Residents in a Room

Episode Number: 41

Episode Title: The Ins and Outs of Involvement

Recorded: August 2022

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VOICE OVER:

This is Residents in a room, an official podcast of the American Society of Anesthesiologists, where we go behind the scenes to explore the world from the point of view of anesthesiology residents.

You know, you get really involved. You can actually make these big differences for people and for the greater group. That's kind of why I like to get into the leadership and advocacy stuff.

It's always been in my nature to be very involved with many different things and wear many different hats. So I'm hoping to be involved with the resident component when I do become a resident.

So I feel like I'm at a point where I'm ready to kind of let others take the role. But at the same time, as my mentors have said to me in the ASA, is that they will always still be here. ASA will always be around.

DR. JUSTIN YUAN:

Welcome to Residents in a Room, the podcast for residents by residents. I'm your host for today's show, Dr. Justin Yuan. I'm a current CA2 at Stanford, and we're recording this episode in Chicago at the ASA Board of Directors meeting. We just had our Resident Component Governing Council meeting as well as Medical Student Component Governing Council meeting. I'm joined by one fellow resident and one fellow medical student, and we're here to talk about the value of getting involved, which can mean different things to different people. So let's get right into it. First, let's meet our guests, Doctor Riley.

DR. ERIC REILLY:

Hey, Eric Rilley. I'm a CA3 resident at Beaumont Hospital in Royal Oak, Michigan.

NATALIE KOONS:

Hey, everyone, I'm Natalie Koons, a current fourth year medical student at the University of New England College of Osteopathic Medicine in Biddeford, Maine.

DR. YUAN:

Thanks for being with us here today, guys. Let's start with some confessions, because I don't think it's very typical for residents or medical students to be spending their Saturday morning at an ASA meeting in Chicago. I don't think any of us are from here. So we all traveled some distance to be here today. So what's up with that? Why are you guys here?

DR. REILLY:

Well, I am the president elect of the resident component, so I'm here to participate in our biannual meeting. Be a part of the Board of Directors, House of Delegates. And really, these meetings just serve as an awesome time to get together with people like you because we never get to see each other and network with all these great faces and voices and anesthesia.

DR. YUAN:

And I'm the outgoing president of the resident component. I'm very excited for Dr. Riley to to take over for the next year. I know he's got a lot of great plans coming ahead.

DR. REILLY:

And I'm just hoping that Justin sticks around for another year.

NATALIE KOONS:

So I am the current ASA medical student component president. I will be the outgoing president this October. So the new Governing Council will take over. Similar to Dr. Reilly, we hold our Medical Student Component Governing Council board of directors meeting here twice a year. And during those meetings we kind of go over the current projects that we've been working on, set up for the ASA annual conference, and discuss next steps as far as the projects that we have been working on. As Dr. Reilly mentioned, it's also another great way to network with leaders in anesthesiology and get to know the other faces and leaders throughout the resident component as well as the national society.

DR. YUAN:

Let's take us back to the beginning. How did the two of you get involved? Why did you get involved? I mean, as a I was just in medical school myself and I remember how busy it was with all the studying. As a current resident, how do you guys do it all?

DR. REILLY:

In undergrad, I guess even in high school, I always just like to be really busy, so I always tried to be involved in a lot of stuff. I think it's because I set high aspirations I wanted. I knew I wanted to go to college, I wanted to be a good applicant. So I just always was volunteering and working and doing stuff. And then in undergrad and medical school, I learned that when you attend things and when you lead things, people give you a lot of free food. And so I just started going to a ton of stuff and then learned that, you know, you get really involved. You can actually make these big differences for people and for the greater group. That's kind of why I like to get into the leadership and advocacy stuff in anesthesia. Specifically in the OR I can care really, really well for one person, but at meetings like this, I can provide a lot of service to a lot of people. I can do a lot of work that affects all of my peers and their patients down the line. So I love that one on one work in the OR, that clinical work, but I also really like helping positively influence change in policy at a more widespread level.

DR. YUAN:

And you were just at the legislative conference in May. Could you tell us a little bit about that?

DR. REILLY:

Yeah, legislative conference. It's in Washington, D.C. It's an awesome opportunity to meet with your state legislators, your members of Congress, kind of bring the matters to their desk, actually shake their hand and teach them what's going on in the ASA. What are we worried about. The No Surprises Act, safe VA care, Medicare reimbursement. A lot of people within anesthesia don't even realize what's going on sometimes with these issues, let alone our Congress people. And so it's a chance to interact with them, interact with your state component societies and kind of organize your thoughts and your missions and say this is the direction we're going to go. This is what we think is really important. These are where we're pouring our resources right now because it's going to affect ABC, because we're worried about these patients in these areas, because we're worried about these jobs in these areas. And so it's just an awesome opportunity to go to D.C. and hang out with everyone.

DR. YUAN:

I've been at this meeting as well, this legislative conference that it's one of the most electrifying conferences when you are in that room with so many like-minded physicians, residents, medical students, all getting together for a similar cause of advocating for anesthesia. Because we get it, not everyone can make it to D.C. There's definitely a role for very solid clinicians to be in the ORs and the ORs and then other people who are more legislative minded, more geared towards advocacy, these are also very important roles for us to get together and speak to our congressmen and women to make sure that our voices are heard. Natalie, what about you?

NATALIE KOONS:

So my pathway to medicine was a little bit different. In undergrad, I really had to be self advocate for myself, and I think that shaped my work ethic and personality. And I was the type of person that created my own opportunities. And so it was my personal anesthesiologist who convinced me to go into medicine. And I worked with him and was exposed to anesthesiology much earlier than most medical students. And so going into medical school, I had this idea of becoming an anesthesiologist, and the way I got involved was with my state society in Maine. So I worked with the Maine Society of Anesthesiologists and really got to know those individuals on a state level and got involved as a medical student and realized that I could have a profound impact on medical students who may not find the field early on as I did, so one of my main goals was to create as many opportunities I could for those individuals who may not have those opportunities in order to share the wealth and show them how great anesthesiology really is. So that was my main motivator of running for a national position and working closely with the state society as well, as the ASA, to create as many opportunities for medical students to get involved, whether it's research, advocacy, leadership, connecting with mentors and really mentoring students below me as well who are interested in going into anesthesia.

DR. YUAN:

I really resonate with that. Natalie Actually my experience to becoming involved with anesthesia, with leadership roles is quite similar. I discovered the Anesthesiology Interest Group very early on in medical school when I was just a first year. Everything the attending was sharing at that meeting was resonating with me. So very quickly I became involved with the Anesthesiology Interest Group and became president of that. It seemed natural at that point because I wanted to share the good news of anesthesia with all my peer medical students to run for a position on the national organization, the medical student component. And then really everything kind of just stems from me wanting my peer experience to be as good as I found it to be at my medical school. Because I know at different medical schools, the anesthesia departments are different sizes, they have different amounts of funding, different amounts of student involvement, different resident engagement. And so since I had such a good experience with my anesthesia program, I just wanted to make sure that other students across the country could experience that as well. I know one of the things that you had worked on within the past few years, Natalie was a resident mentor, medical student mentee program. Could you tell us about how that's going?

NATALIE KOONS:

Every year we send out an application to both residents and medical students, and this application kind of just goes over their simple interests, maybe where they would like to end up for residency as far as location, if they have a subspecialty in mind that they would want to continue after residency training, whether that's academics or private practice. And we do the same thing with the residents and try to match them up as best we can with at least one or two interests to have that student be mentored by the resident, whether it's application material review, advice on applying for residency or whether that's just someone to talk through how to study for boards, how to prepare for the first few years of medical school, how to succeed in your clinical rotations. So this relationship is really up to the medical student and resident. And this past year we matched over 300 medical students with over 100 residents, which is a record, I believe, for the medical student component. So we are very happy to provide those medical students with that mentorship.

DR. YUAN:

That's amazing, Natalie. That's so many mentor mentee pairs and I just want our listeners to know that this was entirely self-directed. Nobody told the medical student component, This is your task, go get it done. Natalie and the rest of her medical student component governing council members came up with this idea that this would be something they could have really benefited from and that they wanted their peer medical students to also be able to get this information from other residents.

It actually reminds me of, back on my time on the medical student component--I was actually president as well--and we had started this idea of interviewing program directors from all different programs across the country because it can be really helpful to identify a face with the program and interview seasons as challenging to make it out to all these different programs. So how do you pick which ones you actually apply to? And so what started out as just the Governing Council members interviewing a handful, I want to say around five program directors, has now, several years later, ballooned into this gargantuan project with over 50 different program director interviews. So that as a medical student, if you wanted to learn more about a program, you could hear it directly from the program director themselves. And these videos are online. All you have to do is Google the ASA medical student component, and that resource is there.

And so I think what I'm getting from a lot of this is that we wanted our wonderful experience with anesthesia to be as good for our peers as well. And that's what really encourages us. If you're thinking about taking on a leadership position, I would really encourage you to ask yourself, what are your motivations? Is it to just get another line on your CV? Because if that's the case, I find that the work can be a bit grueling. But if it's because you want others experience to be really good, then I think that's what will really keep things going, especially when we're so busy as we are.

Let's tackle another question, though. Not everyone wants to be involved at the national level. So what are some other ways people can, quote unquote, get involved with anesthesia or other ways to further their programs? Let's say somebody doesn't want to be president of a national society, what are some other ways that they can do?

DR. REILLY:

The more you get involved in, the more you see everything is connected and the different things you do play off of each other. So, I mean, you can just start so small. You can if you want to be involved in more philanthropy, you can just start your own can drive or something. I mean, that's one thing you can just do on a personal level. Hospital level, there's a ton of committees out there at every single hospital, at every health care center where you can be on, like the wellness committee, you can be part of the research committee. They're always looking for volunteers. There's your state component society. So like for me, the Michigan Society of Anesthesiologists has a ton of committees and opportunities for you to get on like I'm on the communications board for that and the medical student and resident board, and they're always looking for volunteers and people who want to be involved in people who want to put work in. And it doesn't even have to be necessarily anesthesia based. I mean, there's your other medical societies in every single state, whether it's just American Medical Association or whatever, Michigan Osteopathic Association or whatever you want to get involved in. There's so many opportunities you can just keep climbing that ladder to a position where you're comfortable. If you don't really want to be doing the state stuff, you can just stay at the hospital. If you don't want to be doing the hospital stuff, you can just do department. You can run for chief, or you can run for leader of your anesthesia interest group or whatever. I mean, the ladder will keep going up the further up you want to go.

And as you get involved with all that stuff, I think it comes full circle. You know, I got involved in a lot of quality improvement early on in residency and now in my current position, I'm finding that a lot of the advocacy I'm doing for residents and trying to look at like fellowships and regional and stuff is coming back full circle and like tying into a lot of the quality improvement work that I did. And so everything kind of is connected once you start getting to the top of it. And so I think anything you do will help you advance yourself with any involvement that you want to do.

NATALIE KOONS:

I would agree. I also always tell medical students who reach out to me, how can I get involved? And that seems to be a loaded question, especially for the individuals looking to either join the national society or be involved in their state component society. And I always tell them, you know, find something that you're passionate about and put 100% into it. Whether that's community service, whether that's research, whether that's national leadership. Anything that you can put everything into and then share your story about that is going to help. So whether that's reaching out to local physicians at your local community hospital and seeing how you can participate in repurposing unused medical supplies, whether that's doing community service in your town or city, or whether that's being involved on the national level and getting involved with that medical student component. I think anything that you can show that you're passionate about and show that can make a difference will matter.

DR. YUAN:

I couldn't agree more. You could go as national scale as as we are trying to make more broader sweeping changes or I even remember two weekends ago I was playing basketball at the gym and there is a pre-med that I ran into and he was just so excited I could see it on his face that he was in the midst of a resident anesthesiologist, and I couldn't help but remember back when I was a pre-med and how much uncertainty and how much I didn't know about the path ahead. And he was about to apply the cycle. So I offered to get him connected with Stanford to try to see if we could get him shadowing opportunities, because every little bit like that helps. It could be as small as just making a difference for one individual pre-med. And I think that that is also part of getting involved, part of making it better for those that come after us.

But let's kind of touch on an elephant in the room. Do you guys foresee yourselves continuing on with these roles? Is there a point at which you think you might want to step back and just focus on the clinical aspect? I know for myself, having spent two years on the medical student component, two years on the resident component, I'm starting to feel a little tired and I think I after this this term, I might be ready to take a back seat for a little bit. Just focus on clinical work. What are your guys thoughts on that?

DR. REILLY:

Kind of like my nature as I touched on earlier, I really like to be busy. I really like to do things that are helping out others. And so three years ago, I had no idea I was even going to apply for the resident component. And thanks to great mentorship and leaders and opportunities, you know, it's kind of the path that I found myself on. So, you know, two, three years from now, I have no idea what opportunities are going to be there. I anticipate following up on any of that come my way short term. Like next step for me is fellowship and I'll be in a new state. So I guess I anticipate trying to become involved in that state, society and any quality improvement type stuff at the hospital that I can get involved in while I'm there for a year fellowship. So yeah, I'm going to keep looking for opportunities and following up and trying to be as involved with ASA as possible. But I don't have anything specific on my mind that I'm definitely going to pursue.

NATALIE KOONS:

Similar to Eric, it's always been in my nature to be very involved with many different things and wear many different hats, so I'm hoping to be involved with the resident component when I do become a resident, much like you, Justin. But again, you know, time will tell. Things change, life happens and you never know where the pathway takes you. So with good mentorship, hoping to become a leader in anesthesia and stay on this track, especially in the national community and throughout my future residency program.

DR. YUAN:

And I just want to balance that by saying that it's also a very important skill to know how to say no to things, because as we start to become more prominent within our roles, we're going to be identified as people that get things done, people that people can come ask for help on. Can you be part of this committee? Can you do this task? Because we have this track record of getting things done and I think just for our own well-being, because we can always try to do more things, but at a certain point we need to make sure that we're doing things that we actually still care about. As Natalie, you alluded to, things that we actually have passion for, because eventually I think it's a fine line between being squeezed to a point where you won't have the energy to do those things anymore, kind of alluding to burnout, but also at the same time making sure that you're you're still doing the things that you want to do.

I love hearing what you guys are saying. My personal take on it is I feel like I'm at a point where I'm ready to kind of let others take the role. But at the same time, as my mentors have said to me and in the ASA is that they will always still be here. ASA will always be around sometime down the line. When I'm further along my career, I'm like, Hey, I'd really love to get involved with the ASA again. Then that opportunity, that door is always open for me to come back in. I think it's very important that we we know that it's not like we're closing any doors. If you need to take time for yourself, you should certainly do that.

Speaking of time, how do you guys find time for this? Do your programs give you protected time? I mean, I remember how hard it was to even ask for one day as a medical student to get off of a rotation like surgery, for instance. Does your program encourage you to be here? Do do they give you protected time?

NATALIE KOONS:

Not necessarily, no. It's really very self-motivated. And sometimes I don't even know how I find the time, to be honest. But, you know, if you're doing something that you enjoy, sometimes you don't need to find the time. It's just there. But like you were alluding to before, having self-boundaries is super important. And just like with our future patients, you know, having those boundaries to do things that make you you and have wellness and mental health is super important. So I always try to make those a priority in my schedule as a medical student and being very organized and having very good time management are skills that are very important in roles that we're in, because without that, you know, you cannot get tasks done and keep people on task. So I think my experience is throughout undergrad and then also in medical school have prepared me to have that time management and have that organization. So it comes naturally to me but you know, always making time for yourself and like you said, creating your own passions and keeping those streamlined with your work you're doing.

DR. REILLY:

I agree with all that. I think when you are considering getting more involved in something, you need to make sure you can delegate that time, so that’s just part of the time management. So it might take away from reading or watching movies or other things you may otherwise do. For me, that was no problem. I felt like I had plenty of time on my hands so I could get involved and do a lot with the resident component. And then yeah, my program is very supportive. Dr. Soto. My program director was former president of the resident component, and he's very involved with ASA and the MSA. And he realizes the importance of being involved in advocacy. And he tries to get all of our residents involved. I mean, he sends all of us to ASA annual conference every year, and we all are presenting challenging cases and stuff. So as soon as I told him I was going to run for president elect, he was very excited and said, Absolutely, you will have all the time you need. If you need time off, you need funding, whatever you need, just let me know. So I come from a very supportive program, which is lucky to have a structure that can get residents out for stuff like this. I don't think I've had as tough of a time as some people balancing the work with the component, with the work of residency, just because I've had people supporting me to get both done.

DR. YUAN:

When I was a fourth year medical student interviewing for residency programs, one of the questions I always asked was, because I'm so involved with the ASA and would like to continue my work into residency, I always ask the programs what kind of protection I would get to continue to coming, comimg to these meetings to potentially get funding, anything that the program could do to help make it as easy for me as possible to continue doing this work outside of residency. And I got many varying answers. But Stanford stood out to me as one that really cared about my development, my professional development within ASA and true to form they have been very good about getting me the time off that I need to be here now. Of course, certain rotations like ICU, it just can't be done because there's not enough coverage. And and that's understandable. But from what I'm hearing from you, Natalie, and from you, Eric, is that it's program dependent, which definitely plays a pretty big role, but also to a certain extent, it's also how much you're willing to put into it to to get what you want out of it. I know, Natalie, you're you're here in between two away rotations on a layover flight, which is just crazy to me how you're actually still here. But I mean, if you want to get it done, you can get it done.

What about some best moments that you've had since assuming your role on these positions or potentially also some bad moments that you've had?

DR. REILLY:

I would say it comes in pairs. You have your best professional moments and then your best just lifestyle moments. So I'll start with professional. You know, having the resources of the resident component has given me a wide audience and a lot of tools and resources and connects to be fortunate enough to write some articles for the Monitor. And after getting some of those pieces out there, just having people reach out to me and people who I don't even know and say, you know, I read your piece, I was really great. Like thanks to give me a lot of understanding. I mean, that's why we're all in this in the first place to help out others to to make the road easier for others. So those are kind of the high moments for me professionally. And then going to these conferences and hang out with Justin, who every time I see him, it's like seeing a best friend. And we like when we were in Dallas, like went out and bought cowboy hats and went to a rodeo. Like, I love that. That was such a great moment for me.

And then the lows are, I can't think of any that are maybe strictly tied to the resident component. I think it's just I mean, Justin, we were kind of talking yesterday of balancing the professional work we do, the component work, and also residency as a whole, like residency is very taxing. You touched on burnout earlier and then just the nature of what we do in anesthesia, there can be complications, there can be bad outcomes. We can have really tough days, really tough cases. And I think being able to balance the work that we do and realize that what we are doing here isn't just for us, but it affects a lot of people and a lot of people who are giving us their time and resources. And so being timely with our efforts is really important, but sometimes very hard. Given what life throws at us. The low moments aren't strictly tied to the component, but maybe tied to things that may happen in life. And then realizing I still have a lot that I need to get done.

DR. YUAN:

That cowboy hat still hangs on my shelf as a trophy.

DR. REILLY:

Yes.

NATALIE KOONS:

Yeah, I would agree. I think some of the best moments are seeing how many medical students we are impacting. Just in 2017 alone, there was about 1200 medical students in the medical student component governing section, and now there's over 3000. So to see the growth in the medical student section of the ASA and to see how many individuals we can provide resources to is just an amazing feeling as a leader. And like Eric was saying, you know, going to these conferences and making lifelong friendships with the individuals who you are working with, you know, for sometimes two years is just a benefit that you can't replace. As far as lows go, I think again, nothing tied to the medical student component specifically, but just timing in life. So during my second and third year of medical school, it was very difficult personally during board season and kind of stepping away. And again, that goes back to creating those self boundaries and saying, you know, I'm going to be studying 12 hour plus days for the next few months and having those individuals on the Governing Council kind of step up and make sure that your your roles are covered. And it almost is a self-guilt type of thing because as someone being so involved, you want to be available 24 seven and you want to be available for the students. But there is a time and place where you do need to step back and realize, you know what, I am a medical student first and this is my priority at the moment. So those were some difficult times, but none that I didn't get through without everybody support.

DR. YUAN:

For me I'd say some of my best moments really stem from just showing up frequently at these meetings. I mean, I would speak for all of us, we're usually the youngest face in the room. And initially that intimidated me because there's all these chairs and program directors and presidents of blah, blah, blah. I was just like, What do I have to offer in a room like this? But then as time went on, people just showed so much interest in what I had to say that I actually started to view my youth as a leverage point because I'm offering to them something that is valuable as well. Namely, I have such a close experience to being a medical student and a resident and a young trainee, something that people who are 20 to 30 years out of, out of schooling, they just forget what that's like. And we bring this really fresh perspective that people are so eager to listen and respond to. And just by showing up, these opportunities fall my way. You know, just in terms of running into people who say, hey, we're going out for dinner tonight, why don't you join us? And then now I'm having conversations with like the president of the ACA and things like that that I could never plan for. But the only thing that I could do is just to continue to be proactive about, you know, doing my due diligence, being just showing up really is my my biggest piece of advice that I can give for anyone that wants to get involved.

NATALIE KOONS:

And just to add, back in March at the Board of Directors meeting, I think having the perspective of a medical student was very valuable and even sought after. In the roundtable discussions that we had, the medical student perspective was always directed at and asked for in some of these discussions, specifically regarding diversity, equity and inclusion. So I think having the medical student and resident face at these board of directors meeting is so important, especially since we are going to be the futures of the specialty.

DR. YUAN:

Let's close by asking the both of you what advice do you have for students or residents that haven't yet gotten involved but are starting to head down that pathway?

DR. REILLY:

I think that, you know, specifically the field of anesthesia involvement over the next years, throughout our career is going to be very important. I think in all of medicine, really, the more you're involved and the more you really focus in on something, whether that's research or advocacy or doing a fellowship or something, I think that it sets you up to really serve a value to wherever you are working that makes you kind of irreplaceable. And I think that those things are going to be very important throughout our careers as there's concerns with health care access and different models of who's getting hired and who's providing anesthesia and stuff. I think that you need to make an effort to invest in yourself and become an expert at something. And so I would try to have that mindset to kind of feel yourself and know that I need to get involved in something. I need to do something, whether it's advocacy, whether it's on committees, whether it's fellowship, whether it's getting an MBA or something. I would try to find a mentor who aligns with your goals. I think all of us in this room have really good mentors, and they're who kind of helped us get on our way with where we are. So I think that's huge. And then just getting involved in anything that you can, even if you're not necessarily interested in research, doing research will help you build your CV and meet people who then otherwise down the line may be able to help you in your other endeavors. You know, I'm not very interested in research, but I still have a fair amount of it in my background. And through it, I've met people who hey, by the way, do you want to help me write this chapter through this. Oh, you actually got introduced to this person and oh, that's the fellowship you're pursuing now, you know this person. And so everything comes full circle. So I would get involved in as much as you can as time allows and take every opportunity that comes your way, because if you don't take it, somebody else will. There's no shortage of people looking for stuff to do, take advantage of the opportunities when they're there.

NATALIE KOONS:

My biggest advice for medical students who may be interested in anesthesiology but are unsure if that's their specialty of choice, you know, try every avenue to explore the specialty early on. Like Eric was saying, getting involved in any type of advocacy, research, leadership, community service that has to do with the field, just opens so many doors to future opportunities. And so, you know, take the time to explore other specialties and see if that's for you. But if you're pretty set on anesthesia, having a voice at the table is super important, especially as the field continues to flourish and continues to change, and especially institutional changes. Medical students going into residency and young residents becoming attendings is going to be the way of change for an institution. So having a seat at the table early is always a benefit.

DR. YUAN:

And just on a few matters of practical points, definitely become an ASA member. If you aren't already this gets you plugged into the system, you'll start receiving emails from the ASA. Every now there is an application for, let's say, the DC legislative rotation or applying to be a member of the Governing Council or or any number of, of opportunities. So paying attention to the emails, checking the ASA website, there's both a medical student specific page and a resident specific page that are filled with content and resources and many different ways to get involved. And then, of course, as as everyone's been alluding to, contact with your attendings, your co residents, people who might already be plugged in, like your program director, certainly knows other program directors and other people and other committees. And and same with your chairperson as well.

On that note, I think we're ready to wrap up. Thanks so much, Dr. Eric Reilly and Natalie Kunz, our medical student extraordinaire. This is rRsidence in a Room, the podcast for residents by residents. Join us again next month for our next edition of Residents in a Room and make sure to follow us wherever you get your podcasts.

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