The Secret Sauce
by: Monica Newton, DO
There are two things that make residency programs different much like any educational opportunity you will evaluate: the people and the curriculum. I want to share a bit about those, but also what I consider the secret sauce to mastery and that is a culture of learning.
Becoming a master adaptive learner (MAL) requires that you look at residency as growth opportunity. In one of our defining faculty development sessions before we started the residency, we examined Carol Dweck’s work, The Growth Mindset. In it, we began to learn that failures are the path to success if you have the right mindset. Here, this culture is so embedded into our culture of learning that we can spot someone who is “fixed” or stuck and help them out of that to promote their growth. We also look for learners who are growth oriented as they will be less fearful to fail from the start.
I am a fan of Alfred Nobel, who said “I have not failed. I have just found 10,000 ways that did not work.” This I think is key to our success. We work hard to present residents with the best education anyone can give them. At the same time, we recognize that we won’t succeed unless we boldly try new things. If you haven’t failed, you haven’t tried.
So, our people are courageous. Our faculty are master adaptive learners, and our culture of inquiry is based on the growth mindset.
In terms of our curriculum, it is innovative and focused on two key principles
- Clinic first – and the clinic is the curriculum
- The fuller your training scope the more valuable you will be as a family physician
Clinic First
Clinic first was an innovation model the faculty studied during our residency design. It involves prioritizing your clinic experiences because continuity is your greatest teacher. There, you are directly observed performing the skills family physicians do most. Your clinics with YOUR patients build so patients know where to find you no matter what rotation you are on.
The more experience you get performing clinically courageous skills in residency, the more likely you are to continue them when you get out. This includes obstetrics, office gyn procedures, caring for sick kids in the hospital and clinic and managing complex cases. We seek to support you in that journey here and as you go forward. We provide two extra hands on procedural based rotations including procedure month and urgent care that are part of our required curriculum.
Didactics
Didactics and simulations are a huge part of your training as well. Our residency has five hours of didactics every Wednesday afternoon from noon till 5 p.m., except during holidays or certain national conferences.
Didactics are based on systems or life stages including newborn care, adolescence and maternity care. There is a variety of presentation styles, presenters and topics. The number of didactic sessions is taken from the number of questions in the blueprint of your FM Board exam.
Monthly didactics will include a variety of topics, including, but not limited to the following:
- Practice Management including Billing and Coding, Quality Measures, the Business of Medicine
- Behavioral Health
- Pharmacology and interdisciplinary team-based teaching
- Topic specific lecturers, including the top 50 diagnosis encountered in Family medicine and other high yield board relevant materials
- Specialty lectures
- Point of Care Ultrasound (POCUS)
- Simulation/OSCE/Procedure workshop monthly
- EKG and Radiology Workshops
- Evidence Based Medicine and Journal Club
- Board Review
- Games (Jeopardy, Chopped, Family Feud)
Wellness
Resident Wellness is also built into the curriculum. The fifth Wednesday of the month is planned wellness half-days so residents can get their personal appointments made or enjoy some relaxation with colleagues.
Monthly personal and professional development sessions with a behavioralist help to remove the stigma from medical mistakes, help residents place their actions and patient outcomes in a systems perspective, and to support residents and help them learn from error and events that causes secondary trauma.
So, the secret sauce comes back full circle to the culture of learning. It doesn’t matter what we teach you – if the culture is caustic, it will not stick.
It reminds me of a quote from my kindergarten teacher, “It doesn’t matter what you say, how you feel, or what you think. It only matters what you do.” I think she is right. To have a culture where you are respected, uplifted and not expected to be perfect, is the key. No mistake is final, if you get up and keep growing. That is the secret.