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When Something's Up

January 28, 2024

Hi everyone:

Not too long ago, a residency alum called to discuss a situation at his current institution. For privacy, I’ll minimize the details, but here’s the gist.

A trainee at his hospital began to struggle at work after a loved one developed a life-threatening illness. As the trainee struggled, the program director questioned her effort, as if stress wasn’t affecting her performance.

I was disappointed that program leadership didn’t understand a core truth of medical education. Medical trainees at places like ours are exceptional. In medical school they all got stellar grades and strong letters of recommendation. Before residency starts, they already possess deep knowledge, sound clinical skills, and emotional intelligence.

Despite this, some trainees struggle, often for the first time in their lives. Some get low ITE scores while others have trouble completing notes, staying organized, or keeping up with their inboxes. Even in a group as nice as ours, some lose their cool and say things they shouldn’t say.

If there’s one thing I know after decades in medicine it’s this: when trainees struggle, something’s up. It’s almost never true that they’re incapable or don’t care.

When residents struggle, we work with them to identify the problem. Sometimes the reason is obvious and sometimes it’s not, but we always find something. Some residents need time off to care for loved ones. Others need medical care or counseling. Some need an extra day off, reassurance, or a shoulder to cry on. But whatever the problem is, there’s always a diagnosis- and a solution.

All our trainees can thrive with effective support. They need humane schedules and time to eat, sleep, exercise, and socialize. Most importantly, they need a community that will lift them up when they’re struggling.

I’m proud to be part of a program that always thinks the best of its trainees. Our department and GME office will go to all ends to help residents and fellows thrive. That’s how it is at Yale- and how it should be everywhere.

Enjoy your Sunday, everyone. I’m headed into the MICU for a great day with the Green Team!


Submitted by Mark David Siegel on January 28, 2024