MADIGAN ARMY MEDICAL CENTER, Joint Base Lewis-McChord, Wash. – There is always a Friday in June that is celebrated at Madigan Army Medical Center. That is graduation day. For this year’s ceremony for the 100 residents, interns and fellows from 22 graduate health education programs, masks and social distancing were the order of the day in Carey Theater on Lewis Main on Joint Base Lewis-McChord, Wash., on June 11.
“Graduates, one thing that you have learned over this last year is that change is inevitable. Now generally, we don't see this much change in one year, as you've seen in the year of the pandemic, disrupting daily life and disrupting your training. But you met the challenge,” said Madigan Acting Commander Col. Scott Roofe.
Roofe welcomed graduates, a smaller than usual contingent of family and friends, and staff who have supported these graduates through their training for the one to six years of their programs.
He gave a brief history of graduate medical education at Madigan, from its first years of a general residency, which was a 3-year program, in 1948 and a rotating internship of 12 interns in 1949 to more than 350 residents, interns and fellows across 30 programs today.
“Our residency programs far surpass the national average board pass rates and many have achieved 100 percent for several years running,” he said as he highlighted a few of the many stand-out achievements of this year’s graduating class.
Just a few examples of the many ways Madigan’s residency programs have been appreciated by professional organizations and the wider medical community include: The U.S. Academy of Family Physicians recognized the family residency program for its overall outstanding achievement and scholarly activity, surpassing all other Department of Defense family medicine programs. One of the radiology residents was selected to serve on the Accreditation Council for Graduate Medical Education Diagnostic Radiology Review Committee. The emergency medicine residency was awarded $1.2 million in research grant funding.
Roofe thanked the graduates for their efforts and service.
“You've been so much more than trainees; you are the heart and soul of Madigan. We can't do the excellent work that we do every day without you. You embody care with compassion,” he said.
Offering the keynote address was Dr. Belinda Fu, a clinical assistant professor in the Department of Family Medicine at the University of Washington and faculty at the Swedish Family Medicine First Hill residency who uses concepts of improvisational theater in medicine.
After fitting herself into the molds expected of her through years of education and experience in medicine, she found herself changed by some of life’s unexpected challenges. She shared some of her takeaways.
“Life so often is a series of accomplishments and a series of titles, and I bought into this at a very early age. If I did it right, if I poured myself like sand into the mold that these job descriptions and titles offered me, then I would be successful, as I was,” she explained.
Her academic and early professional life went exactly as expected. But, she pointed out, life can be unexpected, and then you need a more solid base on which to stand.
“We have identities, these external structures and roles. So that we can work together, we have commonalities. And these responsibilities and titles bind us together,” she continued. “We have all these communities and there's power in that group and you lived the power of community within these roles, and these labels, especially this year. When uncertainty happened, you were able to respond, not because you knew exactly what to do for this specific situation. But, because you had strength in each other, and what you learned.”
When life threw her a curveball in the form of cancer, she turned to improv. Dr. Fu is an actor in improvisational theater as well as instructor; she has also been involved in the use of improv fundamentals in addressing medicine’s challenges.
“I didn't know who I was, without the labels I'd given myself before. Fortunately, for me, I had started doing improv,” she said.
She explained the three groups of skills in improvisation – attunement, affirmation and advancement. These are listening and acknowledging what is going on, understanding and accepting that it is real, whether it is desirable or not, and moving on to make choices based on these realities.
“I don't know how or why,” she explained. “But I started to rebuild myself by turning those skills of improv onto myself and asking myself, ‘Okay, well, who am I? Can I attune to myself and say, What do I believe in without these labels?’”
From this exercise, during a time when the usual identities she’d fit herself into didn’t apply, she began to construct a deeper understanding of who she was and what she valued.
“Instead of being sand poured into an external mold, I began to shape myself out of wire and clay,” she said. “It's been a deliberate practice.”
She encouraged the graduates to attempt the beginning of this practice themselves.
“Every time there is a break in between roles, we have an opportunity,” she said, introducing the exercise. “As we're sitting here in this moment. Can you attune to yourself and ask yourself, ‘Who am I? What do I believe in? Without all my titles, what is my identity?’ If you know and can enhance and cultivate that intuition and that identity of yourself, then when the unexpected comes in your life, you will be ready, because you've developed your own color, your own shape, you have become your own sculpture, of wire and clay.”
After inspiring the graduates to seek their own solid, but malleable identities that are truer than external accomplishments and titles, Dr. Fu aided in handing out awards and diplomas.
Outstanding Resident Teacher Award, presented by Capt. Maxwell Jensen, president of the Intern Class 2020-2021, to Capt. Matthew Mischo, Dept. of Emergency Medicine
Outstanding Staff Teacher Award, presented by Capt. Sean Scott, president of the Resident Council 2020-2021, to Dr. Richard Ling, Dept. of Medicine
Col. Janice Lehman Outstanding Clinical Nurse Award, presented by Capt. Sean Scott, president of the Resident Council 2020-2021, to 1st Lt. Matthew O’Hare, Dept. of Emergency Medicine
Outstanding Residency Coordinator Award, presented by Lt. Col. Daniel Kang, program director for the Orthopedics residency, to Araceli Trinidad, Dept. of Orthopedics
Lt. Col. Joseph A. Munaretto Outstanding Educator Award, presented by Lt. Col. Kelly Anderson, program director for the Otolaryngology residency, to Lt. Col. Marc Hohman, Dept. of Surgery
Col. Robert Skelton Award, presented by Col. Patricia Short, program director for the Internal Medicine residency, to Capt. Qing Wang, Dept. of Medicine
Maj. Gen. Floyd L. Wergeland Award, presented by Lt. Col. Vance Sohn, program director of the General Surgery residency, to Capt. Woo Do, Dept. of Surgery
Outstanding Resident Teacher Award – selected by the intern class and given to a resident as the most outstanding resident teacher during the current academic year.
Outstanding Staff Teacher Award – selected by interns and residents and given to the faculty member considered most outstanding teacher during the current academic year.
Col. Janice Lehman Outstanding Clinical Nurse Award – selected by interns and residents each academic year and awarded to the most outstanding clinical nurse, either civilian or military in a rank of major or below, who displays excellence in clinical skills, compassion, advocacy for patients and effectiveness as a team member.
Outstanding Residency Coordinator Award – presented annually to a residency coordinator who demonstrates excellence in administration and management of a Graduate Medical Education program.
Lt. Col. Joseph A. Munaretto Outstanding Educator Award – recognizes an educator who demonstrates teaching excellence.
Col. Robert Skelton Award – presented annually to an outstanding resident in a two- or three-year program.
Maj. Gen. Floyd L. Wergeland Award – presented annually to an outstanding resident in a program of four years or greater.
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