03/30/11 Portland, Ore.
Dear School of Medicine community:
On March 17, our fourth year medical students learned where they will spend the next phase of their education in their Graduate Medical Education training. It was an exciting event and you can read more about the results of Match Day in the article below. This milestone and some of the experiences that lay ahead for our newest MDs came into sharp relief as I read an article titled, “The Influence of Resident Involvement on Surgical Outcomes.” The research, published in the Journal of the American College of Surgeons, looks at the effect of resident physician involvement on health care delivery and outcomes.
Serving as Dean requires a significant amount of my time and attention, but I remain involved in my surgical practice and resident education. Not only do I want to contribute the skills and experience I’ve gained over decades to take care of patients and train others, maintaining my practice keeps me connected to the experiences of a faculty member at OHSU.
As a surgeon practicing in a teaching hospital, I am often asked by patients and their family members about the presence of resident trainees in the operating room. It’s a question all physician faculty members receive relating to residents as well as students.
Each of us have our own responses to these inquiries depending on the clinic circumstances, but I always share my unshakable belief that the presence of learners in a clinical setting improves my capabilities and improves patient care. In teaching the next generation of providers, we are individually responsible for ensuring our knowledge reflects the very latest research findings and surgical techniques. The number of residents in a teaching hospital also improves the physician-to-patient ratio, helping to ensure a physician with direct knowledge about an individual patient’s condition is always close by to answer questions and immediately address any complications. Together, these factors have always suggested to me that the presence of residents improves health care.
I was gratified to see this widely-held but not well-documented hypothesis for surgery reinforced by the results of this study. The authors identified 607,683 surgical cases from 234 hospitals and compared outcomes by resident involvement for all general and vascular cases as well as for specific general surgical procedures. The results suggested that “resident involvement in surgical care is safe and possibly protective with regard to mortality.”
The results of the journal study were picked up by The New York Times in a column written by Dr. Pauline Chen, a surgeon, on March 24. She writes, “While my colleagues and I might have believed that our supervision of residents in the operating room ensured patient safety and quality of care, none of us really knew that for sure. Now we do.”
It’s always nice when hypotheses and facts coincide. I think the logic here extends beyond surgical outcomes. Our health system as a whole and our research enterprise is augmented by the educational mission.
As part of the excitement and energy of Match Day, I am sharing this information so that you have it available as you frame your own answers to this question in the future, and as an important confidence-booster for our newest physicians at a time when they are moving into a very different stage of their learning. This is an academic health center and we are all involved in some way in education; I’d like to use this opportunity to thank all of you for your contribution to educating the next generation of physicians, scientists and other health care professionals. You really make a difference.
Mark Richardson, MD, MBA
Dean, OHSU School of Medicine
President, Faculty Practice Plan