And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes, and our sacred Honor.
-The Signers of the Declaration of Independence
Hi everyone:
America’s founders often used pseudonyms—Cato, Brutus, Publius, etc.—to escape being tarred and feathered, challenged to duels, or worse. If they had to hide their names to write The Federalist Papers and Common Sense, then so be it.
Medical trainees also hide their names. On interview day, we invite applicants to ask questions anonymously to avoid being judged. Similarly, residents can submit private “pebbles” to the Chiefs, pose anonymous concerns at Program Directors Meetings, and have their names hidden when evaluating attendings and peers (full disclosure- I can see them). Anonymity allows residents to speak freely and fearlessly, and if that lets you raise concerns you’d otherwise withhold, then so be it. But most of you aren’t proposing revolution.
But there’s a downside to anonymity. First, dialog withers. When pebbles were submitted recently about procedure expectations, it was hard to fully unpack the nature of the concerns, address potential misunderstandings, ask follow up questions, and collaborate on solutions. Second, anonymity can be confusing or hurtful, for example when a resident gives positive verbal feedback and then enters a harsh, anonymous critique in MedHub. Third, signing your name boosts credibility, while anonymous posts may be interpreted (or misinterpreted) as isolated or misinformed. Finally, as we know from social media, named posts are usually more credible and respectful.
For these reasons, I encourage you to communicate openly, particularly for problems you care deeply about and wish to solve. I’d invite you to consider signing your names on peer evaluations as some of you already do. I’d also invite you to raise your hand and challenge me at residency meetings: your open, candid feedback makes me a better program director and makes our residency the best it can be. Your open feedback led to expanded simulation training, a new AI Distinction, more attendings leading noon conference, a new MICU curriculum, and the end of 28-hour-call. It’s also helping us make strides in acquiring new ultrasound equipment (stay tuned).
We will always provide venues for anonymous feedback because there will always be situations where residents feel unsafe divulging their names, and offering anonymity may be the only way for us to learn about major issues. Still, let’s make anonymity the exception instead of the rule. I’m grateful to the many residents who engage in open, and sometimes difficult, conversations, including the Chiefs and members of the Executive Council and Program Evaluation Committee. Special kudos to the interns who wrote directly to me last week asking us to go back to providing meal cards in the MICU. You’re right, let’s do it.
I understand why some of the founders wished to avoid tarring and feathering, but I also note that 56 delegates put their lives on the line by signing the Declaration of Independence. It takes courage to use your name and advocate for your beliefs, but stepping up is what makes you a hero.
Enjoy your Sunday, everyone. I’m headed out to the bike trail for a long ride,
Mark
P.S. Wishing a very happy birthday today to our beloved Program Director Emeritus Dr. Cyrus Kapadia.
P.P.S. What I’m reading, watching, and listening to:
- Does Using ChatGPT Change Your Brain Activity? Study Sparks Debate By Nicola Jones & Nature magazine
- Always Late? Blame Your Time Personality. By Emily Laber-Warren
- MAHA Is a Bad Answer to a Good Question On the Ezra Klein Show
- America Is Abandoning One of the Greatest Medical Breakthroughs By Rick Bright
- Here’s What Happened When I Made My College Students Put Away Their Phones By Ezekiel J. Emanuel
- Plagues Upon the Earth By Kyle Harper
- CT doctors, officials warn EPA rollback threatens air quality and public health: 'At greater risk' By Cris Villalonga-Vivoni
- America First? Not When It Comes to Your Health Video by Francesca Trianni, Adam Westbrook and Jan Kobal
- What It Really Means to Choose Life By David French