General Surgery Residency Newsletter Summer 2021 – Wise Words

Reinvent. Tumultuous. Pivot. Challenge.  These words resonate when reflecting on the last few months and even the last year. As these words imply, it has been a rollercoaster ride throughout the 2020-2021 academic year, the kind of ride where we gripped the handrails to keep up with the pace and at times appreciated that we were not always able to control the speed and turns. There is one word that I did not list, however: “Pandemic” – that one lingering word which continues to shape our everyday lives in multiple ways, often impacting the roller coaster ride, no doubt.  Fortunately, the General Surgery Residency Program has continued to adapt to the many changes we’ve encountered over the last several months, including having been approved by the ACGME to finish 9 chiefs each year starting in 2022!

Despite the earliest hints of the impending impact of the delta variant, we were able to hold the annual General Surgery Chiefs’ Graduation event in late June 2021.  This group saw the last two years of their General Surgery training significantly altered by the pandemic, but they handled this with grace, and all of them easily met their Board-certification case numbers despite those impacts.  While the end-of training-celebration ceremony would normally include a wonderful banquet befitting the occasion, in 2020 we were forced to be all virtual due to the pandemic.  Luckily, this year, with all of the residents and faculty being vaccinated, we were able to implement a hybrid graduation with boxed meals and limited in-person attendees.  Meaningfully, some of the chiefs’ closest family members and friends who made our chiefs’ successes possible through their encouragement and support, were able to attend.  A hearty “thank you” to all guests who attended under such circumstances (regardless of approach), and we would again like to offer our sincerest congratulations to our nine chiefs from the Class of 2021 on their tremendous achievement in spite of the pandemic impacts to their training.  We wish the chiefs all the very best of luck with their future endeavors as they embark on their fellowships across the country, they will be missed but not forgotten!  

As the 2020-2021 General Surgery Chiefs departed, we were fortunate to welcome a new cohort of General Surgery interns to the WashU family in mid-June.  This is the first group to have been recruited through all-virtual means, so it was a truly unique experience to have met the majority of them face-to-face for the first time at our first welcome social event this summer.  Faculty and staff from the Department of Surgery celebrated the occasion with an outdoor “picnic” at the St. Louis Zoo, perhaps a fitting analogy to how we had anticipated virtual recruiting would turn out.  Instead, virtual recruitment was so successful that it is likely here to stay in some form or fashion for the foreseeable future given the great outcome and the cost and time savings for applicants and programs, one of the few silver linings to the pandemic cloud.  I have my concerns about this recruitment modality related to interview hoarding by some applicants and others being disadvantaged by the online format, but it has enough advantages to have staying power.  As I participate in the Association of Program Directors in Surgery Task Force on Recruitment, I have accepted the benefits of virtual recruitment amongst other changes.  I am pleased to see a number of these changes planned for the 2022 recruitment cycle that I think will slow the ever-burgeoning number of applications that we receive each year, complicating our ability to holistically review them all.  Regardless of how they came to us, however, we are so grateful to have such an incredibly accomplished group of interns join WashU Surgery in 2021, and they have not disappointed as they hit the ground running over these last two months.  

While we progress into the new academic year, the pandemic continues to impact our day-to-day lives, and more specifically, the way we have managed the residency training program.  A hybrid learning approach, much like how we handled the 2021 graduation event, has become our norm, another silver lining to the past year.  Weekly Department and Section M&M, education, and case conferences are delivered both on campus in-person as well as via Zoom, which provides flexibility for our trainees and faculty who are off site, and an opportunity for asynchronous learning through recording the sessions.  My weekly PGY class meetings are still held on a rotating basis through this format, where trainees are able to bring up important questions or concerns.  Luckily, we have been able to get back to in-person simulation labs, something that is critical for preparation and training.  Both the didactic and simulation environment has allowed the residents that oh-so-critical in-person commiseration that was so lacking in 2020, hopefully positively impacting well-being for all.  

Speaking of well-being, as I write this, though, we are in the midst of the delta surge across Missouri.  This has continued to weigh heavily on us as so many in our area have elected to forego the vaccines, and thus the pandemic continues.  Perhaps another silver lining to the devastation of the pandemic, however, is the normalizing of seeking psychological support, something that I have been proud to see has been embraced by many of the residents through these trying times.  We have many avenues of support offered to the residents and fellows in the Department.  Each PGY class attends meetings with Dr. Raquel Cabral, GME staff Psychologist, throughout the academic year.  These meetings provide a space for trainees to discuss shared challenges and means to cope with those challenges, all in the setting of the all-too-familiar pressures of surgical training.  In addition, trainees have the option to schedule one-on-one meetings with Dr. Cabral or her partner via this link.  This resource is invaluable.  In addition, BJC HealthCare and WashU have an Employee Assistance Program (EAP) which offers multiple services, including, counseling support, accessible at the BJC/SLCH EAP website, or employees can call 314.747.7490 or toll-free 888.505.6444.  Finally, the GME Consortium has a wonderful website dedicated to staff wellness. This website houses an abundance of resources include Counseling and Psychiatry Services, Physician Support Line, Mindfulness Apps, TED talk links, and links to the Mayo well-being index to track symptoms and any concerns for burnout.  It is my sincerest hope that these resources provide the support needed to manage, and perhaps overcome, the challenges that we will continue to face during these uncertain times.

I hope that you all enjoy the start of Fall, one of the best times of the year in St. Louis, especially with the Art Fair and Balloon Glow in the next few weeks.  As the leaves change color, we have other changes in the residency such as the retirement of Dr. Strasberg, the transition of Dr. Klingensmith to the ACGME full time, and the transition of our Chairman, Dr. Eberlein, a year from now.  We look forward to highlighting their amazing impact and legacy on Surgery, much less WashU and the Department, in upcoming events and newsletters. 

My best wishes for a safe Fall and Winter, and please take care of yourselves and take care of each other!

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