A Message from the President
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March 2010
“Medicine is a team sport and our residents and fellows are major players on the team.”
On March 18, 2010, an annual rite of passage will occur for thousands of medical students across this country: Match Day. This is the day when all fourth-year medical students find out simultaneously (through a complicated computer algorithm) which residency training program they have been accepted into and where they will spend the next three to seven years of their lives. I remember my own like it was yesterday as I learned (nearly 25 years ago!) that I would be spending the next seven years of my life doing a surgical residency at the New England Deaconess Hospital in Boston. Match Day is the start of a student’s transition from medical school to internship, to residency and fellowship, and eventually to becoming a full-fledged physician.
As two of the major teaching hospitals of The Warren Alpert Medical School of Brown University, both Rhode Island Hospital and The Miriam Hospital will “match” their fair share of the best and brightest this country’s medical schools have to offer and together we share an important responsibility. Along with providing the best possible care to our patients, we also are also responsible for training the next generation of physicians and surgeons. It is an integral part of our academic mission and one that is increasingly critical as a physician shortage looms over the nation and our state. And yet, as we approach another “match day,” the tumultuous healthcare landscape and the accompanying variations on healthcare reform are threatening to place unprecedented pressure on the federal financial support for graduate medical education. And so we continue to watch the debate on this topic very closely.
At our combined institutions, we have a total of 70 training programs and 580 physicians in training; combined, we are far and away the largest training site in the state. Under the direction of Dr. John Murphy, this complex enterprise is led by Dr. Staci Fischer (our designated institutional official and director of graduate medical education) and Kay Wagner, administrator of graduate medical education. They provide tremendous oversight and leadership to an organizational enterprise that is extraordinarily complex. They help set policy, ensure compliance with external regulatory agencies and foster an environment where education is recognized and rewarded.
Charged with the responsibility of ensuring that our trainees receive the appropriate amount of education, responsibility, autonomy and accountability — not an easy task even in the “good old days” — are our attending teaching faculty. Our faculty are responsible for developing new methods of teaching that balance the desires of our patients — namely superb, safe, compassionate care, with the needs of our residents — namely, increasing levels of authority, autonomy, and decision making. Now more than ever, teaching faculty must help trainees see the important trees in the forest of ever-changing policies, practices, guidelines, mandates, technologies and patient expectations. In short, they must ensure that the experience of graduate medical education remains transformative; that it transforms novice practitioners into physicians able to think, act, and keep their focus on the ultimate goal of providing the best and most appropriate care for patients no matter what the setting or circumstances.
Residency and fellowship training adds an energetic dimension and excitement to our hospitals that is not found in non-teaching hospitals. It is one of the many reasons I have been drawn to academic medicine for the past 25 years. The presence of residents and fellows in our hospitals ensures that patients receive the very best and most advanced care, and keeps our attending physicians “on their toes” regarding the latest and most evidenced-based care. I can recall during my own days as a member of the teaching faculty being constantly challenged and pushed by those in my charge. It was a responsibility I took very seriously and it has become part of my DNA; it defines how I try to lead these two great hospitals. Let me share with you a few of the highlights from some of our training programs (acknowledging the risk that I will unintentionally omit others that also deserve recognition. My apologies in advance.)
Recently, our surgery residency program, led by Dr. David Harrington and Dr. Bill Cioffi, achieved a remarkable feat – a 100 percent pass rate on its American Board of Surgery examinations (the tests surgeons must pass to become board certified) for the sixth consecutive year. It is the only program in the Northeast, and one of the largest programs in the country, to achieve a perfect pass rate in two consecutive reporting periods.
Dr. Brian Clyne and Dr. Brian Zink lead our emergency medicine residency program, one of the top ranked in the country. This residency provides training in a wide variety of areas including toxicology, disaster/EMS, ultrasound, sports medicine, medical simulation, global health, injury prevention, infectious diseases, pediatrics, ethics, medical education, and research.
Our medicine training program, the largest in the system, boasts 133 residents and is led by Dr. Dominick Tammaro and Dr. Lance Dworkin. The medicine residency training program is often the backbone of any great academic medical center and that is certainly the case at both Rhode Island Hospital and The Miriam Hospital. A number of recent graduates of this program went on to some of the most prestigious fellowships and practice positions in this country.
The residency program in diagnostic radiology, directed by Dr. Martha Mainiero and Dr. John Cronan, is a four-year program that trains physicians in the latest, cutting edge medical imaging technology — an increasingly important component of inpatient and outpatient care. The residency program was recently reviewed by the ACGME and earned a full five-year accreditation — the highest award granted. It was recently ranked one of the top radiology training programs in the country.
Hasbro Children’s Hospital is home to our pediatric residency, led by Dr. Adam Pallant and Dr. Robert Klein. This program also recently underwent an ACGME accreditation site visit and it, too, received the longest accreditation cycle possible in recognition of its excellence. Dr. Pallant, the program director, was specifically commended for his innovative approach to education and his techniques may become a national model.
Our orthopaedic surgery residency program, headed by Dr. Christopher DiGiovanni and Dr. Michael Ehrlich, is one of the most competitive training programs in the country. In the last two years, half of the candidates who matched into our program were members of Alpha Omega Alpha (the national medical student honor society). In addition, three of the past ten awardees of the The Haffenreffer Family House Staff Excellence Awards were orthopaedic residents.
These are just a few of the highlights of our outstanding training programs. There are others that, if time and space permitted, are equally deserving of mention. I would like to take this moment to thank all of our program directors and their support staff – your commitment to sharing knowledge, imparting wisdom and providing educational and training opportunities is helping us to achieve ACGME accreditation and to earn national recognition among our academic medical center peers. I applaud your efforts and appreciate your dedication. With ever increasing pressures on everyone to “do more with less,” teaching is often the first casualty of a busy, hectic work environment. I applaud all of you who guard against this.
And to our residents, thank you for all that you do on behalf of our patients. I encourage all of you to continue to learn to work more in teams. As health care systems mandate better coordination between primary care providers, specialists, third-party payers, and more informed patients, physicians will be required to function more as members of a team and less as solo practitioners. Finally, remember that despite the wonders of medical technology, there is no substitute for time spent at the bedside listening to and comforting our patients. Ultimately, that is the foundation of superb patient care.
In the steadfast pursuit of excellence, I remain,
Sincerely yours,
Timothy J. Babineau, MD
President and Chief Executive Officer
Rhode Island Hospital & The Miriam Hospital
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