Is That Why I Fail?

So the other day I’m walking in to work from the parking lot and I overhear a woman talking. All I could get were phrases as she complained about something to her companions (pagination alert! See page numbers below the Like button):

“They don’t fail residents like they should…”

“They shouldn’t be here…”

“They’re not cut out for it…”

The way I pieced this together was that this was a nurse or some other health care professional expressing her frustration with one of our residency training programs about resident physicians who are simply dragging their way through the system while training directors, faculty, and others are simply not accountable for the residents attaining a basic level of–competency–there, I said it.

I’m not sending the message that our residency programs are not what they ought to be. And the person complaining was sharing her perception of residents with whom she happens to be working–which may or may not be accurate.

But she probably has a point. I shared this experience with the residents and medical students who are currently working with me on the general hospital psychiatry consultation service. As usual, this led to a short rant from me about the Maintenance of Certification (MOC) program (was it short? I get so worked up anymore about it I lose all sense of time).

The trainees are used to that. But when I said that I could see where the nurse (I’ll call her that for the sake of simplicity even though I don’t know if she was a nurse or not) was coming from, and that there is no possible way for MOC to fix this issue, I didn’t get any disagreement from the trainees.

Do you think they were just humoring me? Don’t answer that.

And that reminded me of the recent Clinical Excellence committee meeting I attended, which was about Entrustable Professional Activities.

I told the trainees that Entrustable Professional Activities (EPAs) is an idea found by a colleague of mine, whose judgment I trust. I shared my impression of what EPAs mean, which is that it’s a skill I would trust them to perform on a member of my family.


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