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Here’s one for you residency wonks. This past month started our clerkship program at the Chino Valley Medical Center (CVMC) residency program. For the past almost three years of this program’s existence, I as a residency director, needed to focus on stabilizing and advancing the program so the residents would have as beneficial a training experience as possible.
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Almost two years ago, one of my current second year residents, when deciding on which residency program to choose (she was highly sought-after by multiple programs), asked if I was planning on starting a clerkship. She felt strongly that a clerkship was an important part of a residency, and she was correct. However, at the time, other priorities had to come first. Now, two years later, the CVMC clerkship has been born, and I have already learned a great deal.
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The first lesson was one that reinforced what I already knew: nothing is as a simple as you think at first. Some residency programs are principally located in one institution, while my residents work at several locations covering a large geographic area. As a result, there were five locations we decided might be possible clinical or surgical locations for the clerks. And here, my friends, comes the rub. Because the clerks are coming from potentially nine colleges, each of the colleges needed to establish an affiliation with each of the five clinical sites. That translates to a total of 45 potential affiliation agreements, a veritable mountain of work. I felt justified in waiting the three years to start the clerkship programs, because I never would have had enough time to focus on the project. Things are never as easy as they seem.
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The Chino Valley Medical Center Clerkship has been born, and since the clerks would be coming from potentially 9 colleges, LESSON 1 was that the process was more complex than I imagined.
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This led to my second lesson: include a team. We had decided that instead of having the clerkship run from the hospital, we would instead create a clerkship out of the Western University College of Podiatric Medicine (there is a strong link between the hospital and the College, despite the hospital’s owning the residency program). At first, I tried to facilitate affiliations between the other podiatric colleges and the clerkship rotation sites myself. I soon realized that I was way out of my strength zone and skill set, and I was going to completely fail to make all the agreements happen. It’s a very complicated process since each college must make a separate agreement with each clinical site. This was too tall an order for me! I then went to the College’s administration and asked for help, which has made all the difference. They took a very large load off of me and are helping to facilitate the necessary agreements.
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LESSON 2 was to have an institution administrate the program. Since for a national clerkship, each college we draw from must make a separate agreement with each clinical site, it’s a very complicated process.
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My third lesson again came from the human resources side: the power of others. As a residency program director, I’ve always felt it was part of my job to help residents grow not only in their clinical and surgical skills but also in other ways, such as teamwork and leadership. To stay consistent with my own philosophy, I decided to turn over control of the structure and daily administration of the clerkship to the residents and mentor them with some oversight. The residents really stepped up and went full force, especially my chief, Dr Farid Didari and second year resident, Dr Lisa Breshears.
LESSON 3 was to make the running of the program a mentorship experience for the residents, so I decided to turn over control of the structure and daily administration of the clerkship to the residents. Of course, I lent oversight.
They led the group in creating virtually all aspects of the program, including a highly organized approach with a daily clinical schedule, academic schedule, academic assignments such as lectures, a clerkship guide, and a formalized online assessment tool to assess the clerks and the clerks to assess the program. I was amazed to see the quality of work my residents could accomplish when they were given the chance to be creative. The combined team of my residents made something much better than I could have done alone. I couldn’t be more proud of the work my residents put in to make this an educational experience for the clerks, and wonder if they knew what talent they had as clinical administrators? Perhaps that tradition of mentorship may play forward into my residents running their own residency programs in the future. That would make me even prouder.
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Perhaps that tradition of mentorship may play forward into my residents running their own residency programs in the future.
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Lessons are there for the open-minded among us. Remembering there is something to learn from every situation lays the foundation for personal growth. My resident was correct that we needed a clerkship, and I’m looking very forward to seeing how the clerkship evolves and grows over time.
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