Panel Member Introductions

Herman O I Pfaeffle, MD

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Walter Reed National Military Medical Center (PGY-1)

Naval Medical Readiness & Training Command Portsmouth

Portsmouth, VA (PGY-2/3)

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Internal Medicine

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Interests:

• Social Determinants of Health, Global Health,�Infectious Diseases, Critical Care

Panel Member Introductions

Leonardo D. Borregales, MD

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Weill Cornell Medicine - New-York Presbyterian Hospital

Department of Urology

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Urologic Oncology Fellow

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Interests:

• Prostate, Kidney, Bladder and Penile Cancer
• Access to care, health disparities
• Running, scuba diving

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Panel Member Introductions

Munir H. Buhaya, MD

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University of Texas Southwestern

Dallas, Texas

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General Surgery (PGY-1)

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Interests:

• Academic Surgery & Surgical Education
• DEI in academic medicine
• LMSA former regional director / Latino surgical society resident member
• Wellness

@munirbuhaya

Panel Member Introductions

Felipe D. Perez, MD FAAP

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Stanford University School of Medicine

Stanford, CA

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Anesthesiology

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Assistant Dean, Office of Diversity in Medical Education (ODME)

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Interests:

• Diversifying our healthcare workforce
• Health Policy (State, National Legislation)
• NHMA Anesthesiology Specialty Council

@FDJPerez

How to Select a Residency Specialty?

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A biased opinion to choose Internal Medicine

Internal Medicine

• Definition:
• Internal medicine is a discipline encompassing the study and practice of health promotion, disease prevention, diagnosis, care, and treatment of men and women from adolescence to old age, during health and all stages of illness.
• Intrinsic to the discipline are scientific knowledge, the scientific method of problem solving, evidence-based decision making, a commitment to lifelong learning, and an attitude of caring that is derived from humanistic and professional values.

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Internal Medicine

• Program Requirements
• Length: 36 Months (3 years)

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• Six ACGME Core Competencies (across all programs)
1. Practice-Based Learning and Improvement
2. Patient Care and Procedural Skills
3. Systems-Based Practice
4. Medical Knowledge
5. Interpersonal and Communication Skills
6. Professionalism

​

​

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American College of Physicians

• Largest Internal Medicine Professional Society (ACP)

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• Distinction from Family Medicine

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• Variety of Practice
• Primary Care (not “general practitioners” or “family physicians”)
• Hospitalists
• Intensivists
• Other subspecialists (Cardiologist, Pulmonologist, Gastroenterologist, etc..)

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Available Fellowships/ Subspeciality Exposure

INTERNAL MEDICINE SUBSPECIALTIES

Addiction Medicine�Adult Congenital Heart Disease�Advanced Heart Failure and Transplant Cardiology�Cardiovascular Disease�Clinical Cardiac Electrophysiology�Clinical Informatics�Critical Care Medicine�Endocrinology, Diabetes, and Metabolism�Gastroenterology�Geriatric Medicine�Hematology

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Hematology and Medical Oncology�Hospice and Palliative Medicine�Infectious Disease�Internal Medicine-Pediatrics�Interventional Cardiology�Medical Oncology�Nephrology�Pulmonary Critical Care�Pulmonary Disease�Rheumatology�Sleep Medicine�Transplant Hepatology

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Educational Activities

• Core Rotations:
• Inpatient Medicine Wards (12 months)
• ICU (3-5 months)
• Continuity Clinic (Internal Medicine Primary Care)
• Cardiology, Heme-Onc, GI
• Other Subspecialty Elective
• Core Academics/ Experiences:
• Morning/Noon Report
• Grand Rounds
• Journal Club
• Morbidity & Mortality Conference
• Research & Quality Improvement

History of Internal Medicine

• Origin from antiquities (Socratic method)
• Formally emerged from Germany in late 1800’s
• Evidence Based Medicine vs Empiric Approach
• “Father of Internal Medicine”
• development of the first house staff residency system
• bedside teaching to medical students

Sir William Osler

1

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References

1. “About Internal Medicine | What Is an Internist | ACP.” Accessed March 21, 2022. https://www.acponline.org/about-acp/about-internal-medicine.
2. “Common Program Requirements.” Internal Medicine, n.d., 62.
3. “Common Program Requirements.Pdf.” Accessed March 21, 2022. https://www.acgme.org/globalassets/pfassets/programrequirements/140_internalmedicine_2021.pdf.
4. “Internal Medicine vs. Family Medicine | ACP.” Accessed March 21, 2022. https://www.acponline.org/about-acp/about-internal-medicine/career-paths/medical-student-career-path/internal-medicine-vs-family-medicine.
5. “Sir William Osler and Internal Medicine | About Internal Medicine | ACP.” Accessed March 21, 2022. https://www.acponline.org/about-acp/about-internal-medicine/sir-william-osler-and-internal-medicine.
6. Team, NEJM Knowledge+. “Exploring the ACGME Core Competencies (Part 1 of 7).” NEJM Knowledge+, June 2, 2016. https://knowledgeplus.nejm.org/blog/exploring-acgme-core-competencies/.
7. Images (1-9) on slide 14 are from authors personal collection.
8. Image 10 on slide 14, Book Cover: Tweedy, MD, Damon, "Black Man in a White Coat - A Doctor's Reflection on Race and Medicine" (2017). Confronting Racism, Bias, and Social Injustice in Healthcare: A Lecture Series

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References

• “About Internal Medicine | What Is an Internist | ACP.” Accessed March 21, 2022. https://www.acponline.org/about-acp/about-internal-medicine.
• “Common Program Requirements.” Internal Medicine, n.d., 62.
• “Common Program Requirements.Pdf.” Accessed March 21, 2022. https://www.acgme.org/globalassets/pfassets/programrequirements/140_internalmedicine_2021.pdf.
• “Internal Medicine vs. Family Medicine | ACP.” Accessed March 21, 2022. https://www.acponline.org/about-acp/about-internal-medicine/career-paths/medical-student-career-path/internal-medicine-vs-family-medicine.
• “Sir William Osler and Internal Medicine | About Internal Medicine | ACP.” Accessed March 21, 2022. https://www.acponline.org/about-acp/about-internal-medicine/sir-william-osler-and-internal-medicine.
• Team, NEJM Knowledge+. “Exploring the ACGME Core Competencies (Part 1 of 7).” NEJM Knowledge+, June 2, 2016. https://knowledgeplus.nejm.org/blog/exploring-acgme-core-competencies/.

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Selecting a Residency Program:�Insights and advice

National Hispanic Medical Association 25^th Annual Conference

Arlington, VA March 26, 2002

Leonardo D. Borregales, MD

Department of Urology

Urologic Oncology Fellow

18

Outline

• 5 things to think about before committing to a specialty

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• What is important when selecting a residency program?

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• Reported priorities in selecting a Residency Program

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• Resources available to evaluate Residency Programs

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• Why Urology?

​

19

5 things to think about before committing to a specialty

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1. Do I know what the specialty is all about?

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1. Are there similar specialties that I’m interested in?

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1. Is it a good fit for me? Intellectually – everyday work – Demands

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1. Are residents satisfied with training/ or burned out – low morale?

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1. Am I fully aware of the time commitment?

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20

What makes a good Residency Program?

21

The Location

• Although you will be primarily at the hospital …

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• Significant other, extended family and friends around will positively impact your social life

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• Being around those that truly care for you is likely one of the best wellness activities

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• Consider a place where you will be entertained/happy during your off time

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• Cost of living 🡪 financial position now and after finishing residency

​

​

​

​

22

Factors with highest rating of importance:

​

• Program’s ability to prepare residents for future training or position

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• Resident esprit de corps

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• Faculty availability and involvement in teaching

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• Depth and breath of faculty

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• Variety of patients and clinical resources

Factors with lowest rating of importance:

​

• Institutional-level characteristics such as:

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• Call rooms

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• Salary

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• Benefits

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• Program website/brochure

​

23

Resources to investigate programs

• Mentors!
• Residents!!
• Social Media!!!
• AMA’s Freida
• Residency Explorer
• Match A Resident
• Program’s own websites

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Why Urology?

​

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• Opportunities to treat a super wide spectrum of pathologies. From pediatric to geriatric patients (both male and female)

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• Perfect combination of surgery, radiology, and medicine

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• Bread and butter urology is exciting, and provides tremendous impact to patients

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• Supportive environment

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Why Urology?

​

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Summary

• Your residency program is going to be your home for the next 3-7 years. Choose a place where you/and your family will feel welcome.

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• Be thorough when creating your rank list but understand that you will do well in most places.

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• Don’t be shy. Reach out to your medical school faculty for advice and recommendations. Reach out to program directors and residents where you have more questions.

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Thank you

​

​

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@LeoborregalesMD

ldb4001@med.cornell.edu

29

Selecting a Residency Program

​

National Hispanic Medical Association 25^th Annual Conference

Arlington, VA March 26, 2002

Munir H. Buhaya, MD

General Surgery PGY-1

University of Texas Southwestern

munir.buhaya@utsouthwestern.edu

“When choosing a medical specialty, think about your problem-solving style” - Kenneth Mattox, MD

Hans von Gersdorff, ca. 1517

What’s important to you?

Familia

Education

DEI

Service

Familia

Education

DEI

Service

Location

Teaching

Academia (Research)

Faculty & Leadership

Residents

Mentorship

Initiatives

Diversity

Outreach

Patient Population

Local Community

Global

2= Great

1= Ok

0= Poor

Simulation

Do your research

60 Programs = $1200

Education

UTSW Sim Center

Protected time for Didactics

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Chief Conference

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Grand Rounds

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M&M

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Leadership & Teaching Education Opportunities

Research

$$ Funding $$

17 Research Residents

Patient Population & Clinical Settings

52% Hispanics

Wellness & Culture

Interview Season

Be prepared

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Be yourself

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Show interest

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Be intentional

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Ask all your questions

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Follow up

​

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Trust the Process

Structural Disadvantage Curriculum

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Anti-Black Racism / Housing & Homelessness / Latinx Health / LGBTQ+ Health

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Mass Incarceration / Mental Health & Substance Abuse

National Hispanic Medical Association 25^th Annual Conference

Arlington, VA March 26, 2002

Selecting a Residency Program:�Insights and advice

​

@FDJPerez

Be the Change

@FDJPerez

7 Step Guide to Bring About Change

Step 1: Committee Formation

Step 2: Mission Statement

Step 3: Recruit

Step 4: Start to sponsor

Step 5: Create anti-racism changes

Step 6: Inclusion

Step 7: Retain and promote

​

@FDJPerez

Case Study: Stanford Anesthesiology Department

45

© 2021 AMERICAN SOCIETY OF ANESTHESIOLOGISTS.

@FDJPerez

Timeline

Step 1: ADC Founded

• 2 faculty, 1 resident

2015

2016

2017

2018

2019

May 25, 2020

2021

@FDJPerez

Step 1: Create a Committee �Step 2: Create a Mission

ADC Mission:

The Stanford Anesthesiology Diversity Council's (ADC) mission is to recruit, support, retain, and promote diversity within the Department of Anesthesiology,  Perioperative, and Pain Medicine.

@FDJPerez

Timeline

Step 1: ADC Founded

• 2 faculty, 1 resident

2015

2016

2017

2018

2019

May 25, 2020

2021

Step 2: Mission Statement

​

Step 3: Recruit

4 UiM residents joined the ADC

​

@FDJPerez

Timeline

Step 1: ADC Founded

2015

2016

2017

2018

2019

May 25, 2020

2021

Step 2: Mission Statement

​

Step 3: Recruit

4 UiM joined the ADC

​

Step 4: Continue to recruit and start to sponsor

+4 UiM residents

Leadership positions: GME Diversity Council

@FDJPerez

Timeline

Step 1: ADC Founded

2015

2016

2017

2018

2019

May 25, 2020

2021

Step 2: Mission Statement

​

Step 3: Recruit

4 UiM joined the ADC

​

Step 4: Continue to recruit and start to sponsor

+4 UiM residents

Leadership positions: GME

Step 5: Anti-racism changes > SCORE Program

+5 UiM residents

@FDJPerez

Timeline

Step 1: ADC Founded

2015

2016

2017

2018

2019

May 25, 2020

2021

Step 2: Mission Statement

​

Step 3: Recruit

4 UiM joined the ADC

​

Step 4: Continue to recruit and start to sponsor

+4 UiM residents

Leadership positions: GME

Step 5: Anti-racism change-> SCORE Program

+5 UiM residents

Step 6: Inclusion

• Leadership Roles and Community Engagement
• +10 UiM residents
• Leadership Education in Advancing Diversity (LEAD)

@FDJPerez

Timeline

Step 1: ADC Founded

2015

2016

2017

2018

2019

May 25, 2020

2021

Step 2: Mission Statement

​

Step 3: Recruit

4 UiM joined the ADC

​

Step 4: Continue to recruit and start to sponsor

+4 UiM residents

Leadership positions: GME

Step 5: Anti-racism change-> SCORE Program

+5 UiM residents

Step 6: Inclusion

​

Step 7: Retain and Promote

• ADC Division Leads

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Recruit

• Over 50 members

Sponsor

• Resident Leadership

Anti-racism changes

• Diminish minority tax

Inclusion

• Curriculum Changes

Promotion�ADC Division Leads

Each Division has someone dedicated to DEI efforts

​

@FDJPerez

7 Step Guide to Bring About Change

54

Step 1: Committee Formation

Step 2: Mission Statement

Step 3: Recruit

Step 4: Start to sponsor

Step 5: Create anti-racism changes

Step 6: Inclusion

Step 7: Retain and promote

​

@FDJPerez

California Society of Anesthesiologist (CSA)

• QR code to Draft of the Resolution that formed the CSA JEDI Committee

@FDJPerez

Nationally

• ASA Committee on Professional Diversity
• Mentorship Grant Program

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• JEDI Collaborative of Anesthesiology DEI Officers
• Just formed as a committee

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• You can join medical student components and resident components of your medical society�

@FDJPerez

Thank you

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Twitter

CSA Resolution

Department ADC

Visiting Clerkship

High School

Outreach

Resident Leadership

GME Council

Office of Diversity in Medical Education