Residency, Success, Team Sports and Being a Member of a Team

In a recent medical education twitter chat, other medical educators and I were discussing success being tied to previous experience playing a team sport.  It stemmed from this article, which suggested that success in residency (otolaryngology) may be more likely if one played a team sport earlier.  This is a fascinating observation, and one that I hadn’t thought of when interviewing applicants.  Others commented that there may be bias since in early schooling, boys are more likely to be members of team sports than girls.

It is interesting that residency program directors really struggle with trying to find the magic bullet that will determine success.  What does “success” really mean?  For program directors, I suppose it could mean having a resident who performed very well clinically, who was not a rabble rouser and thus “caused no trouble”, and who received excellent evaluations throughout training.  It could mean impeccable surgical outcomes for procedurally-related fields (although there are other factors besides a resident involvement in surgery that might affect surgical outcomes).  It could also mean getting a job and starting a practice after residency, or securing a fellowship after residency training.  I really don’t think there is ONE thing that defines this success. 

There may be success on a test (such as passing a board examination): that has been studied.  The old adage: “past performance predicts future performance” is true with regards to tests, in my opinion.  How this translates for programs directors is that those students who performed well on USMLE Step 1 and/or Step 2 are more likely to pass the board examinations after residency.  While this is only one aspect of “being a doctor” (using competency language, it would be the competency of medical knowledge), residency programs are indeed being evaluated on this measure of board pass rate.

There may be success regarding professionalism. Some might take the reverse approach.  When one is unprofessional, what factors predict that unprofessional behavior? This has been studied by Dr. M Papadakis, and basically, past “unprofessional” behavior in medical school predicts future disciplinary action by state medical boards. 

There may be success in securing a match position.  Many educators have published on this, such as this from plastic surgery. 

There may be success in other domains as well.  Here is a description that uses a surgical aptitude test.  Here is another study looking at the utility of letters of recommendation to predict success. 

I have heard many references over the years that medicine is a “team sport”.  No one takes care of a patient by only herself/himself.  We really need a team to help patients optimize their health.  I believe that the field of geriatrics models this very well, and has described training on working in multidisciplinary teams.  The importance of teams in medicine has also been outlined for patient-centered medical homes, such that teamwork competencies need to be defined.

One of my mentors (a female) has mentioned “I love seeing applicants who were Eagle Scouts”.  I have heard others who get excited seeing certain extracurricular activities, such as volunteerism, on a written application.  Like others, I certainly enjoy reading some things on an application more than others, but I really haven’t found any one thing that predicts success. 

To me, it is not just the application that is important. The application gets you in the door [for the job interview], but the interview gets you the job.  As for defining success: well, we in medical education have a long way to go before we are able to pinpoint that one down.

Burnout and Resiliency in Medicine

I have not blogged in a while; there are many reasons for this, including many things going on in my life as well as with my work as a medical educator and administrator.  The weather here in the Midwest has also been challenging this winter (and another storm headed this way over the next 24 hours) which likely has contributed to my lack of blogging.

Nevertheless, I really enjoy what I do and find meaning in my work.  In fact, a timely discussion with residents during a teaching clinic highlighting this really hit home.  We were talking about burnout and ways to combat it.  The practice of medicine is hard: helping improve the health of our patients is a privilege which brings great responsibility.  This can, however, impact physicians’ own lives in various ways.

Social media itself (in the form of blogging) can be a great tool to ease burnout in medicine.  See this recent blog on this very topic. 

Can burnout be prevented?  What about resiliency in medicine?  Does one's resiliency lessen the potential impact of burnout?  Our institution is proud to host the FIRM (Finding Inspiration and Resilience in Medicine) conference on April 25, 2014.  This conference is being organized by medical students, which really demonstrates how our future generation is paving the way for the necessary changes to the way medicine can and will be practiced.  At that conference, one of our own faculty who wrote a recent post on this topic will be featured. 

So what steps do you take to prevent burnout?  How can you develop the resilience necessary to stay on top of your game and be the best you can be for patients and for yourself/your family?  Some have described interventions during training that impact burnout.  These curricular efforts should be applauded, and are one step towards an improved culture in medicine that helps everyone: patients and health care professionals alike. 

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!