Our trainees on the frontlines

You know that things are serious when we are in the national news every day this week. There should be no doubt that our state (and country) is experiencing one of the worst health crises in our history and our hospital is at the epicenter. The spotlight is on us, and our faculty have become spokespersons to the nation and to our elected leaders about the importance of taking measures that we know can stop and mitigate the spread of COVID-19. I applaud your courage in speaking truth to power. As you look closely at these news reports, what you do not see is chaos, but professionalism and a steely resolve to mobilize our entire workforce to ensure that University of Iowa Health Care will continue to provide best-in-class care for the thousands of patients we screen each week for COVID-19 symptoms and for the nearly 100 patients we are managing in our hospital right now. What you might also not see on the news are our outstanding trainees, interns, residents, and fellows who have stepped away from their assigned and necessary training rotations, giving up vacation time, giving up research and elective time, giving up family time to put themselves on the frontlines of caring for patients in this pandemic. The country might not be seeing you, but we see you. There are many “heroes” in healthcare during this pandemic, from ICU and hospitalist faculty to nurses and custodial staff, but I want to focus today on those who came here to train to be internal medicine specialists who are temporarily putting aside those aspirations in order to save lives of Iowans. It is tiring and stressful and words of appreciation do not dull anxiety and fatigue, but I know that the leaders of our training program and our chief residents are committed to ensuring that we manage your assignments and provide as much support as possible to minimize burnout. “We are in this together” can become a slogan, but to our trainees, please know that we have your backs. 

Nothing I can say here will make that work disappear, but what I can tell you is that you are not alone. What we have already accomplished proved what we knew in the spring, that our teamwork, our collective wisdom and skill ensure that we provide the best care we can to those who depend on us. The best difference though is that now we know more. About how to treat this virus’s manifestations as well as how to keep each other safe. We have gotten better at working together, forged bonds that make it easier to rely on the person next to us and increased our effectiveness. Because we are stronger now, more united, we will get through this. As always, a reminder: part of your responsibility to this work is to let leadership here, especially me, know when you need some relief. We will do everything we can to make sure you get the help you need. Thank you for everything you continue to do on the front lines–as the last line–for our state.

Despite the challenges, we have not suspended our commitment to training the next generation of physicians, namely our medical students. And here again, in this regard, our trainees are at the frontline. I was very encouraged and frankly filled with pride when I read letters to some of our house staff from the Carver College of Medicine’s Office of Graduate Medical Education celebrating and recognizing their unique contributions to the training of our medical students. GME partnered with the Clinical Teaching Collaborative to celebrate resident and fellow teaching excellence for a second year. Earlier this month they hosted a set of panel discussions and sponsored other activities and giveaways to recognize the critical role trainees play in medical student education. One of our second-year residents, Dr. Jason Winward, was on one of those panels with a fourth-year Neurology resident and a Chief Resident at UnityPoint Health in Des Moines. Read their discussion of how they have adapted their teaching style to fit the necessities of the current moment, but also note the excerpts of comments that our medical students made to you, our residents and fellows, for your stellar contributions to their education. Thank you!

Our faculty commitment to doing more today—that we were not doing six months ago when the pandemic started—is to innovate to ensure that we can continue to safely incorporate meaningful clinical experiences and bedside teaching during our medical student education. I see this when I round with our teams each week. This is essential to our mission and our commitment to the future of our profession, and when medical students were not with us, it felt like something important was missing. We also see how much our medical students missed it as well. Our Education Leadership team has always solicited feedback from them at the end of their clerkships, sub-internships, and other internal medicine rotations. Because continuous improvement is a pillar of our education philosophy, we assess their experience in formal ways, but we also ask for written feedback. We pay close attention to this feedback and I note the many gracious words that are shared about the quality and commitment of our faculty. You can read some of their feedback here.

We are proud of the ways our residents demonstrate how they take what they learn from our faculty, blend it with their own talents and skills, and grow into leaders themselves. It never grows old and is at the heart of what makes being in academic medicine so satisfying. Our residents do not just become good educators in our program, they also are mentored to success in scholarship as well. Associate Program Director Dr. Brian Gehlbach explains the approach and the results in this video. We can also see the results in the wave of presentations that residents and fellows have delivered this fall. At just one meeting, the Midwest Society for General Internal Medicine, 5 of the 8 oral presentations invited to the Innovations section were from QI projects our residents spearheaded. One moderator even joked, “We should have just renamed this the Iowa afternoon.” This is a message that we are sending loud and clear to the many outstanding medical students who have applied to our residency program this year and who we are actively recruiting and interviewing each week. We are now one month into our residency recruitment season and what I see of the outstanding applicants is that national interest in the quality of our training programs remains very high. I am optimistic for the future and look forward to welcoming our first “pandemic” class of virtually recruited house staff who will join us next summer after this recruitment season is over.

Finally, although this has been an unusual year, our need to spread the word of the good work being done in this department remains. Whether it is to celebrate outstanding achievement by our peers or to showcase to potential faculty, fellow, and resident recruits just who we are and what we value, it is important for us to “spread the word.” In that spirit, I am happy to announce that the 2020 issue of VITALS will soon be making its way out across the country. Read about its production and follow links either to a PDF version or to a more interactive, page-turning one here. My thanks to everyone in the department and within University of Iowa Health Care who contributed to its production and the stories it contains.

About E. Dale Abel, MD, PhD

E. Dale Abel, MD PhD Francois M. Abboud Chair in Internal Medicine John B. Stokes III Chair in Diabetes Research Chair, Department of Internal Medicine Director, Fraternal Order of Eagles Diabetes Research Center Director, Division of Endocrinology and Metabolism Professor of Medicine, Biochemistry and Biomedical Engineering

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