Residency Update

April 2018 

By summoning every fiber of my being, I was able to resist the urge to send an April Fools newsletter announcing the new 24 hour call on all elective rotations following the release of the iCompare data.  It was difficult. As such, this month’s Residency Update had to be published on April 2nd.

Big News

iCOMPARE, Part I:  As many of you heard or read for yourselves, the first of three large analyses of the iCOMPARE study data was published two weeks ago in the NEJM.  I’ve attached the PDF to this edition of the Update if you have not already seen it.  Full analysis cannot be undertaken without parts II and II but there’s a lot to digest in here as a standalone study.  This is why the APDs and myself went around to noon conference at all sites last week to discuss. To my eyes, the big takeaway is that there is no educational or personal benefit to working 24-hour call shifts as an intern (Table 4 and Table 5) and, even more importantly, that burnout, feelings of depersonalization and lack of accomplishment are HUGE problems in how we train doctors (Table 6).  How do we train the smart, dedicated, idealistic physicians of tomorrow in our current health care model?  Answering that question is our challenge going forward, and one we have to take on immediately.

ACGME Annual Survey:  Thank you to all of you who have filled out the 2018 Annual Survey from the ACGME.  As you know, we need 70% of residents and 60% of faculty to complete the survey by April 13th or we will not be in compliance.  Remember, the survey comes to you from an “ACGME Do Not Respond” address.  If you have not received something like this, please let Jennifer Weber know.  More information (but NOT a link to the survey) can be found here: http://www.acgme.org/Data-Collection-Systems/Resident-Fellow-and-Faculty-Surveys

Patient Placement:  Together, GME and UCH have come up with patient placement documents to help make it a slightly more clear where a patient with a certain level of acuity should go in the hospital.  Please see the attached guidelines and let me know if you have any questions.

CMR Selection Updates:  After receiving some very thoughtful anonymous feedback, it is clear that the Chief Medical Resident selection process could be made more transparent to our residents and faculty.  Starting in 2018-2019 we will be implementing a selection process that involves clear start and end dates with a full explanation of what happens after you vote, both for residents and faculty.  More details to come around Chief selection time next year but thank you for this feedback.  Please keep offering ways to improve the program, anonymously or in person!

Red Eye Rounds:  All of you in the program currently know this exists, but for those of you who do not… http://www.denverhealth.org/for-professionals/clinical-specialties/hospital-medicine/admissions-blog/admissions-article/improving-residency-education-at-night-red-eye-rounds-51869 

Upcoming Events

Conveniently, the annual meeting of the Society of General Internal Medicine happens to be in Colorado this year. Join your Internal Medicine colleagues from around the country at the Sheraton Downtown from April 11th-14th 2018.  This year’s theme is “Health IT: Empowering General Internists to Lead Digital Innovation”. The second message we learned from iCOMPARE is that we have to get our hands (and heads) around how we interact with technology in medicine so the timing of this meeting is critical.

 

The 4th Annual DOM Quality and Safety Symposium occurs on Wednesday April 18th, 2018.  This year’s theme is “Sustaining Health Care Quality in the Midst of Health Care Reform”.  The abstract and poster submission deadline is approaching on April 6th at 10:00PM so get those submissions in!

 

The University of Michigan will beat Villanova in the NCAA Men’s Basketball final tonight, overcoming the largest point spread in a title game since 2010, lights-out shooting from Villanova’s wily backcourt and whatever curse is placed upon your team when you ruin a Cinderella season and Sister Jean’s hopes.  Tomorrow this will fit in the “Big News” section but until ‘about 9:30 tonight, it remains an upcoming event.  If you want to watch the game with your program director (fun, right??) and a mass of people in maize and blue who are still looking for a phrase to describe this season that doesn’t include “fab” or “five”, come to Lodo’s Downtown at 7:00PM tonight. GO BLUE! 

 

Accolades and Accomplishments

2018 Gold Humanism and Excellence in Teaching Award:  It is with great pleasure that I announce that the University of Colorado School of Medicine has named Ajay Major and Steven Taylor recipients of the Gold Humanism and Excellence in Teaching Award.  This is one of the highest honors a resident can receive for their educational efforts because it comes directly from the students themselves.

From the announcement: “The Humanism and Excellence in Teaching Award, run separately from the Gold Humanism Honor Society, recognizes residents who demonstrate excellence in teaching and in delivering compassionate, relationship-centered care. Third-year students nominate residents who they feel are deserving of the award, and a committee of junior medical students chooses the winning residents from the pool of nominations. This was an extraordinarily competitive year for the award, as 16 residents were nominated, and Drs. Major and Taylor represent the highest example of humanism in medicine.” Ajay and Steven will be honored in a ceremony on April 20th.  Congratulations!

University of Colorado School of Medicine Outstanding Program Coordinator Award: This year’s winner comes as no surprise to any of us…our own Program Administrator Jennifer Weber, C-TAGME is the 2018 recipient of this incredible honor.  When you think of how many programs there are at CU and what it takes to coordinate the activities of 179 residents and, more impressively, our entire faculty, it might be more amazing she doesn’t win every year.  I’m assuming there is rule against that.  Jennifer, THANK YOU! 

What I’m Reading

I don’t know that the answer to all burnout lies in this short article from physicians at Mayo, UCSF and Mt. Sinai, but it encapsulates a lot of what I think makes for a good team and a strong organization.  As leaders in medicine, see if you agree:

https://jamanetwork.com/journals/jama/fullarticle/2677478

Febuxostat is new and effective, but at what cardiovascular cost?  A new, original analysis from the CARES investigators:

http://www.nejm.org/doi/pdf/10.1056/NEJMoa1710895 

What I’m Reading When I’m not Reading Medicine 

A beautiful and haunting story that personalizes the path of homelessness in America, a path that often includes undertreated or under recognized mental illness:

https://www.nytimes.com/2018/03/03/nyregion/nyc-homeless-nakesha-mental-illness.html

The tools we use to help us think—including smartphones—may be part of thought itself. A brilliant piece on a modern-day philosopher who is shaping how we think about how we think.

https://www.newyorker.com/magazine/2018/04/02/the-mind-expanding-ideas-of-andy-clark 

What I’m Doing When I’m not Practicing Medicine 

This past month, on a bright, sunny and unseasonably warm March day, Mariah and I joined tens of thousands of Colorado residents at the Denver March for our Lives, downtown at Civic Center Park.  It was invigorating to see so many passionate, young voices speaking out about something they believe in.  Regardless of your beliefs surrounding this particular issue, I would encourage all our residents to find their voice in the world and to support causes they believe in. 

One of the hard parts of residency was feeling like I had to put my larger, more idealistic dreams on hold while learning the day-to-day operations of being a doctor. But when we work for change on a large scale, we are doctoring in a way.  We’re using our knowledge, our voice and our platform as physicians to engender change so that others can live healthier, longer or higher-quality lives.  At the end of the day, improving the health of our community is at heart of being both a physician and an advocate.

If there is something you feel passionate about, I would encourage you to advocate in a way that is productive and fulfilling, both for yourself and others. If you want to know how to get involved in community outreach, public health or advocacy I would encourage you to think about joining the Health Equity Pathway, speaking with any of the pathway leaders or come see me – I’m always happy to chat about these issues. 

Birthdays!

Here are all our April birthdays – please wish these folks a happy birthday when you see them. 

RebeccaKant4/1
MonicaPetluru4/3
ChristopherHarvey4/5
AndreaSteel4/6
AndreaStand4/7
CharlesTharp4/10
EvanTrinidad4/12
JohnGerstenberger4/14
PedroGiro4/14
EvanCherry4/18
AliciaRizzo4/19
GeoffroyFauchet4/22
ClaudiaDouglas4/23
OmarJawaid4/26
JessicaRice4/26
EmilySimons4/26
ErinBredenberg4/28
   

  Geoff ​