It is understood without qualification or a second thought that residents and fellows deserve gratitude and thanks for their dedicated contributions to their Department of Pediatrics clinical teams. They put in long days (and often nights) and hundreds of hours working with their patients, with medical students, and fulfilling other program requirements. The department could not function nearly as well without them.
In 2018, the Gold Humanism Honor Society created “Thank a Resident Day” to make explicit for a day the thanks that may be generally felt yet left unspoken. On this day, health care teams in medical institutions across the country participate in expressing their thanks to physician residents and fellows. In 2022, more than 500 medical institutions participated. The UW School of Medical and Public Health Department of Pediatrics joins them to offer its profound gratitude and thanks to its own residents and fellows on February 24.
“The residents and fellows help us as clinicians to do our best work, inspiring us to provide teaching and role modeling to support the next generation of pediatricians,” said Megan Moreno, MD, MSEd, MPH, interim chair and professor, Division of General Pediatrics and Adolescent Medicine. “But the residents and fellows also teach us through their own ideas, knowledge, and approach. So in honor of this day of thanks, I want to express my sincere appreciation for our residents and fellows.”
The SMPH Department of Pediatrics Residency Program welcomes 15 pediatric residents and one pediatrics-neurology resident as interns every year, with 47 pediatric residents progressing through various levels of the three-year program. They work within the department at the American Family Children’s Hospital (AFCH) and across the city at other clinical sites.
Residency is very rigorous and programmatic, with a focus on learning the system and practicing core elements of being a physician, including efficiency, organization, prioritization, resourcefulness, and numerous modes of medical communications. Assisted by physician mentors, more advanced residents, and other medical staff, new residents quickly increase their knowledge and skills, learning strategies of perceiving, evaluating, and responding to patients’ signs, symptoms, and needs. Residents may average up to 80 hours at work per week: there is a lot to learn and the days are full. Four weeks of inpatient overnight duty is also an important rotation for all resident interns to practice their skills at the bedside with more autonomy and responsibility
Adam S. Bauer, MD, associate residency program director and assistant professor, Division of Neonatology and Newborn Nursery, oversees the curriculum for Pediatric Education and Active Resident Learning (PEARL) and social media outreach. He noted that the experience of being the primary clinician with whom their patients interact was an important aspect of training that the program works hard to provide to residents. “Through it, residents learn greater responsibility, focus, and agency,“ he said.
Bauer asked colleagues at American Family Children’s Hospital to get statements from pediatric patients who had expressed their gratitude about their resident physicians:
From a 15-year-old pediatric patient: “I like how hard-working and determined they are, like how every time I come in, they work hard to try and figure out what’s going on.”
From another teenage pediatric patient: “I so appreciate [the residents’] care, thoughtful attention, and patience throughout my hospital stay. I now feel happier and hopeful.”
(Thanks to Kirstin A. M. Nackers, MD, associate professor, Division of Hospital Medicine; and Laura Chen, MD, assistant professor, Division of Hospital Medicine, for acquiring these statements.)
Bauer added his own statement of thanks: “Thank you to all of our pediatric residents and fellows for the unwavering incredible care that you provide to our pediatric patients, day in and day out. We are beyond fortunate to have such an engaged, thoughtful, intelligent, and determined group of residents and fellows, and we know that the future is bright with you in the world of pediatrics.”
Daniel Sklansky, MD, residency program director and associate professor, Division of Hospital Medicine, noted that recent residents have been faced with an unprecedented situation in the face of the COVID-19 pandemic and the necessary strictures of a public health emergency.
“They have been working on the front lines facing the unexpected demands the pandemic placed on them,” Sklansky explained. “Children and families need more support, and emotional reserves have been scarce. We thank our residents for their dedication to patients, positive spirit, flexibility, and teamwork.”
As residents progress through the program, their responsibilities grow. Sklansky described this as scaffolded autonomy and individuation. In their second year, residents practice their supervisory skills in specific clinical situations before taking on broad supervisory roles in their third year. By the third year, residents decide whether to remain in general pediatrics, or to pursue a subspecialty, such as cardiology, neonatology, or hospital medicine, to name a few of the 16 subspecialty divisions. Those who decide to pursue a pediatric subspecialty may decide to seek a fellowship position with the department — or with another institution — to continue learning and gaining experience for several more years.
Fellows occupy an unusual position, according to Cathy Lee-Miller, MD, assistant professor and fellowship director, Division of Hematology, Oncology, and Bone Marrow Transplant. (Lee-Miller is also currently interim director of fellowships for the department.) “You cannot practice medicine with an MD unless you complete a residency,” Lee-Miller explained. “However, training beyond residency is not required to start practicing medicine independently. Those who seek out a fellowship have opted not to begin their post-training careers, but have chosen instead to devote one to three more years of their lives to gaining more knowledge and skills — including research experience — in a subspecialty.”
At any time, there are approximately 25 fellows working within the Department of Pediatrics, distributed among about 14 different subspecialties. A fellowship includes a clinical research requirement: the recipient must produce a scholarly product, such as a grant or a paper, for example. Future breakthroughs in subspecialty research often show first inklings during a clinician’s fellowship tenure.
“Our fellows are a great group of people,” Lee-Miller explained. “The subpopulations they work with include the sickest and the most complex patients. Our fellows are determined to understand and address these complexities through their focused, dedicated work.”
That is why “Thank a Resident Day” is also “Thank a Fellow Day” at this Department of Pediatrics — and everywhere else it is acknowledged.
Join the department’s efforts to express gratitude to its residents and fellows by emailing a note of thanks to individuals or groups to firstname.lastname@example.org. We will collect and share these sentiments with residents and fellows on February 24.