Thirty Summa Health emergency medicine residents who are losing their training program when the health system loses accreditation on July 1 have issued a letter thanking the nurses, staff and former ER doctors who trained them.

The letter is the only public statement from the 30 doctors-in-training since the crisis began on Jan. 1. (All 230 Summa residents signed and released a no-confidence letter in former Summa CEO Thomas Malone on Jan. 1.)

The ER residents were caught in the firestorm after the abrupt changeover of Summa’s longtime ER physician group and the subsequent loss of national accreditation for the ER program and probation of the hospital system. Hundreds of doctors demanded Malone’s ouster before he agreed to step down.

Now, just weeks before nine of the residents graduate and 21 others leave for other programs around the country, the group said in a letter released to the Beacon Journal that it wanted its “last message as a collective group to focus on one thing: gratitude.”

The one-page letter starts with what the residents and Summa have lost: “There will be no pomp and circumstance this year for the departing residents of the Emergency Room Program at Summa Health. Nor are there eager new interns waiting to begin their careers this coming July. The sad reality is that one of the finest Emergency Medicine programs in the country is coming to an end.”

It goes on to thank paramedics and a host of hospital staffers, saying, “We have seen the exemplary care you provide the patients and we have only tried to follow in your footsteps.”

The residents thank the ER nurses, saying, “It has been an honor to work alongside you,” and salute patients as their “unsung heroes.”

To their mentors and teachers, the doctors of Summa Emergency Associates (SEA), whose group had staffed Summa emergency rooms for nearly 40 years, the students gave their highest praise.

“You never abandoned us. Though we grieved the loss of our mentors, you continued to teach us during this difficult time by exemplifying the principles of integrity and class. While once faculty, you are now family.”

Reaction to the letter was positive.

Dr. Jeff Wright, who leads SEA, said the residents “chose to take the high road.”

Many of the residents, especially those who are graduating, “will be some of the best emergency physicians in the country,” he said.

The students all learned a valuable lesson: “Take nothing for granted. Embrace what you have and stand up for what you think is the right course. It was extremely unfortunate that their young careers and education were so negatively affected the last six months of their residency.”

Dr. Cindy Kelley, Summa’s vice president of medical education, said the residents’ letter was positive, but showed their hardship.

“It’s indisputable that it has been a huge disruption to them. Those faculty do become their family,” said Kelley. “Residency is hard enough, but for them to go through this, it was really a catastrophic event for them. It’s understandable that they are expressing that and it has been painful.”

Dr. John Zografakis, president of the Summa medical staff, said the letter showed “the passion of the residents.”

“While this was a devastating outcome … of losing the residency, I was very impressed by their desire to put all of that aside and thank the people who are here who helped train them in their formative years,” he said.

The residents ended their letter by quoting Dr. Michelle Blanda, their former longtime emergency department chair. Blanda, the letter said, “often preaches that medicine is a constantly evolving profession. She urges ‘Do not be the physician who is afraid to change.’ Dr. Blanda, we hear you! So as we move on to other programs or graduate, we make this promise to you all. We will embrace this change but forever carry the parts of you that make us whole.”

Blanda, an SEA doctor, said it was a touching tribute.

“It’s not so much what you do when things are easy, it’s what you do when things are difficult. This is a perfect example of that. These residents have made an adjustment … despite how difficult it has been and how tragic it has really been for the community, there was some good that came from the community.”

Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ  on Twitter or www.facebook.com/BettyLinFisherABJ and see all her stories at www.ohio.com/betty