So what's it like to actually be a resident at Virginia Mason? As noted in our mission statement, we want to develop exceptional physicians, fulfilled individuals, and innovative leaders. In multiple ways, we make a real effort to respect residents’ time, improve their work experience, and encourage them to lead rich lives both in and out of the hospital.
Optimizing U is the name of our curriculum devoted to helping you get the most out of your experience at Virginia Mason. The overall purpose of the Internal Medicine Residency is to create tailored experiences to develop exceptional physicians, fulfilled individuals and innovative leaders. Optimizing U is how we develop you to be a fulfilled individual.
The pillars of Optimizing U are the foundations of excellent human preparation and recovery: Sleeping Well, Nourishing Well, Moving Well, and Thinking Well. With these foundations, you have the opportunity to be Working Well and Living Well. The curriculum is delivered in multiple venues including Noon Conferences, House Staff Meetings, and our Fall and Spring Retreats and often consists of interactive/experiential sessions. Specifically, we cover diverse topics such as application of sport psychology to the practice of medicine, debunking the myth of multitasking, the psychology of optimal experiences, Three Good Things, Growth Mindset, as well as mindfulness practices, such as 2 feet and a breath and box breathing. We monitor its impact by regularly surveying your overall Quality of Life while in the program. Finally, we engage you in the development and direction of the curriculum. We hope that what you learn in Optimizing U helps you become the best version of you and launches you on a journey to reveal your full potential in the program and beyond.
Developing rewarding relationships with colleagues and staff
Our internal medicine residency is a small, close-knit program. Residents get to know each other in and out of the hospital, often going on hikes, meeting for trivia night, and sometimes even taking trips together. There are also opportunities to build relationships with residents in other programs. Many of the Virginia Mason radiology and anesthesia residents rotate through medicine wards their intern year. In fact, after graduation this year, residents from all programs (medicine, surgery, anesthesia, and radiology) joined each other for a celebratory night of karaoke!
Both the program leadership and attending physicians are easily accessible, supportive, open to new ideas, and heavily invested in resident education. Attendings provide a nice balance of support and autonomy, giving residents graduated responsibility as their clinical skills improve.
As there are very few fellows, residents work directly with subspecialty attendings. Many are consistently among the most highly-rated teachers. On inpatient months, subspecialty attendings are amiable and accessible for consultation. Electives provide further opportunities for working one-on-one in an outpatient environment. Whether planning a career in general internal medicine or aiming for fellowship training, these relationships can be incredibly valuable.
Residents work in multidisciplinary teams with social workers, nurses, nurse practitioners, medical assistants, physical therapists, respiratory therapists and pharmacists. The hospital is small enough to really get to know other providers and form strong working relationships. Multidisciplinary rounds and dedicated inpatient and psychiatric social workers serve to identify and solve issues with patient disposition. The palliative care service is run by nurse practitioners with specific training in the subject, and psychiatric social workers help care for patients with mental health needs. Inpatient pharmacists and respiratory therapists round with the team in the MICU.
Giving and receiving feedback
Timely feedback and meaningful change is ingrained within the culture of Virginia Mason.
While at Virginia Mason, residents evaluate all aspects of the residency program, both formally and informally. Ideas and criticisms are continually solicited to improve the program and meet residents’ needs. When major changes are made to the program, the program leadership discusses those changes with residents and provides a forum for expressing support and concerns. All residents complete an annual electronic evaluation of the Internal Medicine Program, the outcome of which is taken very seriously. In addition to solicited feedback, unsolicited ideas are openly encouraged, well received, and even put into action when appropriate.
“Virginia Mason is incredibly responsive to feedback and always trying to make things better for residents. I’ve personally been able to put several of my ideas to improve the residency into action, and I’ve also witnessed the program leadership adjust course during a major change based on resident feedback.”
Residents are evaluated and given face-to-face feedback throughout each rotation by their faculty attending. The final written rotation evaluation reflects the six general competencies as described by the ACGME (patient care; medical knowledge; practiced-based learning; interpersonal and communication skills; professionalism and systems-based practice).
This evaluation process improves the educational experience of the resident by providing an educational plan at the start of each rotation, an opportunity for midcourse corrections and a timely overall performance evaluation at the end of each rotation. In addition, a 360 degree evaluation of each resident is performed annually by faculty, nursing, ancillary and administrative co-workers.
Residents are given the opportunity for self-evaluation prior to their periodic discussion with the program director of intermediate learning goals and long-term professional plans. Residents meet formally with the program director for performance evaluations three times yearly. Residents can, and do, meet with the program director informally, at any time. We pride ourselves on the open-door nature of our program.
Adhering to reasonable duty hours
The program believes the best learning and safest care occurs when residents are well rested. Duty hours are tracked regularly, and extended hours are reviewed with the residents’ well-being in mind. If residents report extended hours, the program leadership investigates the cause and tries to make adjustments to prevent the unnecessarily excessive hours from recurring. This can be anything from helping a struggling intern with efficiency so he or she can get out of the hospital on time to making broader program changes to address systemic issues. In fact, duty hour violations have gone down in recent years due to changes made to the program. Over the past five years, there have been fewer than five instances of residents reporting less than eight hours break between shifts. This translates to less burnout and a chance to have a rich life outside of residency while still getting excellent training. Many residents find they are able to pursue hobbies outside of medicine and spend time with their families even on difficult inpatient months, allowing them to stay balanced and fulfilled during the inevitable challenges of training.
Enjoying the perks of being a Virginia Mason resident
In addition to the intangibles mentioned above, Virginia Mason helps residents out in very real ways, including free parking, a generous monthly food stipend, comprehensive health insurance, and discounts on movies tickets, ski passes, gym memberships, bus passes and much more. Plus, unlimited chocolate milk! All of this helps keep a little extra money in residents’ pockets to spend on the things that are important to them.