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HSS Residency Leadership Group: Fostering the Future

by Elizabeth Hofheinz, M.P.H., M.Ed., August 8, 2019

What does one exceptional residency program do to help facilitate the daily lives of its trainees? It provides formal mentorship. Hospital for Special Surgery (HSS) in New York, ranked #1 in orthopedics for 10 years by U.S. News and World Report, knows that to create the leaders of the future you have to pay close attention to their present.

Duretti Fufa, M.D., a seasoned hand surgeon at HSS, directs the residency program. She told OSN, “We have 9 residents per year, for a total of 45 at any one time. Four years ago, at the suggestion of Todd Albert, M.D., we formed the Residency Leadership Group (RLG), a team of six faculty members who participate in key educational roles for the residents. We hold monthly meetings to discuss residency-related issues, set goals for the year and respond to residents’ concerns. We encourage an open dialogue amongst the members, each of whom is from a different subspecialty.”

“For the first three residency years we provide each resident with an RLG mentor; then during the fourth and fifth years of residency, they select a more career-directed mentor who is outside of the RLG. The faculty members commit to being readily available for ‘their’ resident and meet with the resident biannually.”

Listening and adjusting…

Dr. Fufa: “One of our biggest areas of focus currently is resident workload. For a very intensive five-year period they have extremely little control over their schedules. Thus, when they suggest things that might help them with time/schedule management, we listen and try to implement their suggestions. This ranges from simple matters such as fixing a slow computer to larger initiatives, such as finding additional administrative supports to help decrease their stress levels.”

Hot topics for residents…

To be on the leading edge, you have to address the topics that are rising to the top. “In line with our goal of training residents to be educators and leaders within the field,” says Dr. Fufa, “two years ago, we instituted a leadership curriculum for the residents. This involves a deep dive into various topics through a lecture done by the RLG. Another topic we’re working on is improving how we evaluate how residents are progressing and acquiring surgical skills through objective evaluation. For three years, we have had an event called the Surgical Games in which residents perform various simulated surgical tasks with direct observation from a faculty member who provides immediate, objective feedback.”

Asked about how she selects and rewards faculty members who give their time to the RLG, Dr. Fufa notes, “Each group member has demonstrated incredible commitment to educating our residents. Our reward is spending time with the residents and watching them mature into fantastic surgeons and clinicians. .”

Workload is not only and issue for residents, but for faculty as well and time is a valuable commodity. Dr. Fufa: “Yes, mentorship of this nature is a time commitment. We do our best to recognize and acknowledge the faculty members who give their time month after month. At each department meeting, I make sure to note the work the faculty are doing. Additionally, we try to offer special faculty development opportunities for key educators as well. Before taking over as the residency program director, the hospital sponsored my participation in a course for educators in health professions at Harvard.”

And if your institution would like to implement such a group, Dr. Fufa says, “Because time is a universal challenge for faculty, strong administrative support is key. We are lucky to have wonderful program administrators who help keep our program running on a daily basis. Additionally, it is important to foster your team and being responsive to their needs.”

“Going forward I want to empower the faculty on the RLG to drive their own initiatives…ones that will ensure that we continue to innovate and maintain our position as educational leaders. Thus, instead of simply setting the goals myself, or getting a group consensus, this year each member is going to take on an initiative of his or her own choosing.”

There are two substantial initiatives that are underway, says Dr. Fufa. “We are assessing the magnitude of resident burnout at our facility. Based on comments from our residents, our initial efforts have focused on making improvements to the apartment building where they all live. We took one apartment and transformed it into a gym; we also renovated the outdoor space next to the building, converting it into a wonderful additional living space where they can gather socially.”

“Given that workload is the biggest driver of burnout, we are investigating initiatives to address it. We hope to be able to use the information to implement practical solutions such as more flexible schedules, additional access to physician extenders, and perhaps, more administrative support.”

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Elizabeth Hofheinz

Two time winner of the MORE award Ms. Hofheinz was the first writer employed by Orthopedics This Week. The MORE award is granted annually by the American Academy of Orthopaedic Surgeons to recognize excellence in journalism. Ms. Hofheinz is currently the Director of Communications for Ortho Spine Partners (OSP) and resides in New Orleans, Louisiana with her entrepreneur husband and delightful daughter.

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