We’re excited to celebrate our Graduate Medical Education program through a blog series that will culminate with GME Appreciation Day on February 16. Get to know the names and faces of our program! The GME department is comprised of residents, fellows, program directors, associate program directors, program administrators and GME office staff. 

Mitchell H. Tsai, MD, MMM, is an Associate Professor in the Departments of Anesthesiologyand Orthopaedics and Rehabilitation.

Mitchell H. Tsai, MD, MMM, is an Associate Professor in the Departments of Anesthesiologyand Orthopaedics and Rehabilitation.

When I reflect on teaching new physicians, the words of one my mentors come to mind. He reminded me that it was a privilege to watch motivated, inquisitive individuals grow as they learn. What I know now, I would add that the following sentiment: it is also our privilege to learn and grow with our students. In the past 10 years, I would be hard-pressed to find a resident who did not make me question something, or every now and again, change my own practice.

The role of a physician-teacher is multifaceted. Historically, the academic physician had a three responsibilities: clinician, educator and researcher. With the changing landscape of healthcare, we need to reevaluate the impact of each of these roles, especially the last role. Although clinical teaching is expected, I believe that it is just as important that we teach our residents to understand the broader implications of the perioperative services at the institution, regional, and national level. For example, as health care networks move beyond the traditional boundaries of the doctor and patient relationship, physicians are managing increasingly patients at the population level. For future anesthesiologists, this means understanding the components of a perioperative surgical home and learning how to manage patients beyond the silo of the operating room.

In the preoperative setting, anesthesiologists need to reduce variability in preoperative testing and work with our surgical colleagues to prepare the patients for surgery. In the intraoperative setting, anesthesiologists need to understand the basics of operating room management to ensure a sustainable financial platform to deliver perioperative care. In the postoperative setting, anesthesiologists need to understand how our clinical decisions affect a patient’s recovery. Every day, I look for these opportunities to help the resident understand how change is possible. In the process, I hope that I fulfill my roles as a clinician, educator, and researcher by facilitating any change in the system.

Finally, I believe that every physician will need a different skill set to confront the changes in our health care system. Future physicians will need to understand not only their own specialty, but appreciate the potential opportunities when we collaborate with our colleagues. Believing that the management of an operating room was crucial to the surgical residents at this institution, Elise Ames, MD, from the Department of Orthopaedics and Rehabilitation and I created a leadership and management curriculum for the Orthopaedic residency program in 2012.

Every year, a new group of first-year orthopaedic interns rotate through this reading and reflection group. Over a two-month span, we challenge the residents to develop rudimentary frameworks on management and leadership. Our hope is that they will use and test these frameworks as they progress through their residency and continue to refine them when they graduate. In addition, we discuss theories in organizational change, high reliability organizations, and operating room management with the idea that these tools will be useful as our future colleagues interact with a changing health care delivery system. In 2015, we expanded the reading months for the Departments of General Surgery, Urology, and Neurosurgery.

As I look back at the last 18 years, I have had the wonderful opportunity to start and continue my medical career in the Larner College of Medicine at UVM and the UVM Medical Center. Over the years, I have watched talented, selfless individuals at the top and bottom of the organization transform graduate medical education. My current chair and former DIO, Dr. David Adams, believed whole-heartedly that teaching house staff to take care of another would not only reap benefits for the patients that we care for each day, but also nurture the necessary collaboration and mutual respect to create change in a health care system. It is through this holistic lens that I believe is the reason that most of us went into medicine.

Mitchell H. Tsai, MD, MMM, is an Associate Professor in the Departments of Anesthesiologyand Orthopaedics and Rehabilitation (by courtesy). In his spare time, he raises his wonderful, blended family with his amazing wife, Sheramy.

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