Associate Chair for Graduate Medical Education

The three years of internal medicine residency are an incredibly busy time, as we work to turn new medical school graduates into physicians who are capable of practicing on their own, or landing spots in competitive fellowship programs for additional subspecialty training.

Residency is an immersion in learning while doing. Amid the never-ending demands that house officers face on the inpatient services, in the outpatient clinics, and in conferences and grand rounds, it’s hard to find time to focus on the broader issues that they will face now and in the future.

That’s why our department has in recent years created a series of retreats for each residency class, which this year became a standard part of the curriculum for all house officers. Under the direction of myself, associate program director Martha Buckley, MD, and assistant program director Daniel Kaul, MD, these retreats have grown to include many faculty who set aside time to share their knowledge.

Each retreat focuses on the issues and challenges that are unique to each year of residency. For the interns, whose first year of residency will end in a transition to their first supervisory roles, the retreat focuses on leadership skills. These include “people skills”, team management, and how to teach while also supervising.

For the second-year residents, who must decide whether to pursue subspecialty training or general internal medicine, the emphasis is on career paths. Two-thirds of our house officers go on to fellowship-level training, and while most of them have a very good idea of what road they wish to choose, the retreat helps them prepare to apply to various programs around the country—or our own fellowships. The retreat also lays out the different challenges and rewards of academic and community-practice careers, and gives insights into the business aspects of being a practicing physician.

In the third year, the retreat takes on a different function: reminding residents that life is not just about work. The discussion focuses on how to find a balance between family, friends, career, and personal interests that is sustainable over the long term. It also gets into the details of very practical issues that will face these physicians as they go forward, including negotiating employment contracts, functioning in different practice settings, and more.

What we find with these retreats is that the house officers truly open up to the insights that each of our speakers bring, whether they are faculty, senior residents, or professional staff such as Chief Risk Officer, Richard Boothman, who discusses issues related to open communication and other areas for which U-M has become known for innovation.

This year, we’ve also made progress in our effort to encourage the development of physician scientists—those individuals who have earned a PhD or other advanced degree in addition to their medical degree. A new formalized track brings them to U-M for a two-year internal medicine residency followed by fellowship. We also anticipate that many of the graduates of this track will find a place on the U-M faculty, further enhancing our position as a top institution. In 2008, seven physician-scientists will complete this track, which is overseen by associate program director James Beck, MD.

This type of innovative, attractive program is what keeps us in the top echelon of residency programs nationwide, and brings us candidates drawn from the upper tiers of the country’s medical school classes.

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