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Circle Game

June 12, 2022
by Mark David Siegel

And the seasons, they go round and round

And the painted ponies go up and down

We're captive on the carousel of time

We can't return, we can only look

Behind, from where we came

And go round and round and round, in the circle game

-Joni Mitchell, “The Circle Game”

Hi everyone,

And just like that, a residency year ends and another begins. Another circle around the sun.

This morning we thank Jakob Park, Jenny Xiang, and Emmy Coleman, our 2021-22 NHPCC, VA CRQS, and VA COE Chiefs. Like the Traditional Chiefs whom we thanked last week, Jakob, Jenny, and Emmy led with talent, innovation, and dedication, doing most of their essential work behind the scenes.

Listen to their mentors sing their praises:

Dr. Paul Bernstein on Jakob Park:

As the best Chief Residents do, Jakob buoyed our morale, fed our brains and was out in front arguing for resident causes. His talents extended to didactics too, teaching effectively in small groups, Report, Grand Rounds and Wednesday noon conferences. It was clear he was happy to be Chief. Jakob was insightful enough to grow confident sensing his own personal growth, which amplified his talents. The NHPCC and Jakob as our second Ambulatory Chief Resident were a great fit but we all profited from the union.

Dr. Naseema Merchant on Jenny Xiang (see attached for more):

Besides leading our lofty yearlong ambulatory QI curriculum which she has made even more robust, Dr. Xiang mentored residents on their projects, served as a subject matter expert in the QI distinction pathway and at other learning venues serving faculty, medical students, and other trainees. Jenny launched the very first High Reliability Organization centered patient safety reports for our residents this year, something that is absolutely unique to Yale… Additionally, she fully established the newly launched resident peer review conference, another very rich and special educational endeavor.

And Dr. Rebecca Brienza on Emmy Coleman:

I recruited Emmy after working with her on the VA Cohen service. During our time on this service together, I observed Emmy to be intelligent, thoughtful, committed to teaching and education, compassionate to trainees and patients and a sincere pleasure to be around. Although Emmy did not train in the COE clinic, she quickly and seamlessly went to work to understand and embrace our model of interprofessional training and collaborative care. Working closely with Emmy throughout the year, I was continuously impressed by her attention to detail, quick ability to master very complex assignments, empathy and support of trainees, impressive teaching skills as well as her calm and deliberate approach even in the face of stressful, unpredictable situations. Her grand rounds on the impact of healthcare system waste on the environment was timely, creative and addressed a much neglected area, important to us all. On a personal note, Emmy is a complete pleasure to work with and always brought positive energy to her interactions with faculty, team members and trainees. We wish her the best in her role as hospitalist at Maine Medical center and she will be missed!

Thank you for your contributions, Jakob, Jenny, and Emmy, and good luck to the 2022-23 Chiefs—Michael Fuery (NHPCC), Samantha Magier (CRQS), and Lisa O’Donovan (COE)—who will carry on your legacies.

Finally, as is tradition for this Sunday morning, here are excerpts from my graduation speech:

Unbelievably, you spent most of your residency fighting a pandemic. In March of your intern year, your clinics and specialty rotations were shut down, because we needed you on the front lines. You were promoted to senior residents months earlier than expected. You withstood social distancing when you needed to be together, and you endured illness and worry. Through it all, you rose to the challenge, you taught, you created new knowledge, and you cared your patients. In every way, you exceeded our expectations and made us proud.

You also trained during a period of national upheaval, as we dealt with climate change, wars, election shenanigans, attacks on women’s rights, and waves of gun violence. You learned how poverty and systemic racism undermined patients’ health, and you fought back, delivering state-of-the-art care to everyone, no matter what the color of their skin, no matter what language they spoke, no matter what circumstances brought them to our door. The world can learn from you.

All graduations are bittersweet, this one especially. In addition to saying good-bye to our graduates, we are saying farewell to our APD, Dr. Chris Sankey, who is leaving to become co-chief our new Hospital Medicine Firm. It would take too long to list all of Chris’s contributions to our program, but I’ll highlight a few. First, Chris elevated our commitment to careers in general internal medicine. He recognized an unspoken assumption that our residents were expected to pursue fellowships. Chris transformed that assumption by creating a popular hospital medicine elective, by building a bridge to our colleagues in NEMG, and by encouraging residents to listen to their hearts and pursue hospital medicine and primary care if that was their dream. As a premier academic general internist, Chris showed us why general internal medicine must be recognized as the bedrock upon which our specialty is built.

Second, as an award-winning teacher, Chris has been a dedicated mentor to residents pursuing careers in education. He helped lead our Clinician Educator Distinction, created a stellar inpatient lecture series, and taught many of us how to assess, evaluate, and coach. Chris epitomized the principle that the quality of a training program hinges on its commitment to education.

Finally, Chris has been a tireless advocate for trainees, uniquely able to see the world through the eyes of a resident, working to acquire skills despite the long hours, pressures, and fatigue of clinical training. Chris, we will miss you and know that you will contribute profoundly in your new role.

Two weeks ago, we lost a beloved faculty member, Dr. Fred Kantor. Fred devoted more than 60 years of his life to our residency. At age 90, he was still attending resident report until last month when illness took him away. Fred’s legacy includes the educational fund he created with his wife, Linda; the famous “Kantor Rule” which taught us to use common sense at the bedside; and the Kantor Teacher-of-the-Year Award, which we will announce later tonight.

Fred was the source of our unofficial residency motto, “as good as any, nicer than most.” His words roll so easily off the tongue that we could easily overlook their depth, particularly as they apply to you, our graduates. Indeed, you are as good as any. You are brilliant and kind, and there’s not one of you I wouldn’t trust with a family member. You each stand ready to contribute as master clinicians, scientists, and educators.

But as Fred taught us, it’s not enough to be good; you need to be nice. And you are. We see it in the compassion you show your patients, in the way you’ve supported each other over the past three years, in your ability to listen, and in the words you choose when you speak. These are the hallmarks of the true physician, honoring Dr. Kantor’s legacy. “As good as any, nicer than most.” He was talking about you.

So, congratulations, Class of 2022- for your stunning accomplishments, for your contributions to Yale and the New Haven community, and for the legacy you’ll leave behind. Best wishes as you begin long, fruitful careers. The world needs you now, and we couldn’t be prouder of all that you’ve done and all that you stand poised to do. Be well, take care, and stay nice.

So, with that, we bid farewell to our departing class as we welcome our new interns and circle back to begin another academic year.

Enjoy your Sunday, everyone,


PS Pictures from graduation and orientation:

Submitted by Mark David Siegel on June 12, 2022