Graduating Co chiefs Q and A

10 July 2019

The week of June 2 - 8, 2019 marked the graduation of the University of Alberta Department of Family Medicine Class of 2019. On behalf of all of the faculty and staff of the Department of Family Medicine, congratulations to all of the graduates.

We asked Kristen Timm, Derek Chan and Daniel Prada, three of the co-chiefs for the family medicine residency program, to reflect on the role of co-chief and their work over the last year.

Was co-chief on your radar when you started your residency? If yes, why? If no, why not?

Kristen Timm: I considered running for the co-chief position early in my residency. I was very excited about the program as a new resident and I had several ideas about how to make it work even better for residents. I thought that being a co-chief would help enable me to drive the innovation and change that I wanted to see in the program.

Derek Chan:When I first started residency, I was so overwhelmed with so many new things that Co-Chief was not on my radar. I remember seeing Kiran and Bryan, our two R2 Co-Chief's at the time, standing up at the front they were so confident, well spoken, and accomplished it seemed like a position that was beyond anything I could achieve. I also knew very few people in residency at the time so it was a challenge enough just trying to get to know everyone when the majority of people had prior medical school friendships to build on.

Daniel Prada: It was, I had a lot of experience in management and leadership, so I felt my experience could be of help to the program.

What were some of your biggest achievements as co-chief?

KT: The overarching theme of the work that I do as a co-chief is to advocate for my resident colleagues. One area of interest for me is curriculum development and medical education. As an R1, I worked to expand resident exposure to obstetrics by bringing the SOGC's ALARM course to Edmonton and making it accessible for all our residents. Since becoming co-chief, the ALARM course has been recognized by the department as an important part of our training. I have also worked to develop new content for the Foundations course that will help equip residents for patient care when on-call for off-service rotations and additional content to promote professionalism among residents. Ultimately, I want to help all of our residents become the best physicians that they can be.

DC: Some of the things I had set out to do when I first became Co-Chief was to improve our program at the local level, expand what we could do at the provincial level, and further our presence at the national level. We are very lucky in our program in that our program director Dr. Chmelicek, is a very receptive program director and has made our program into one of the best resident-driven family medicine programs in the country.

I think that locally we were able to bring in some structural changes such as the new Annual Co-Chief Survey that is now into its second year to better help quantify gaps and areas of improvement to our program. In this past year, the data has resulted in residents being able to have the option to do some of their second year elective time in PGY1 if they choose, PALS being required before residents start their Pediatric Emergency rotation or general Pediatrics rotation, and significant improvements to our women's health curriculum including more outpatient gynecology clinics and improved coordination. In addition, an area that residents identified a lack of exposure to was practice management, so the practice management club was formed to complement some of the existing curriculum. Lastly, our robust enhanced skills committee of the FMRA were also able to add to the complement of courses they already organize and we were able to offer LEAP this year to further the palliative care competencies of residents.

At the provincial and national level, I am fortunate to also sit on the Board of Directors of the Alberta College of Family Physicians (ACFP) and as a resident representative on the Section of Residents' Council of the College of Family Physicians of Canada (CFPC). Our program's representation was greatly enhanced at these levels and I was able to bring about changes to how our resident reps are selected at the provincial level to better reflect resident perspectives. I think one of our biggest achievements at the national level was reflected in CaRMS and being able to fully match incoming residents in the 1st round, reflecting how robust and sought after our family medicine program is within the country. With the Section of Resident's Council, I was also able to be part of the national GIFT project and provide 10 national recommendations to improve Quality Improvement education in family medicine residency education across the country, allowing the U of A to be well represented within this initiative.

DP: In general, making sure all the resident's concerns were addressed and that the rural nature of our program was taken into consideration.

What was the greatest challenge in the role?

KT: One of the greatest challenges of being a co-chief is trying to represent a large group of residents who have diverse needs and interests. All of the residents are incredibly busy people. Not only do they work more than 40 hours a week with clinical duties, but they also dedicate many hours to studying, volunteering, research, and more. It can be difficult to engage people when they have so many demands on their time.

DC: I think that the greatest challenge within the role involves leading the Family Medicine Resident's Association (FMRA) and keeping residents motivated as they are all helping in a volunteer capacity. We are blessed in our program with some very strong resident leaders who are willing to take on initiatives which has made this job much easier but it is a challenge nonetheless. Like most things, the family medicine residency program is ultimately what you make of it and the stronger the involvement of residents in shaping their education and program, the better future family physicians we develop and graduate.

DP: Given the fact that this is a rural program, we spend many of our rotations in rural places. This made it hard for all us to be together and be able to discuss in person concerns regarding the program. Having said that, the Grande Prairie program runs very smoothly and the very few concerns/recommendations we had were quickly addressed.

What was the greatest joy in the role?

KT: Being able to stand up as a voice for other residents is very rewarding. I am proud of my fellow residents and it is a great reward for me to know that I have supported them on their journey to becoming great family physicians.

DC: The absolute greatest joy in the Co-Chief Resident role is your ability to mentor and connect with other medical students, incoming PGY1 residents to the program, and current co-residents. You are essentially the lead cheerleader for family medicine as a specialty and speaking with medical students about the resident perspective of family medicine was absolutely crucial to the role and resulting CaRMS success. Mentoring incoming PGY1 residents has also been an absolute pleasure as it helps ease anxieties and fears about the transition from medical student to resident, and helps new residents overcome any challenges they may be facing within their program. Lastly, the rapport and relationship built between Co-Chief's and the Program Director is a crucial one as it has allows another avenue for co-residents to directly bring issues to the PD and have them rectified from the top.

DP: Receiving the trust of my colleagues was a big honour, participating in in APC and RPC and being the voice of my fellow residents was of great joy

Do you have any parting words of wisdom or advice for future residents and co-chiefs?

KT: Although the journey to train as a physician is a long one, your time in the residency program will pass quickly, so make the most of it. Embrace challenges that will help you to grow in your skills and knowledge as a physician. Invest time early on to clarify for yourself what you need to learn in order to be intentional about achieving your goals. Surround yourself with friends who have similar goals and seek out mentors who will teach you.

DC: My parting words of advice for future residents is to never be afraid to take advantage of opportunities that present to you, especially when it involves being exposed to a different area of medicine or expanding a skillset. You never know where it will take you and being a resident is the best opportunity to learn now!

In terms of advice for future Co-Chiefs including Nathan and Jill who are taking over next year, I'd say that it is important to never be afraid to represent the resident perspective on issues and to approach every problem with a potential solution in mind to further enhance our residency program. The other piece of advice I'd say is to keep residents motivated to help out throughout the year since the program is only going to be as good as you and the FMRA can make it!

DP: Enjoy the program, early identification and early addressing of issues/problems in the program is very important.

Finally, is there anything else you would like mentioned?

DC: I'd like to directly acknowledge my Co-Chief, Kristen Timm, who has been absolutely one of the most dedicated residents I know. The position of Co-Chief really is a 2 person job and ultimately relies on both residents as the last line of defence to get things done. Kristen has been stellar in making sure the FMRA is running smoothly and the year would not have been as successful without her leadership!

DP: It was a privilege to be part of this program.