Attending Physician Guest Writer
Geisel School of Medicine at Dartmouth
Dr. Ronan is an associate professor of neurology and medicine at the Geisel School of Medicine and is the program director of the Dartmouth-Hitchcock Neurology Residency.
Practical Wellness: Perspectives from a Program Director
A program director's perspectives on practical wellness in residency and how graduate medical education leadership can facilitate housestaff resiliency and self-advocacy.
As a program director, I am worried about my trainees who are already challenged with the usual stressors of graduate medical education (GME). This new illness is threatening to upend and disrupt our program in ways that I cannot even imagine, and therefore cannot plan for.
You could feel it in the air, in how the nurses double-checked the orders, how the attendings’ notes bloated in size, and even in how the patients, despite their general lack of knowledge towards the inner workings of the hospital, exuded mild apprehension. It was day one of the academic year, the day that the new interns — my new interns — started.
In America today, history is repeating itself with ardent voices calling for division between “aliens” and “nationals,” instilling an “us” versus “them” mentality. What is happening under our watch is eerily reminiscent of the internment camps of World War II and the separation of individuals based on ethnicity that we have seen throughout history. We have created a climate of widespread fear, detaining immigrants and asylum seekers in abhorrent conditions, without a basic standard of care, and separating parents from children.
Softly and subtly, the rustling of the leaves quickens and a cool breeze sweeps across the town. A child rocks gently on a swing and a father stands in the bazaar bartering for the best value for vegetables for dinner. His wife is hospitalized with hemorrhagic dengue; shivering with fevers that rise and fall as do her blood counts.
When I am asked about my future plans, my response is rightfully met with confusion. I am entering the workforce as an academic internal medicine physician devoting my practice entirely to the outpatient setting. Yet, two-thirds of my residency training has been managing patients within the walls of a hospital. That disconnect raises interesting questions about my career choice, and, naturally, makes me an anomaly among my peers.
They said to stop compressions. We all agreed. This baby had no life when she was born, and we had fought for twenty whole minutes with our arsenal of medicine to give her life.
Happy New Year from all of us at in-House! We are proud to announce the in-House Top 12 of 2019, our 12 most-read articles of 2019. Thank you for your readership over the past year and for your ongoing support of our publication, the premier online peer-reviewed publication for residents and fellows.
Residency is a challenging time plagued by long hours, overwhelming clinical service loads, escalating documentation requirements, and inadequate resources for support. A recently published study in the New England Journal of Medicine illustrates how mistreatment in the training environment takes an additional toll on medical trainees.
I had just started my first clerkship of third year at a nearby hospital when the news broke. Hahnemann Hospital, the main teaching hospital of my medical school, was closing. More accurately, the hedge fund manager who purchased the hospital a year earlier was filing for bankruptcy. He separated the valuable Center City real estate from the hospital itself to ensure a tidy profit for investors at the expense of patients and staff.
On October 16, 2019, our collective of health care workers at Yale University disrupted the meeting of the Graduate Medical Education Committee. Heads turned and followed us to the front of the lecture hall, where we unfurled our banner declaring “Doctors are Humans Too.”
I elected to pause my training after completion of a transitional year internship to enter active duty service as a United States Air Force flight surgeon. While it is a less-than-traditional pathway, it allowed me to serve a greater mission.
It wasn’t caterpillars turning into beautiful butterflies, that’s for sure. “The Change” was when a bright-eyed, optimistic female junior resident turned into an angry, and sometimes mean, senior resident with very little patience for anyone.
Resident Physician Contributing Writer
Mayo Clinic
Dr. Yassmeen Abdel-Aty is a fourth-year Otolaryngology-Head and Neck Surgery resident at Mayo Clinic in Arizona. She is one of three female residents in her program. She plans to pursue a career in Laryngeal Surgery. She enjoys teaching residents, medical students and PA fellows, hoping to incorporate teaching into her future practice. Her interests include international medicine, education, women in medicine and diversity & inclusion.
