Dr. Mark Stradling looks over patient charts Monday at Valley Hospital Medical Center. He is one of 25 doctors inaugurating a new osteopathic medicine residency program, a first in the state. Photo by Gary Thompson.

Doctor of osteopathic medicine doesn't roll off the tongue quite as smoothly as medical doctor. But other than the capitalized initials after the physician's name and a better understanding of the body's muscle and skeletal systems, there's not much difference between the two.

Both fields produce professionals with the hope that they'll help the sick through medical intervention.

"Some consider DOs second-rate physicians,'' said Mark Stradling, one of 25 graduates of U.S. osteopathic medical schools who began rotations Monday at Valley Hospital Medical Center in its new osteopathic residency program.

The program, a collaboration between Valley and Touro University Nevada College of Osteopathic Medicine, is the first osteopathic residency program in the state.

The goal of the program is, among other things, to increase the state's pool of physicians, especially in internal medicine and family practice, said Dr. C. Dean Milne, a doctor of osteopathic medicine and director of medical education at Valley Hospital.

The program has already increased the state's Graduate Medical Education residency and fellowship slots.

GME is the required clinical training provided to graduated physicians.

Currently, among the state's five hospitals offering residency programs, there are about 220 residents in eight specialities: internal medicine, family practice, pediatrics, obstetrics and gynecology, surgery, dentistry, psychiatry and emergency medicine, according to a report in the June 2006 Nevada Hospital Association newsletter.

Health officials would like to see slots doubled to meet population growth and eventually fill the need for licensed physicians.

According to the American Medical Association's 2004 Annual Report, Nevada ranked 46th in the United States for its physician-to-population ratio.

"Nevada is still experiencing a major shortage of primary care physicians, especially in Las Vegas and we see this as a way to increase the physician population in this community and to promote internal medicine and family practice specialities within the medical corridor,'' Milne said about the new residency program. The program includes three sub-areas -- a three year program in internal medicine, a three year program in family practice and a one-year rotating internship.

The internship is for residents who plan to move on to a speciality such as radiology, anesthesia, dermatology, emergency medicine and ophthalmology.

For example, Milne said one of the residents in the one-year program will be going to the University of California at Davis' radiology residency program and another will go to the University of Michigan for anesthesiology.

Residency programs in ophthalmology and dermatology at Valley are pending approval from the American Osteopathic Association, said Gretchen Papaz, a spokeswoman for Velly Hospital.

Health officials have said residents tend to stay and practice in or near the communities they train. So, the more residency programs a hospital or school can offer to future physicians, the better mix they can add to the pool, Milne said

"Hopefully these physicians will stay in this area and practice medicine,'' he said.

Although Shadling might not be one of those physicians staying in Nevada -- he is in the one-year fellowship program and probably will do his three-year residency in ophthalmology somewhere else -- he is honored to be among those participating in Nevada's inaugural osteopathic medicine residency program.

In his schooling and, through his own research of the field, he has found statements that DOs being just "second-rate" doctors untrue and wants the public to understand that the only difference between an MD and a DO is that a DO receives additional training on the musculoskeletal system.

"I think it's exciting. It's a big promotion for us (DOs),'' said Stradling, 35, who graduated from Lake Erie College of Osteopathic Medicine in Pennsylvania and did his undergraduate work at the University of Arizona.

"Out West, osteopathic schools are very limited in terms of residency programs available. This is highly exciting, not only to begin a program but to be able to perform here,'' he said.

Papaz said the residents are from various states, including the East Coast.

Both staff at the hospital and Touro University have planned the residents' rotations and curriculum. And, like residency programs for medical doctors, doctors of osteopathic medicine will be supervised by an attending physician for competencies on a procedure before they allowed to perform it.

They will be able to chart patients' progress and admit and discharge patients. As their skills increase, so will their responsibilities.

Additionally, once the residents reach second-year status, they will oversee first year residents.

Additionally, the hospital is scheduled to open a 10,000-square-foot clinic for internal medicine and family practice in late October, which should provide the residents with opportunities for hands-on training in a clinical setting.