Residency Match Day

The residency match just concluded last week.  For those unaware of this annual event close to the end of medical school, students interview with and rank residency programs, and programs do the same with interviewing medical students.  Information about the results of the Match can be found here. 

Students found out their individual match results on Friday, March 15, 2013, opening envelopes with the name of the program where they are headed for their residency training.  It is an incredibly anxiety-provoking yet exciting event that most physicians remember for years to come.

From the program point of view, I am ecstatic to see the names of the medical students I have the privilege of training for the next four years after they graduate in a few months.  This year was no exception.  I couldn’t be prouder of the students matched to my program!  The joy that comes from observing the opening of the envelope and just knowing where one will spend the next few years is a sight to behold.

With the advent of smartphones and tablets that can capture moments like Match Day easily, it is exciting to see how different schools approach this rite of passage.  There was even a Twitter handle to capture the information across the country: #Match2013.  Below is a short list of how some medical schools “observe” Match Day.  The list is certainly not exhaustive, but is fascinating to show how different schools approach Match Day festivities.

Baylor

Cincinnati  

Einstein

Michigan  

And some, like my own institution, Indiana University School of Medicine, found students who threw a bit of humor into the day:

Indiana 

Congratulations to all of the students who matched!  May your futures be bright, and may your passion for caring for patients continue to flourish!

Thoughts on Incoming Intern Orientation

This particular week is the week that the new intern physicians arrived, and become oriented to clinical care. Ours start on June 24 with managing real patients. They are brimming with excitement, but also have a lot to do during the week.

It is interesting to hear from the "old guard" about how it used to be. "My

orientation was 'here is the ER, and here are the bathrooms: now go and see some patients.'" While I certainly would not think that such an orientation is acceptable nowadays, I have to reflect on what exactly we now make the new interns go through.  HIPAA training, ACLS, PALS, NRP, FIT testing, composites, meal cards, explanation of the numerous (not an exaggeration here) computer systems and log-in codes that are necessary are literally just a small part of orientation--and that doesn't even include Handoff training (my personal area of interest).  I mean no disrespect to our hospital administrative personnel by these comments, but am constantly reflecting on what we could do better for our incoming learners.

So what do they actually remember? While as educators we certainly do feel that it is important to have them learn why HIPAA training is critical, or that they have to foster professionalism within the context of social media, I do think that what currently exists truly is an overwhelming mass of "do this, don't do that, you must sign this, you must complete that." So how much do they really retain, when we KNOW that many learners lose interest after a very short time (adult learning theory tells us this)?

Does making interns sign a "I heard this info"-form really help? Does "don't forget to do this" really mean translation of knowledge? Will taking multiple modules online actually help when they won't be back to that particular hospital for 5 months? I'm not so sure.

If anyone has better ways of completing this training in an environment that

promotes retention of information, believe me, I am all ears. I suppose that a similar situation exists in starting other new jobs, and new hires are frustrated. What is so telling is that so many come back later saying "if only I had known that information during orientation, then I wouldn't have done X".

So how long are your orientations, and what do you do to make it educational and fun? Do you feel that the interns complete orientation ready for direct patient care within your system?  Personally, I am looking forward to the "10 things you ought to know about internship"-talk that one of the CURRENT residents is giving later in the week. I would be willing to bet that that is the most useful "orientation" information that the incoming interns will actually get for the entire week, despite months of planning and trying to fit so many “required” things into the week.

I am curious as to any ideas that others have. Believe me, everyone is learning here, and this is after knowing for 10 years exactly what previous trainees have told us about orientation.  I’m sure other educators out there have similar thoughts.  Please let me know your ideas.