Hi everyone,
Graduation 2024 is in the books! As promised here is the text of my speech. I’ve also attached a copy of the program with the list of award winners.
Congratulations to all!
Mark
Graduation Speech
June 2, 2024
Good evening, and welcome to Graduation 2024! It’s great to see so many residents, faculty, staff, and family members here to toast our graduates.
First, some acknowledgements.
To our interns: Today is a milestone for you too. In just three weeks, you will move on to specialty training or start leading your own teams. Few jobs are more taxing than internship. You have amassed knowledge and procedural skills while taking excellent care of your patients. You are ready for the challenge.
To our PGY2s: It is imposing and humbling to become a senior resident, and you have succeeded. Now it’s your turn to become program leaders, share your wisdom with juniors, and show you’re ready to be attendings. You have served your interns, students, and patients well. You will be stellar PGY3s.
To our faculty: You’ve devoted countless hours attending in the clinic and hospital. You’ve served as MACs, committee members, letter writers, and project mentors. You’ve applied a keen eye, shown patience, and known when to intervene and when to hold back. You’ve made our residents shine.
To our APDs (Matt, Jackie, Cindy, Shaili, Isabel, Ben, and Mahalia): For most of the year, we were down one APD, and then three of us took leave. But you carried the load, and you supported your residents. You led committees, advocated for wellness and safety, and were present when we needed you. I’ve lost count of the number of times I reached out to you to discuss a problem, only to learn you had already solved it. I’m excited about our future as this team continues to gel. You are magnificent partners.
To our staff (Brett, Aliyah, Julia, Nicole, Tatianna, Joanna, Lori, Denise, Mary Sarah and so many others): You are the unsung heroes of this residency. You ensure our residents are fed, paid, scheduled, evaluated, recruited, and celebrated. You keep the records and complete the forms. And please join me in a very special thank you to Brett Marks, who created tonight’s celebration.
To our families (spouses, partners, children, parents, siblings, and significant others): I know how hard it is to support a loved one whose work demands up to 80 hours a week, including nights and weekends. They could not have succeeded without the food, shelter, and love you provided. Let’s hear it for the families.
To our CRQS, COE, and NHPCC Chiefs (Sebastian, Evan, and Koeun): You enhanced our program with your talents and skills. You centered patient safety, quality improvement, ambulatory education, interdisciplinary teamwork, and community engagement. You are exceptional junior attendings and role models, and you will continue to contribute for years to come.
To our Traditional Chiefs (Lexie, Emily, Ramya, Necia, and Kevin): We don’t have enough time to list even a fraction of your contributions. It’s been a joy to watch you grow into junior faculty, managers, confidantes, mentors, advocates, teachers, and life coaches. You created thoughtful, humane schedules, led riveting reports, and hosted 14 pre-interview dinners and Q&A sessions. You represented your residents at meetings with department and hospital administration, and you spoke up, even when it was difficult to do so. You led us through long leadership conferences, keeping us focused on our mission: the well-being and education of our residents. You reinvigorated in-person teaching; mapped out the end of 28-hour call; moved us to Teams and SharePoint; created SOPs for residency operations; led simulation sessions; showed us the value of structured teaching, procedural training, and Care Signature Pathways; redesigned night teams in the middle of the academic year; focused our attention on creating a safe, respectful workplace; responded to emergencies big and small; and solicited resident input on all major decisions. You define leadership. Thank you for everything you’ve done for this residency and for me, personally.
To our graduates: Your moment has come! Wasn’t it just yesterday that we were sampling New Haven pizza at orientation and enjoying our first dinner together at Bear’s Smokehouse? You arrived at the height of the COVID pandemic and despite the obstacles, you created a community of skilled, caring physicians and friends. You contributed to this program on committees devoted to wellness, program improvement, recruitment, distinctions, and residency government. You wrote for The Beeson Beat, played softball on The Beeson Bombers, and performed at Arts Night. Through long days and nights caring for patients, you clung to your core values: practicing state-of-the-art medicine, mentoring junior colleagues, and role modeling patience, respect, and compassion. The sky is the limit for you. Thank you for teaching me and for leaving this program better than you found it.
Last week, I had dinner out with the Rising Chiefs so we could share our our passions and goals for next year. As we sipped wine and enjoyed grilled vegetables, gnocchi, and pizza, one of the Chiefs asked how I managed to stay well and flourish as a physician, particularly when so many residents and attendings these days suffer from burnout and regret their career choices.
The answer isn’t straightforward. As an intensivist, I’ve encountered countless tragedies, and as a program director, I’ve wrestled with many moments of sadness, particularly when residents struggle. My hours are long. But I love my job, and while I’m not an expert on wellness, I do think I’ve learned important lessons during my 32 years at Yale and nearly 13 as program director. Here are six lessons, which I hope you’ll find helpful.
1) Do the Little Things: You will accomplish great things during your career. You will make rare diagnoses, come to the rescue in emergencies, and master sophisticated procedures. You will win awards and rise in the ranks. But spectacular moments like these are uncommon, unpredictable, and fleeting. Rare diagnoses may prove untreatable, interventions may come too late, and procedures may fail. But each day will offer you the opportunity to sit with your patients, look into their eyes, listen to their fears, and reassure them with your words. Do the little things for your patients, and do them for yourselves.
2) Do your best: When I was a resident, I carefully tracked my wins and losses, the patients who lived and those who died. A wise palliative care nurse showed me how this distorted thinking would inevitably lead to guilt and frustration. Most patient outcomes, both good and bad, are beyond our control. Some patients recover because they are young and resilient; others deteriorate no matter how hard we try. We can only do our best: study, work hard, be careful, pay attention, and be present. Beyond that, outcomes are out of our hands.
3) Take care of yourselves: One lesson I had to unlearn from residency was that self-care was secondary to patient care. But we can't be good doctors, let alone flourish, if we don’t care for ourselves. Your work hours will inevitably be long, and you will shoulder the weight of professional responsibility throughout your career. So, be sure to work in an organization that offers humane schedules, values life outside the hospital, supports a just culture, and honors your contributions. Equally importantly, uphold the four pillars of self-care: sleep, exercise, nutrition, and community. Each pillar is indispensable to humans who practice medicine.
4) Stay humble: When I graduated from residency, I thought I’d reached the pinnacle of knowledge and skill, but I soon learned how much I had to grow. Good physicians know their limitations. They see mistakes as opportunities to learn. They absorb the wisdom of colleagues, not just physicians but all medical professionals. They ask questions and look things up. They learn from their patients. Stay humble, now and throughout your careers.
5) Follow your moral compass: Few of you truly know where your career is headed. In a few weeks, you will become primary care physicians, hospitalists, and subspecialty fellows, but most of you can’t know which direction your career will take you in 10 years, let alone 20, particularly as medicine transforms itself with high tech treatments and artificial intelligence. Some of you will become department chairs, funded investigators, master clinicians, or educators, but trust me, you don’t know what’s coming. When I was in your position, I didn’t know I’d become a program director. But no matter what direction your career takes, follow your moral compass. Resist cynicism. Uphold honesty, integrity, generosity, and respect for all people, especially the marginalized and vulnerable. Speak up. Choose your words carefully, think well of others, and remain compassionate and kind, just as you are today.
6) Surround yourselves with good people: Medicine is the ultimate social profession and internal medicine may be the most social specialty of all. More than ever, we work in teams, side-by-side with nurses, therapists, pharmacists, APPs, support staff, trainees, and colleagues. As teams, we tackle great challenges, which promise professional satisfaction. But true joy in medicine comes from surrounding ourselves with smart, compassionate, funny, dedicated, joyful people like the members of this residency community: people like you.
So, as you prepare to graduate, please do all that you can to flourish. Do the little things. Do your best. Take care of yourselves. Stay humble. Follow your moral compass. And surround yourselves with good people. You are ready to graduate, and I am beyond proud of all that you’ve accomplished in your short careers. I wish you all success, health, and happiness for decades to come.
Thank you.