charge nurse in Chapel Hill. He began medical school in 1981 and graduated in 1986, having spent a year doing research in addition to the typical four years as a medical student.
After medical school, Dr. Garrison began his emergency medicine residency at what was then Pitt County Memorial Hospital. When he completed his residency, Dr. Garrison became ECU’s first emergency medical services (EMS) fellow, and later the first Robert Wood Johnson Clinical Scholar from an emergency medical residency. “It was a huge honor for me because it’s a very competitive fellowship,” he said.
As his wife Lynne was completing her plastic surgery residency in Pittsburgh, Dr. Garrison recalls a conversation he had with Dr. Dan Pollock, a friend from the CDC. “Lynne and I were considering jobs at Johns Hopkins and in Greenville, and Dan said, ‘You have to go back to Greenville because that’s where you’ll make a difference.’ Thanks to Dr. Pollock’s advice, we made our way to Greenville for the second time.”
Since returning to Greenville, Dr. Garrison has served in many capacities: the founder and director of the Eastern North Carolina Injury Prevention Program, a professor of emergency medicine, the chief of the ECU Health Medical Center’s medical staff, the interim chair of emergency medicine, the associate medical director for the North Carolina Highway Patrol and the chair of the Pitt County Board of Health, among others. But one role, that of associate dean of Graduate Medical Education, has given him the opportunity to foster growth and continue his pursuit of lifelong learning.
“I didn’t have a long-term plan to work in graduate medical education,” Dr. Garrison said. “But I’ve always leaned towards leadership roles. What I like about GME is that you have oversight of all these programs to train medical school graduates to be physicians. I think it’s more important than medical school because it makes you the specialist you’re going to be.”
Under Dr. Garrison’s oversight, ECU’s Brody School of Medicine and ECU Health Medical Center now have more than 40 training programs, including residencies for physicians and dentists, sub-specialty fellowships and combined programs. Altogether, there are 410 physicians completing their post-medical school training at ECU Health. Dr. Garrison expressed pride at the GME program’s success, facilitated in part by diligent accreditation management and the program’s continued growth.
“We have two brand new programs: a fellowship in cardiac electrophysiology and a neurology residency. And we’re very excited to be deep in the planning for a new ophthalmology residency,” he said. Dr. Garrison also lauded the expansion of the internal medicine and psychiatry residencies, the addition of a critical care component to emergency medicine/internal medicine residencies (only the second such program like it in the country), the establishment of a pediatric dentistry residency, a hospice and palliative care fellowship, and the development of a rural family medicine residency.
The Rural Family Medicine Residency program began when Dr. Garrison and Dr. Mike Waldrum connected with Sen. Brent Jackson about starting a program to meet the needs of rural areas in eastern North Carolina. Sen. Jackson, a Sampson County native, wanted a rural residency for Duplin County, and with Dr. Waldrum’s and Dr. Garrison’s input, he put forth a proposal to the North Carolina General Assembly to appropriate funds for the new program, to be established in Duplin, Hertford and Halifax counties. “North Carolina is the second largest state in terms of a rural population,” Dr. Garrison said. “I think of rural as being issues with distance to health care, access to health care services, and impoverishment. That’s the heart of the Brody School of Medicine and ECU Health’s mission, and we do a pretty darn good job at it.”
Now the first cohort of four rural family medicine resident physicians graduated in June, along with the 125 physicians who completed their training on June 30. Earlier this year, Dr. Garrison learned that all four graduates of the rural residency passed their board certification exams in family medicine on their first attempt, and 50% of that class will be staying and working in rural eastern North Carolina and for ECU Health – one in Duplin and the other in Hertford and Beaufort counties. “It’s the thing I’m most proud of during my time in GME,” Dr. Garrison said. “It’s been five years since that visit with Sen. Jackson, and now ECU Health is the national model for a rural academic health system.” The newest rural family medicine program class includes nine resident physicians, making the program one of the largest rural residencies in the country.
For Dr. Garrison, his work in GME has been fulfilling, and he emphasized three important benefits of GME. One is that GME is a critical part of both the Brody School of Medicine and the health system. “Resident physicians and fellows provide a lot of care. They write about 75% of the orders written in the hospital, including admitting patients, medication prescriptions and all plan of care orders. The hospital depends a lot on resident physicians and fellows, and they are learning while they are doing,” he said.
ECU Health Medical Center and ECU Health Maynard Children’s Hospital serve as the primary teaching hospitals for The Brody School of Medicine at ECU, something Dr. Garrison noted as being a major factor in GME success: “Graduate medical education has always been about resident physicians and fellows employed by the health system working with faculty employed by the University.”
In addition to their vital role in the health system, Dr. Garrison said resident physicians promote lifelong learning for their instructors. “I had a professor at UNC who was asked why he taught at the university instead of making more money in private practice,” he said. “He said that every day a medical student or resident asked him questions he didn’t know the answer to – so he figured he should stay at the university until he knew everything. Our resident physicians and fellows keep us in the throes of learning.”
Perhaps most importantly, Dr. Garrison said that resident physicians and fellows serve as a pipeline for physicians that we need here in North Carolina. “One of the things we know is that residents are more likely to stay where they train than where they go to medical school,” he explained. “They serve as pipeline for the needs we have, especially for North Carolina. A GME program adds value in these ways.”
While these benefits may be applied to any GME at any medical school, Dr. Garrison emphasized that the Brody School of Medicine and ECU Health are special. “My experience, and that of almost any and every physician who trains here, is that they are going to get a phenomenal education,” he said. “This is one of the largest and busiest medical centers in the country. I tell resident physicians and fellows that if they come here and stay here, they will be really good physicians because they will be taking care of people with a variety of diagnoses and will be taught by talented professionals. It’s a fabulous place to train and that’s why our graduates are so capable.”
Although he has retired from his associate dean role, with Dr. Mary Catherine Turner stepping in as interim associate dean, Dr. Garrison isn’t going too far away. “I’ll be working part time helping with fundraising at the ECU Health Foundation,” he said. “I’m not done quite yet.”
Still, his presence in GME will be missed. Dr. Audy Whitman, the program director for the Rural Family Medicine Residency program, said Dr. Garrison’s impact has positioned ECU Health resident physicians and fellows for a brighter future. “He’s been a great resource and role model to me and has provided me with sage wisdom and infallible guidance as I worked to start our new Rural Family Medicine Residency. I am forever grateful and in his debt,” Dr. Whitman said. “Under his tenure, Dr. Garrison cultivated a thriving GME system that positively impacts hundreds of physicians training every year, which in turn positively impacts the lives of millions of North Carolinians served by our ECU Health system and graduates of its GME system. Dr. Garrison has been a force for good that is hard to find, difficult to replace and impossible to forget.”
Dr. Michael Waldrum, dean of Brody and CEO of ECU Health, echoed those sentiments.
“Graduate Medical Education is such an important part of who we are at ECU Health,” Dr. Waldrum said. “We are fortunate to have such a strong GME program, and that is a testament to Herb’s steadfast commitment, passion, dedication and leadership. Herb has contributed in so many ways to our organization, and highest among them is his outstanding leadership of our GME programs. We are deeply appreciative of his contributions which position us to continue our work as a world-class clinical training ground.”