Hi, everyone. You are listening to the Becker's
Healthcare podcast.
Thank you so much for tuning into this
episode where we are joined by doctor James
Wyant,
program director of a new neurology
residency program supported by Centerra and Eastern Virginia
Medical School.
We're gonna be discussing today what it takes
to get a new physician training program up
and running, as well as the the retention
piece and challenges within this process as well.
Doctor. Wyant, thank you so much for joining
us today. Excited to have you. Thanks for
inviting me on.
Yeah. Well, do you wanna start off let's
start off with challenges. Can you share
what you have found to be a big
challenge in launching and growing the neurology residency
program, and how has you and other leaders
worked through it worked through that?
There have been so very many challenges.
The
biggest overarching challenge is that this is a
a monumental project. It's totally new to me.
Never been a program director before.
I work at Sentara,
which is a regional
medical provider group in,
Southeastern Virginia.
And the
program is a a Eastern Virginia Medical School
program, so there's a lot of collaboration between
organizations.
And,
that that collaboration
and the collaboration between all the very many
stakeholders
in this program have really helped overcome the
biggest challenge, which is that,
there are so many
small pieces to
starting a program like this. There's a a
lot of paperwork that needs to be completed.
You gotta develop a a curriculum for training
the,
residents that are coming on board. You gotta
make sure that the faculty
knows what they're doing. They're well qualified.
They're invested
in developing
as mentors and teachers
and,
cultivating
just a a culture where it's a good
learning environment invested in in research.
So your question was, what is the biggest
challenge?
The biggest challenge for me has been
getting a handle on the many moving parts
and assembling that into one cohesive
program.
Yeah. Thanks, doctor Wyatt. Yeah. Definitely so many
moving parts there, and I imagine that in
and of itself just makes it so critical
to have, you know, a great partner that
that you are working with to stand this
up.
A sentiment that I do hear often from
other leaders when when talking about
residency programs and fellowships is securing
buy in from local hospital teams on the
ground,
particularly when, you know, those facilities might be
hosting residents for the the first time and
then how that can be a real challenge
at times.
Have you encountered that dynamic? And if so,
what lessons,
have you learned in navigating it or a
piece of advice you'd share?
Thank you for asking the question.
I I very much fear
that,
that hesitancy to engage,
because I know that all the all the
faculty members, all all the team members that
are helping make this program exist
are already working hard at patient care.
So
their limited bandwidth
to
help start a program is something that I
was worried that,
I wasn't gonna get by in, but I
haven't seen that. In fact,
every person that I talked to to say,
hey. Would you help us with interviewing candidates
or hosting residents? It has been nothing but
positive feedback.
So I think I happen to
land
in a a community, a, a culture that
was already
fertile ground to start a a neurology program.
So I haven't really faced that yet.
That that's that's
been to my benefit.
You asked for advice that I would give
to other people,
facing that,
trusting the process,
convincing
leadership.
I think it would need to come in
a top down approach, but convincing leadership and
then,
potential faculty members that the residents can add
value,
can assist with workflow rather than slow it
down,
is gonna be, essential
to fighting that hesitancy
to to buy into
the program. Of course, there's gonna be a
learning curve.
Many of the
faculty
of my brand new program
have not
recently spent a lot of time engaged in
teaching residents.
And that's a tough thing to do because,
medical students
are still
learning a lot of the basics of of
medical care, whereas residents, they're kinda past that,
and they're learning at a higher level. And
so that means that the teaching needs to
occur at a higher level, and that's tough.
That can slow down,
clinical workflow
until you're certain that the residents
have at least some experience,
and then they still require supervision.
But they can really add value. They can
help see patients
while they're learning.
So both the patients
benefit from that, the faculty members benefit from
that, and the residents learn from that.
So you asked the question about whether or
not I've had trouble securing buy in. I
have not. Thank goodness.
Yeah. No. That's great to hear, and I
think it's an interesting point just around
where residents can add value. And one of
the things I've heard too from,
leaders in in academic medicine and teaching hospitals
is,
just seeing evidence to that, like, having residents
on-site can improve quality.
So it's interesting point.
Doctor Wyatt, can you share a little bit
about how the new residency program is expected
to improve access to neurological
care in the region? Obviously,
you know, with the physician shortage, neurology is
is a big part of that specialties,
and what outcomes you're hoping to see.
Yeah. Regionally
and nationwide,
probably globally, there's an insufficient
amount of,
neurologic care providers. And that's not just physicians.
There's,
not enough
medical assistants and,
advanced practitioners and, and nursing staff,
physical therapists, occupational therapists, etcetera,
that is required for the collaborative
team based approach
that is required for many
neurologic conditions.
The need for
residency training programs is
one component of,
what I have seen
Sentara
engaging in, which seems like a,
a concerted effort to
safeguard the infrastructure for patients'
access to care.
So I I think starting this residency
is going to help,
expand and and safeguard the the clinical workforce
years down the line by establishing a pipeline
of of training.
And then if we've got a a culture
that,
is
supportive
of the the residents' well-being,
they will realize that Sentara and EVMS and
ODU, it's a a good place to work
and hopefully
stay local and continue to provide care for
for patients in this region.
My
direct administrators
have done a great job
of shielding me from
major financial considerations
here because I know it's a major,
investment
by Sentara and EVMS to start up a
new program like this.
The the business argument that we made to
get approval to start this residency
was that
our patients need more
local access to neurology.
And it took very little convincing
to get our administrators to recognize the value
of starting this program.
The
Sentara credo is
we improve health every day.
And
we're a medical care providing institution,
so we're focused on how to best serve
our community. And my hope is that this
residency
accomplishes that,
improving health care every day
for our local community,
by having
enthusiastic,
compassionate
care providers
trained right here and staying right here.
Yeah. Absolutely, doctor Weyen. I think
interesting to hear too, like, the a little
bit of what you shared there on the
the business case side and really just sounds
like it comes down to, you know, there's
a regional need there for access, and this
is a sustainable way to to build that
and and provide that for patients filling a
gap, so to speak.
You started to talk a little bit as
well about
retention and and well-being and how, you know,
as residents go through an experience, they'll see
that this is a good place to work
and this is where we want to stay.
And obviously, you know, we see a lot
of national data that speaks to where you
train is where you end up practicing for
a while. So
how is the program can you talk a
little bit more about how the program is
structured
or how you anticipate,
Sentara will
aim to support long term retention of trainees
in the region?
The two parts of your question are are
closely tied. How how we crafted this program
and how we intend
to keep,
our our trainees
encourage them to remain local and care for
patients locally. Although, I'm sure that some are
gonna decide that they they wanna
pursue careers
elsewhere. My hope is that, a whole lot
of them are gonna wanna stay stay here
and find this to to be a good
place to work.
I think it comes down to,
fostering
good teamwork,
and my leadership already does that within the
department.
When I joined this department a few years
ago, because I haven't been here that long
at at this particular
location,
I discovered that,
all of my colleagues
liked working with each other and communicated very
well. And so it's gonna be easy to
duplicate that model in our residency.
EVMS
cares about resident well-being.
There's no two ways about it. Residency is
very difficult. You gotta work hard. You're expected
to do,
a lot for a lot of people and
also safeguard your own well-being.
And EVMS
and the,
overarching
graduate medical
education,
department
is,
insists that we build that into our, didactic
curriculum.
So residents are we're not just gonna be
supervising them. We're also gonna be teaching them,
hey.
How do you become a good neurologist
and also safeguard your own
mental
well-being
so that you don't get burned out, so
that you can continue caring for patients in
your community for a really long time and
have a a satisfying and fulfilling
career.
So that that's
a wellness and,
professional growth and
teaching leadership skills from an early
phase of the the residency,
not
just the clinical nuts and bolts competency
of,
how do you understand neurologic disease and come
up with a game plan for treating a
patient afflicted by a neurologic disease.
Yeah. Thanks, doctor Weihen. I think interesting to
hear on the well-being piece too. It's like
sounds like it's owned by both, you know,
stakeholders in terms of there's a a role
that the university plays and then there the
medical school, and then there's also a role
that Sentara plays and it really needs to
be something that's routine and something that is
built into,
the learnings that they're that they're going through.
Yeah. Absolutely.
Well, to close us out, doctor Wyant, what
advice would you give to leaders at other
hospitals or health systems that are planning to
either debut a residency for the first time
or expand their existing
offerings?
Advice?
Good luck. It's a lot of fun, but
it's a lot of hard work.
The,
emphasizing
the importance of culture,
is key.
Don't try to do this alone.
So
engage with, faculty members, future faculty members,
leadership,
communicate constantly,
and,
try to celebrate your progress. It's a a
huge undertaking. So, it's gonna be a whole
bunch of small victories that that keep you
going. Yes. I I crafted a curriculum.
Yes. I I got
the leadership to say that we've got the
financials in place to,
to pursue this project and,
be impatient
because,
we have just started this residency program.
So
we're just barely getting the the project off
the ground, and we've got a whole lot
left to go to maintain it and to
start,
producing some outstanding
neurology,
graduates.
We've just,
got our our first class. They're all interns,
first year neurology residents,
and
we are extremely fortunate
that,
they're all compassionate and enthusiastic and and great
people. And so I know that they're gonna
make great neurologists.
We are have started
searching out and interviewing,
candidates for our second class,
and we're incredibly fortunate that the pool of
talent
is,
enormous. We've had a lot of interest in
our program even though it's a
a new program.
So for those out there that are considering
starting a program,
it is worth it.
And,
be patient and gather as many people around
you as you can that are willing to
help in any kind of way because I
definitely could not have done it without a
whole lot of support. This is,
in fact, I shouldn't even be using I
because this is not a solo project.
There are
so many people that deserve my
thanks and admiration because I could not have
gotten to where
we are yet without,
an enormous amount of assistance.
So
those are those are my bits of advice
is you need a lot of people to
help you is the main the main piece
of advice.
Yeah. Absolutely. I I imagine.
Before we go, do you mind just sharing
to the number of,
residents you have in this first class and
how you anticipate that number growing next year?
Our our first class is, three residents. Going
forward, we're gonna have four residents per year.
So,
once we fully matriculated,
residents to fill every class and graduated this
first class, there'll be a total of 16
neurology residents,
here at any one time. And,
looking forward into the future,
we might develop some,
fellowship programs. I I hope that I get
to be a part of that,
and that might,
expand the number of, local trainees.
It's a
four year residency. Neurology residency is a a
four year
undertaking.
So 16 total once we're fully up and
running, but three right now.
Well, doctor Wyant, thank you so much for
your time today. Appreciate you being on the
podcast for such an important topic.
Well, thank you for letting me talk about
it. I I love talking about it. It's
a whole lot of fun, and it's something
I'm pretty passionate about. So I appreciate you
asking me questions about it. Let me, spout
off about it.
Yeah. Absolutely. I look forward to connecting again.
Yeah.