How MCW's Residency Directors and Residents are Dealing with COVID-19
Kathlyn Fletcher, MD MA
In the musical, Hamilton, after surrendering to the Americans, the British staggered away singing an old drinking song that repeated the words “The world’s turned upside down.” That phrase continuously resurfaces in my consciousness these days. As a residency program director, I am constantly barraged with changes, adjustments and contingencies. We are tasked with being flexible and leading our trainees so that they can do the same. In the midst of this uncertainty and constantly changing landscape, we need to create moments of connection and normalcy for our programs.
What MCW residency programs are doing
I asked a few of my fellow MCW residency program directors what they are doing to manage anxiety, prevent the downsides of social isolation and promote strength/resilience in their residents. Program directors reported that their housestaff were feeling anxiety. They also sensed that some of that anxiety was related to the anticipation of a surge and/or not knowing when the surge would actually arrive. Other residents are worried about their own health and the health of their families.
To manage anxiety, some program directors such as Heather Toth (Medicine-Pediatrics) are making an effort to check in with residents in person. Cynthia Lien (Anesthesiology) walks into ORs to check on individual residents. She also emphasized the importance of listening carefully to the concerns of the residents. On the other end of the spectrum from in person meetings, I have also begun writing nightly emails to the residents in my program (Internal Medicine) and including all our leadership team as well (AAs, coordinator, chief residents, APDs, vice chair for education). This allows me to summarize the most important updates of the day and try to provide some levity. I have had very positive feedback about these nightly updates. Matt Goldblatt, General Surgery program director, told me that pre-COVID, he routinely did a weekly newsletter, and now is doing that twice weekly.
Finding new ways to stay connected
In order to maintain connectedness, some programs such as General Surgery and Medicine-Pediatrics, are having virtual video meetings and/or “happy hours.” Dr. Goldblatt participates at the beginning of the happy hour to give a virtual “in person” update. Colleen Crowe of Emergency Medicine hosts program-wide WebEx calls to answer questions and provide updates. We also started this in Internal Medicine.
Because we have more than 90 residents, we ask the residents to submit questions through a Qualtrics survey the night before the meeting. Having the questions ahead of time serves two purposes: avoiding the chaos of multiple people unmuting and asking questions and allowing me to be prepared with answers. We also had a reflective writing session via WebEx during which we shared essays that the residents submitted ahead of time. After reading each essay aloud, I asked questions to promote discussion about the main themes. One of our chief residents read the responses as they were typed into the chat box. This session went surprisingly well and allowed for some normalization of feelings that may not have been discussed openly otherwise.
In summary…
This is an important time for program directors to provide leadership, especially as it pertains to information sharing and managing the concerns of the residents. Program directors have found different ways to communicate with their residents as we each work to support and sustain our trainees using tools such as WebEx meetings, nightly emails, and individual check ins.
Program directors must be innovative but we must also keep one foot firmly planted in the way it used to be/the way it will be again. Even as our residents are looked upon as valuable contributors to our workforce in this time of crisis, they are also still trainees. We must make certain that we be vigilant as we monitor their experiences and learning opportunities.
Kathlyn Fletcher, MD MA is a Professor of Medicine and Program Director of the Internal Medicine Residency Program at MCW
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