Hacking Pathology Residency Training

As we celebrate the Christmas season and gear up for 2014, I’ve been thinking about resolutions and things in my life that warrant change. And since I was able to go home this year for Christmas break, I’ve had some time to do something that I enjoy but haven’t been able to do in a while – watch TED videos. I recently watched this one given by a 13-year old about hackschooling at TedxUniversity of Nevada. Makes me wish I had done some when I was younger (my first aspiration was to be an artist) but of course, I was raised in a traditional Asian household that revered education and practicality (“you can do drawing as a hobby but you should be a doctor”). Don’t get me wrong, I do not blame my parents and now at this point in my life, it is my choices that will determine my future and happiness.

And so I’ve been thinking about my education, both personally and professionally. In terms of nurturing my creative side, I realize that I need to set aside some “me time” where I engage in my previous interests (though probably not during PGY-2). And for my social justice/service side, I know that I will eventually return to my community activities when I can consistently have time to give, although I still watch from the sidelines and contribute when I can. But in terms of my chosen profession, I often wonder if there is a way to “hack” our residency training to make it both more creative and effective and to be proactive rather than reactive?

Tying together some themes I have previously blogged about (competency evaluation and transforming our profession), I’d like to address some issues I see. Pathologists need to be more engaged, both within the system and within society or be left behind. With healthcare reform, gone will be the days when a physician can continue to practice the way s/he was trained – there will be a constant drive for life-long learning, both in terms of knowledge and utilization of new technologies, especially disruptive or exponential ones, than is present currently. I’m not going to argue for or against the finer points of the ACA or the recent cuts in pathology codes in the new physician fee schedule except to say that the landscape we residents will inherit will be vastly different than the one our attendings, or even we, now currently train.

But competency needs to be more than a checklist. We need to learn how to navigate and show our worth within the value-based systems where we will most likely work. First, of course, we need to learn our material well. We cannot interpret data, educate non-pathologists, or advocate for specific decisions if this foundation is lacking. But how do we residents take ownership and accomplish this in addition to the training we may or may not receive in our residencies? And how do we learn to be a patient advocate rather than just a reporter of results?

I will leave you these questions to ponder until my next blog where I will elaborate on some of my observations and ideas on this topic. For those of you who attended Eric Topol’s keynote at CAP ’13, I will leave you with similar talk by Dr. Daniel Kraft given at TedxMaastrict about 2.5 years earlier – http://www.ted.com/playlists/23/the_future_of_medicine.html– and hopefully, it’ll spark some ideas.

I hope everyone has a prosperous year in 2014!

 

Chung

Betty Chung, DO, MPH, MA is a second year resident physician at the University of Illinois Hospital and Health Sciences System in Chicago, IL.

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