MADIGAN ARMY MEDICAL CENTER, Joint Base Lewis-McChord - It has all been done. All the clinical rotations are complete; all the exams sweated through. Even all the simple things are ready. The seats are tagged and flags straightened for an event that many residents, interns and fellows have awaited for years. Friday, June 10, Madigan Army Medical Center on Joint Base Lewis-McChord, graduated its 2022 class of healthcare professionals in a ceremony at Carey Theater.
Ninety-three doctors across 24 of Graduate Medical Education's 30 programs left behind the title of trainee at the ceremony to emerge as Army leaders.
As a simple display of the excellence of this group, Col. Douglas Maurer, the director of the Medical Education and Research Division, offered an impressive statistic.
Overall, the rate of passage on their board exams on the first attempt for Madigan graduates stands at roughly 96 percent, which is about 10 percent higher than their civilian counterparts.
He also noted prior to the ceremony that the accomplishment of completing residencies, internships and fellowships in medicine is no small task.
"This is the culmination of many years of training for these healthcare providers," he said, noting that especially for those in longer residencies like general surgery, which is five to six years, it can be 15-20 years of preparation as these graduates had to start planning and working toward this day in high school. "That's a long time coming for today. So, that's very special."
These are also unusual times.
Maurer commented that it, "Has been challenging for the residents to get all of the procedures, patient encounters, sets and reps during times that we've had shutdown operations because of COVID, or been super busy taking care of COVID patients. Both of those have been extreme challenges. So, I think it's very rewarding for them to get to today."
In his introductory remarks at the ceremony, Madigan Commander Col. (Dr.) Jonathan "Craig" Taylor recognized not only the efforts of the graduates, but those who have supported them throughout their training.
"The people that gather here today have all contributed to the overall success of these graduates. Thank you to each of you that are here with us today and there are many more back in the hospital continuing to serve our patients, as they have shown their unwavering support of our graduates," said Taylor.
Taylor encouraged the graduates to lean into what lies ahead of them.
"Lean in, to begin to restore the health of our communities and our world. Lean into changing disparities in health that exist in our world. Lean into shaping the future of military medicine so that we really do finally provide that seamless healthcare from birth to life's final moments across our system, across the VA and across our civilian systems. Lean into the challenges of mental health that are affecting so many. Lean into where you see the need. If you see something that is slipping, please go there and lean in.
And finally, in the life that is outside your life of medicine, lean in also. Lean into your family and friends, lean into all the moments that really matter. Be present. Rely on your colleagues to be there to cover for you and yes, cover for them in turn," he said.
Taylor concluded that leaning in together is how we solve the challenges we face.
Dr. Hala Sabry, a board-certified emergency medicine physician, feminist leadership coach, founder of Physician Moms Group and mother of five (including two sets of twins), served as the guest speaker.
She acknowledged the momentous occasion this day represented.
"Graduates, this is a huge milestone in your career. Many residents and fellows nearing the completion of their training experience a mixture of emotions ranging from enthusiasm to anxiety to relief, uncertainty and sheer fatigue from the long hours of preparation."
She also likened this journey to that of any relationship, whether it be with a significant other, friend or child.
"It takes passion to stay in a relationship year after year. It is your passion and love that keeps you committed to your relationships. This is the same passion and commitment that it took to finish your residency or fellowship, even when you felt like there were not enough hands to help," she said.
A self-described "Type A personality", Sabry had three clear goals at the outset of her career. 1. Become an emergency medicine physician; 2. become a mom; and 3. become a hospital CEO.
After a great deal of time and struggle invested, she achieved the first two goals. She took every opportunity possible; for example, she sat on six hospital committees. When a director position came open, she was ready to move closer to her third goal.
While on maternity leave with her first child, a leave she cut short in order to prove her dedication, she was passed over for that leadership position. A male doctor who was not as experienced as she and was, in fact, someone she recruited to the organization, was selected for the position.
Upon her return, she asked the leader who made the decision why she was not chosen. He told her he knew of her interest and she was, indeed, the best qualified. But, that he went with someone else because he assumed she would want to, "Be a good mom and have time for her child."
In response to this situation, she started a social media group called Physician Moms Group. She found that she was far from alone in this sort of experience. Studies conducted by the group have determined that more than 90 percent of those surveyed had faced some form of gender bias in the workplace.
When the group started with 20 women, she had no idea what it would do.
"I'll tell you, it started a revolution of women in medicine. I was shocked that it would grow so quickly, and I'm here to report today that, almost eight years later, this tiny group that started from a moment of vulnerability, sadness, anger, fear and anxiousness, grew to a united front of now over 125,000 physician members spanning over 100 countries in what is now a full-fledged global organization. Apparently, I wasn't the only person with a story of blunted dreams due to systemic barriers - barriers that need to be broken down by standing strong together, demanding those changes," Sabry said.
The group supports formal research, has provoked policy change for parental leave, produced the first online COVID information center for physicians and has just this week financially supported the only pediatrician in Uvalde, Texas, as well as a young survivor and her family, in traveling to Washington, D.C. to testify in front of Congress on the gun violence that recently devastated their town.
For that last effort, it took the group just 51 minutes to raise $18,000 for expenses and Sabry herself made all their travel arrangements.
She now spends her time trying to change the culture of medicine that she feels demands that you are to sacrifice everything in your life to maintain your identity as a physician first.
She enumerated nine pieces of advice she hoped would aid the graduates as they transition to positions of higher responsibility and as leaders.
1. Your learning is never over. Never think you are too smart to be wrong. You will fail, but failure is actually really amazing. It is all learning. Failure makes us more expert and increases our confidence in doing our job.
2. Be humble. The most difficult part of your job will be preserving your humility, compassion, optimism and gentleness in the face of limited resources, tragic outcomes and a stressful workplace in a system that can, at times, be set up to hurt patient care and the doctor/patient relationship.
3. Your voice matters. We all have a responsibility to be the change that we want to see in the world for our children and the future generation of healthcare workers.
4. Losing your first patient or being involved in your first lawsuit as an attending physician is extremely tough. Try to remember not to blame yourself. Do all that you can and be comforted that you did all that you could.
5. It's OK not to be OK. No matter where you are, when people are in trouble, they ask for a doctor. Follow your values and be confident in your leadership.
6. Do not put off that one thing for when you have a better time to do it in your career. Tomorrow is not promised and you've worked too hard to not enjoy your life now. Life is short, we all need to live for today.
7. For parents - just know that parenting is hard. Be present with your kids when you are around them and do not feel guilty when you are separated from them.
8. Remember that your dreams will come, it may look a little different than expected.
9. Lastly, even though you will no longer be considered a trainee, know that you will still have many people to lean on and to learn from. Never stop learning, trust your training and know that you are enough. But, also know that there are physicians all over the world who are willing to support you. Please use your fellow physicians as a resource and continue to grow personally and professionally.
Capt. (Dr.) Michael Czarnecki, the intern class president, presented the Outstanding Resident Teacher Award to Capt. (Dr.) Steffen Lis, a resident in Internal Medicine.
Capt. (Dr.) Katey Obsorne, the president of the Resident Council, presented the Outstanding Staff Teacher Award to Lt. Col. (Dr.) Brian Boldt, the program director for the Diagnostic Radiology Residency.
Capt. (Dr.) Joscelyn Hodge, the vice president of the Resident Council, presented the Col. Janice Lehman Outstanding Clinical Nurse Award to Kristina Ieronimakis, a registered nurse in the Intensive Care Unit
Lt. Col. (Dr.) Tatjana Calvano, the program director for Internal Medicine, presented the Outstanding Residency Coordinator Award to Kirsten Maio-Smith, the coordinator for the Internal Medicine Residency
Dr. April Fritch, the program director for the Clinical Psychology Internship, presented the Lt. Col. Joseph A. Munaretto Outstanding Educator Award to Dr. Christopher Graver, the chief of Neuropsychology
Lt. Col. (Dr.) Jillian Phelps, the program director for the Emergency Medicine Residency, presented the Col. Robert Skelton Award to Capt. (Dr.) Sean Scott. This award is presented to an outstanding resident in a two or three-year program.
Lt. Col. (Dr.) Ryan Speir, the program director for the Urology Residency, presented the Maj. Gen. Floyd L. Wergeland Award to Maj. (Dr.) Theodore Crisostomo-Wynne.This award is presented to an outstanding resident in a four-year or greater program.