Keith Baker, MD, PhD, vice chair of education, shares more about what drew him to teaching, the successes and challenges that residents at Mass General face, and how the residency program has evolved since his time as a Mass General anesthesia resident.
In 2017, Daniel Saddawi-Konefka, MD, MBA, took on the role of the Anesthesia Residency Program Director at Massachusetts General Hospital. He saw it as an opportunity to give residents what he found most valuable in his training—a learning-oriented environment that fosters lifelong growth for the program and its residents.
“I came to Mass General to become a clinical dragon slayer, which means developing a principled approach to care for any condition,” he says. “I wanted excellent clinical exposure and a culture that values learning, so that I could be equipped to treat every single patient that comes through the door.”
Dr. Saddawi-Konefka talks about the department’s approach to resident education, teaching initiatives in the department, and his passion project that helps providers access mental health care.
Q. What is your philosophy as an educator?
Competence is not the destination when it comes to our education as anesthesia providers—rather, it is simply a bar that we pass on our journey of lifelong growth. Our goal is mastery and expertise, which must be continuously and endlessly cultivated.
I hold the program to those same standards. I think our program is incredible, but we will always find opportunities to make it better. We are deliberate in instilling this growth philosophy into everything we do.
We've launched several new initiatives as part of the Mass General Anesthesia Residency Program. In the last five years, we’ve:
- Gone fully categorical to increase longitudinal mentoring, foster community, and take advantage of the formative intern year rotations available at Mass General
- Created incentive shifts to ease the cost of living for residents
- Spread the residency educational footprint to learn about advanced, non-OR interventions for some of our most ill patients
- Shortened weekday call to transform daytime portion into time for academic pursuits
- Implemented a transformative method for reviewing and reflecting on feedback
- Provided sustainable funding for advanced ultrasound certifications
- Established a fund for resident research grants
- Increased rotation-specific didactic offerings
- Expanded time for electives
- Increased vacation time to four weeks per year, in addition to five days of meetings per year
- Added yearly social events including class retreats and an anesthesia-surgery resident mixer
Q. To what do you attribute the success of the program?
We have world-class faculty and team-oriented residents who are invested in learning. We also have an incredible case mix.
Importantly, our residents and faculty are diligent in sharing feedback with us about the program so that we can continue to improve. We are lucky to have steadfast and high levels of support for education from the department and institution so that we can aim for both incremental and transformational change.
Q. We’ve talked about your teaching philosophy, but what have the residents taught you?
So many things. One of the lessons I’ve appreciated most over the years is how important it is to stay humble and curious when it comes to helping residents grow. Growth is both complex and personal, so advice is rarely one-size-fits-all. I think the best “recipe” for success is to avoid assumptions and keep your eyes on what’s most important—the resident’s growth and well-being.
Q. In the spirit of continued growth, what is on the horizon for the Mass General Anesthesia Residency Program?
One transformative change slated for September is our curriculum overhaul for the advanced residents (CA1-3)—we’re transitioning our core didactics to be full days every four weeks with sessions that are customized by year.
- The CA1 curriculum will focus on anesthesia principles and skills workshops
- The CA2 curriculum will focus on advanced foundations and topics, evidence-based small group discussions, and advanced skills (e.g., ultrasound, mechanical circulatory support, interventional pain, etc.)
- The CA3 curriculum will expand on advanced topics, but also include oral board and OSCE preparation, a seminal article series, a professional development series (e.g., personal finance, working with CRNAs, medicolegal aspects of practice, etc.), and teaching opportunities as facilitators of our intern year afternoon curriculum sessions
Q. What other initiatives are you most proud of?
In March 2020, a friend and I started discussing the emotional toll that the COVID-19 pandemic was likely to take on health care workers. Even before the pandemic, providers had alarmingly high rates of burnout, anxiety, depression, and suicide. Unfortunately, these high rates are coupled with very low rates of getting help, due to the many barriers (e.g., access, time, money, stigma, potential impact on future practice [e.g., licensing, credentialing, insurance], etc.).
We cofounded a national nonprofit called the Emotional PPE Project. It started as a directory of volunteer, licensed mental health care providers in every state in the United States, all of whom were willing to help health care workers for free—no paperwork, no disclosure of information. To date, we’ve connected over 2,000 health care workers with free, confidential therapy.
We fairly quickly evolved to include research and advocacy efforts. For example, we published an article on inappropriate mental health questions on initial physician licensing applications and worked to advocate for change. Work like this from various entities has catalyzed sweeping change in many states, including revised licensing applications and new legislation that outlaws such questions.
Q. What would you say to a medical student who is interested in training at Mass General?
Above all, we lead with kindness. Trainees who come here do so because they care about helping patients on some of the hardest days of their lives. Beyond that, our goal is growth, regardless of current level of performance. We are ecstatic about medical students who share these core values.
I would be remiss if I didn’t also mention the robust resources and networks, both at Mass General and beyond. For people who are interested in also growing in non-clinical areas—research, global health, device innovations, education, administration, quality and safety, etc.—we have robust resources to help you achieve these goals.
About the Mass General Anesthesia Residency Program
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