Category Archives: Residency

Hashtag Mentorship

Randall Reitz

Randall Reitz, PhD

#researchismypants
#takeitlikeahurdle

Mentorship has been around since the era of The Odyssey.  In the poem, as Odysseus prepares to leave for the Trojan War, he entrusts his son Telemachus to the tutelage of his trusted colleague, named Mentor. Our modern usage of this term extends from Homer’s character, but mentorship has evolved greatly in the nearly 3,000 years since (and now occasionally involves hashtags).

I recently had the privilege of being a small-group mentor with STFM’s Behavioral Science/Family Systems Educator Fellowship (BFEF).  I worked alongside Jill Schneiderhan, MD, to provide guidance to four early career behavioral medicine faculty and it was the highlight of my year.

My own small group was smitten with hashtags. They provided a pithy lingua franca to describe and unify our experiences. The two hashtags at the top of this post linger most in my memory.

#researchismypants came from a tear-filled (joy and sadness) discussion during our final dinner together. One of the fellows declared that she had just sworn off wearing pants. I observed that “research is my pants” and that I had just sworn off research. Neither of us could further abide these noxious crimps on our preferred lifestyle.

#takeitlikeahurdle came from the ride home on Highway 5 after that dinner. One of the fellows observed that she had recently sprinted across the same interstate earlier in the day, yelling for her husband to leap over the median “like a hurdle”.

 

hashtag mentorship

Randall’s BFEF Small Group

 

These hashtags encapsulate much of the tension of early career professionalism. People entering a new field face the dual pressures of being as helpful and generous with their colleagues as possible (to ingratiate themselves to the system). They also need to begin to delimit the scope of their job descriptions so that they maintain sanity and high self-expectations for work quality. The new professional needs to bring both positive energy and expertise to the projects they take on (ie, #takeitlikeahurdle) but also assert the confidence and negotiating skill to decline opportunities that aren’t a great fit (#researchismypants).

Each of the fellows successfully navigated experiences that embodied this tension, whether it was making a tough decision to change residencies for a better fit, standing up to a challenging colleague, enduring with pride the difficulties of relationship strife, or confronting unhealthy expectations from their department. It was an honor to scaffold our mentees during these trials. It was a thrill to watch how our charges came through stronger.

By my estimation, the BFEF Fellowship is an eminent example of modern mentorship.  What does it look like?

  • Intensive face-to-face mentorship at two STFM conferences and the Forum on Behavioral Science Education
  • Individual, small-group, and large-group meetings
  • Monthly small-group phone calls
  • Weekly synchronous and asynchronous points of contact (ie, email, project feedback)
  • A professional learning contract to personalize and guide the experience
  • A community of volunteers that support the mentors

This fellowship is one of many run by STFM, including training programs for leadership, practice transformation, teaching medical students, and medical journalism. These great offerings are constantly looking for faculty, advisors, and trainees, and I highly recommend you apply. Having experienced STFM training as both a mentee and mentor, I can attest to the richness of the experience from both sides.

#mentorshipalwaysevolves
#mentorshipneverchanges

Moving Away From Data Points and Back to the Patient Story

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Kathryn Freeman, MD

This past spring, I consciously moved away from learning clinical skills and spent time at two conferences: the National Medical Legal Partnership Conference, and the Family Medicine Advocacy Summit. There, instead of learning about medicine, I learned about stories.

When I reflect on what I learned in medical school, it was all about taking a patient story and converting it into a formal presentation. We spend years training our residents to boil down a patient’s history into discrete facts in a defined structure, using medical terminology to convey a message that only other physicians can understand. But that only allows us to communicate with each other, not with the world around us, or with the people, partners, groups, and leaders who have the potential to make a larger impact our patients’ health.

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Family Medicine Residents Are Underutilized Resources for Quality Improvement

DanNguyenMD

Dan Nguyen, MD

I think it’s time for family medicine to rock the boat. Family physicians, and especially family medicine residents, are uniquely qualified to promote quality improvement by standardizing patient care processes.

As a family medicine intern at an urban academic institution, these past 6 months have been a blur of rotations. Every 4 weeks, we start a new service and drink from a fire-hose of learning the intricacies of “how-to-be-a resident.” Our intern training is the most diverse; we rotate through inpatient services in OBGYN, pediatrics, family medicine, internal medicine, general surgery, intensive care, and the emergency department.

For inpatient services, there are common tasks that all residents perform. We answer pages, place admission orders, write progress notes, discharge patients, sign-out the patient lists, etc. We have access to the same electronic medical record, the same resources, and are unified by an academic institution.

What dawned on me is that every service seems to coordinate patient care completely differently. Every 4 weeks, I would re-learn how to do the same types of tasks but with different methodology. The most glaring disparities I noticed were in how different services handle transitions of care, especially patient sign-out.

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