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Hi, everyone. You are listening to the Becker's

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Healthcare podcast.

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Thank you so much for tuning into this

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episode where we are joined by doctor James

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Wyant,

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program director of a new neurology

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residency program supported by Centerra and Eastern Virginia

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Medical School.

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We're gonna be discussing today what it takes

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to get a new physician training program up

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and running, as well as the the retention

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piece and challenges within this process as well.

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Doctor. Wyant, thank you so much for joining

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us today. Excited to have you. Thanks for

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inviting me on.

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Yeah. Well, do you wanna start off let's

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start off with challenges. Can you share

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what you have found to be a big

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challenge in launching and growing the neurology residency

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program, and how has you and other leaders

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worked through it worked through that?

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There have been so very many challenges.

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The

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biggest overarching challenge is that this is a

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a monumental project. It's totally new to me.

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Never been a program director before.

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I work at Sentara,

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which is a regional

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medical provider group in,

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Southeastern Virginia.

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And the

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program is a a Eastern Virginia Medical School

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program, so there's a lot of collaboration between

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organizations.

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And,

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that that collaboration

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and the collaboration between all the very many

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stakeholders

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in this program have really helped overcome the

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biggest challenge, which is that,

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there are so many

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small pieces to

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starting a program like this. There's a a

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lot of paperwork that needs to be completed.

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You gotta develop a a curriculum for training

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the,

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residents that are coming on board. You gotta

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make sure that the faculty

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knows what they're doing. They're well qualified.

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They're invested

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in developing

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as mentors and teachers

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and,

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cultivating

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just a a culture where it's a good

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learning environment invested in in research.

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So your question was, what is the biggest

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challenge?

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The biggest challenge for me has been

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getting a handle on the many moving parts

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and assembling that into one cohesive

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program.

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Yeah. Thanks, doctor Wyatt. Yeah. Definitely so many

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moving parts there, and I imagine that in

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and of itself just makes it so critical

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to have, you know, a great partner that

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that you are working with to stand this

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up.

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A sentiment that I do hear often from

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other leaders when when talking about

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residency programs and fellowships is securing

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buy in from local hospital teams on the

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ground,

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particularly when, you know, those facilities might be

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hosting residents for the the first time and

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then how that can be a real challenge

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at times.

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Have you encountered that dynamic? And if so,

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what lessons,

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have you learned in navigating it or a

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piece of advice you'd share?

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Thank you for asking the question.

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I I very much fear

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that,

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that hesitancy to engage,

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because I know that all the all the

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faculty members, all all the team members that

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are helping make this program exist

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are already working hard at patient care.

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So

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their limited bandwidth

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to

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help start a program is something that I

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was worried that,

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I wasn't gonna get by in, but I

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haven't seen that. In fact,

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every person that I talked to to say,

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hey. Would you help us with interviewing candidates

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or hosting residents? It has been nothing but

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positive feedback.

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So I think I happen to

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land

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in a a community, a, a culture that

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was already

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fertile ground to start a a neurology program.

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So I haven't really faced that yet.

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That that's that's

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been to my benefit.

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You asked for advice that I would give

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to other people,

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facing that,

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trusting the process,

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convincing

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leadership.

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I think it would need to come in

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a top down approach, but convincing leadership and

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then,

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potential faculty members that the residents can add

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value,

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can assist with workflow rather than slow it

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down,

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is gonna be, essential

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to fighting that hesitancy

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to to buy into

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the program. Of course, there's gonna be a

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learning curve.

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Many of the

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faculty

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of my brand new program

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have not

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recently spent a lot of time engaged in

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teaching residents.

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And that's a tough thing to do because,

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medical students

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are still

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learning a lot of the basics of of

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medical care, whereas residents, they're kinda past that,

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and they're learning at a higher level. And

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so that means that the teaching needs to

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occur at a higher level, and that's tough.

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That can slow down,

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clinical workflow

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until you're certain that the residents

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have at least some experience,

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and then they still require supervision.

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But they can really add value. They can

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help see patients

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while they're learning.

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So both the patients

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benefit from that, the faculty members benefit from

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that, and the residents learn from that.

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So you asked the question about whether or

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not I've had trouble securing buy in. I

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have not. Thank goodness.

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Yeah. No. That's great to hear, and I

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think it's an interesting point just around

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where residents can add value. And one of

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the things I've heard too from,

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leaders in in academic medicine and teaching hospitals

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is,

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just seeing evidence to that, like, having residents

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on-site can improve quality.

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So it's interesting point.

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Doctor Wyatt, can you share a little bit

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about how the new residency program is expected

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to improve access to neurological

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care in the region? Obviously,

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you know, with the physician shortage, neurology is

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is a big part of that specialties,

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and what outcomes you're hoping to see.

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Yeah. Regionally

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and nationwide,

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probably globally, there's an insufficient

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amount of,

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neurologic care providers. And that's not just physicians.

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There's,

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not enough

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medical assistants and,

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advanced practitioners and, and nursing staff,

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physical therapists, occupational therapists, etcetera,

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that is required for the collaborative

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team based approach

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that is required for many

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neurologic conditions.

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The need for

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residency training programs is

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one component of,

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what I have seen

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Sentara

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engaging in, which seems like a,

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a concerted effort to

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safeguard the infrastructure for patients'

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access to care.

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So I I think starting this residency

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is going to help,

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expand and and safeguard the the clinical workforce

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years down the line by establishing a pipeline

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of of training.

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And then if we've got a a culture

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that,

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is

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supportive

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of the the residents' well-being,

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they will realize that Sentara and EVMS and

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ODU, it's a a good place to work

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and hopefully

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stay local and continue to provide care for

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for patients in this region.

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My

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direct administrators

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have done a great job

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of shielding me from

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major financial considerations

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here because I know it's a major,

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investment

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by Sentara and EVMS to start up a

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new program like this.

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The the business argument that we made to

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get approval to start this residency

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was that

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our patients need more

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local access to neurology.

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And it took very little convincing

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to get our administrators to recognize the value

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of starting this program.

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The

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Sentara credo is

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we improve health every day.

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And

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we're a medical care providing institution,

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so we're focused on how to best serve

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our community. And my hope is that this

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residency

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accomplishes that,

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improving health care every day

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for our local community,

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by having

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enthusiastic,

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compassionate

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care providers

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trained right here and staying right here.

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Yeah. Absolutely, doctor Weyen. I think

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interesting to hear too, like, the a little

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bit of what you shared there on the

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the business case side and really just sounds

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like it comes down to, you know, there's

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a regional need there for access, and this

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is a sustainable way to to build that

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and and provide that for patients filling a

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gap, so to speak.

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You started to talk a little bit as

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well about

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retention and and well-being and how, you know,

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as residents go through an experience, they'll see

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that this is a good place to work

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and this is where we want to stay.

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And obviously, you know, we see a lot

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of national data that speaks to where you

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train is where you end up practicing for

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a while. So

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how is the program can you talk a

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little bit more about how the program is

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structured

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or how you anticipate,

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Sentara will

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aim to support long term retention of trainees

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in the region?

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The two parts of your question are are

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closely tied. How how we crafted this program

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and how we intend

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to keep,

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our our trainees

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encourage them to remain local and care for

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patients locally. Although, I'm sure that some are

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gonna decide that they they wanna

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pursue careers

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elsewhere. My hope is that, a whole lot

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of them are gonna wanna stay stay here

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and find this to to be a good

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place to work.

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I think it comes down to,

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fostering

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good teamwork,

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and my leadership already does that within the

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department.

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When I joined this department a few years

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ago, because I haven't been here that long

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at at this particular

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location,

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I discovered that,

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all of my colleagues

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liked working with each other and communicated very

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well. And so it's gonna be easy to

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duplicate that model in our residency.

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EVMS

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cares about resident well-being.

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There's no two ways about it. Residency is

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very difficult. You gotta work hard. You're expected

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to do,

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a lot for a lot of people and

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also safeguard your own well-being.

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And EVMS

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and the,

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overarching

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graduate medical

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education,

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department

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is,

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insists that we build that into our, didactic

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curriculum.

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So residents are we're not just gonna be

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supervising them. We're also gonna be teaching them,

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hey.

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How do you become a good neurologist

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and also safeguard your own

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mental

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well-being

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so that you don't get burned out, so

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that you can continue caring for patients in

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your community for a really long time and

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have a a satisfying and fulfilling

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career.

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So that that's

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a wellness and,

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professional growth and

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teaching leadership skills from an early

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phase of the the residency,

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not

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just the clinical nuts and bolts competency

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of,

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how do you understand neurologic disease and come

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up with a game plan for treating a

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patient afflicted by a neurologic disease.

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Yeah. Thanks, doctor Weihen. I think interesting to

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hear on the well-being piece too. It's like

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sounds like it's owned by both, you know,

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stakeholders in terms of there's a a role

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that the university plays and then there the

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medical school, and then there's also a role

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that Sentara plays and it really needs to

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be something that's routine and something that is

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built into,

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the learnings that they're that they're going through.

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Yeah. Absolutely.

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Well, to close us out, doctor Wyant, what

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advice would you give to leaders at other

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hospitals or health systems that are planning to

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either debut a residency for the first time

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or expand their existing

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offerings?

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Advice?

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Good luck. It's a lot of fun, but

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it's a lot of hard work.

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The,

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emphasizing

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the importance of culture,

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is key.

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Don't try to do this alone.

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So

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engage with, faculty members, future faculty members,

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leadership,

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communicate constantly,

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and,

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try to celebrate your progress. It's a a

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huge undertaking. So, it's gonna be a whole

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bunch of small victories that that keep you

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going. Yes. I I crafted a curriculum.

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Yes. I I got

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the leadership to say that we've got the

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financials in place to,

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to pursue this project and,

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be impatient

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because,

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we have just started this residency program.

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So

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we're just barely getting the the project off

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the ground, and we've got a whole lot

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left to go to maintain it and to

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start,

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producing some outstanding

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neurology,

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graduates.

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We've just,

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got our our first class. They're all interns,

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first year neurology residents,

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and

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we are extremely fortunate

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that,

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they're all compassionate and enthusiastic and and great

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people. And so I know that they're gonna

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make great neurologists.

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We are have started

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searching out and interviewing,

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candidates for our second class,

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and we're incredibly fortunate that the pool of

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talent

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00:14:51,324 --> 00:14:51,824
is,

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enormous. We've had a lot of interest in

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our program even though it's a

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a new program.

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So for those out there that are considering

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starting a program,

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it is worth it.

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And,

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be patient and gather as many people around

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00:15:11,000 --> 00:15:13,160
you as you can that are willing to

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help in any kind of way because I

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00:15:15,320 --> 00:15:17,664
definitely could not have done it without a

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whole lot of support. This is,

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00:15:20,384 --> 00:15:22,704
in fact, I shouldn't even be using I

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because this is not a solo project.

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There are

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so many people that deserve my

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00:15:29,709 --> 00:15:32,049
thanks and admiration because I could not have

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gotten to where

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00:15:34,509 --> 00:15:36,209
we are yet without,

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an enormous amount of assistance.

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So

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those are those are my bits of advice

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00:15:43,795 --> 00:15:45,394
is you need a lot of people to

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help you is the main the main piece

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00:15:47,634 --> 00:15:48,215
of advice.

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00:15:48,835 --> 00:15:50,695
Yeah. Absolutely. I I imagine.

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00:15:51,475 --> 00:15:53,154
Before we go, do you mind just sharing

425
00:15:53,154 --> 00:15:54,855
to the number of,

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00:15:56,090 --> 00:15:57,690
residents you have in this first class and

427
00:15:57,690 --> 00:16:00,830
how you anticipate that number growing next year?

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00:16:02,250 --> 00:16:05,690
Our our first class is, three residents. Going

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00:16:05,690 --> 00:16:08,830
forward, we're gonna have four residents per year.

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00:16:09,115 --> 00:16:09,615
So,

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00:16:10,235 --> 00:16:11,615
once we fully matriculated,

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00:16:12,634 --> 00:16:14,795
residents to fill every class and graduated this

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00:16:14,795 --> 00:16:17,295
first class, there'll be a total of 16

434
00:16:17,754 --> 00:16:18,894
neurology residents,

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00:16:19,434 --> 00:16:21,514
here at any one time. And,

436
00:16:23,190 --> 00:16:24,889
looking forward into the future,

437
00:16:25,269 --> 00:16:26,730
we might develop some,

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00:16:27,509 --> 00:16:29,590
fellowship programs. I I hope that I get

439
00:16:29,590 --> 00:16:30,730
to be a part of that,

440
00:16:31,750 --> 00:16:32,649
and that might,

441
00:16:33,429 --> 00:16:36,330
expand the number of, local trainees.

442
00:16:36,950 --> 00:16:37,610
It's a

443
00:16:38,475 --> 00:16:41,434
four year residency. Neurology residency is a a

444
00:16:41,434 --> 00:16:42,174
four year

445
00:16:42,554 --> 00:16:43,054
undertaking.

446
00:16:44,394 --> 00:16:47,195
So 16 total once we're fully up and

447
00:16:47,195 --> 00:16:49,294
running, but three right now.

448
00:16:51,539 --> 00:16:53,860
Well, doctor Wyant, thank you so much for

449
00:16:53,860 --> 00:16:55,700
your time today. Appreciate you being on the

450
00:16:55,700 --> 00:16:57,559
podcast for such an important topic.

451
00:16:58,259 --> 00:17:00,179
Well, thank you for letting me talk about

452
00:17:00,179 --> 00:17:01,779
it. I I love talking about it. It's

453
00:17:01,779 --> 00:17:03,860
a whole lot of fun, and it's something

454
00:17:03,860 --> 00:17:06,394
I'm pretty passionate about. So I appreciate you

455
00:17:06,394 --> 00:17:08,795
asking me questions about it. Let me, spout

456
00:17:08,795 --> 00:17:09,615
off about it.

457
00:17:10,154 --> 00:17:12,815
Yeah. Absolutely. I look forward to connecting again.

458
00:17:13,275 --> 00:17:13,775
Yeah.