Table 1
Resident and faculty ages and postgraduate year or years post-training
|
UW Psychiatrya |
HL Psychiatrya |
UW Medicinea | |
|---|---|---|---|
|
Residents | |||
|
Age (years) | |||
|
<35 |
26 (70.3%) |
25 (96.2%) |
62 (91.2%) |
|
35–44 |
4 (10.8%) |
1 (3.8%) |
4 (5.9%) |
|
45 or older |
2 (5.4%) |
0 (0.0%) |
0 (0.0%) |
|
No response |
5 (13.5%) |
0 (0.0%) |
2 (2.9%) |
|
Residency year | |||
|
PGY-1 |
5 (13.5%) |
10 (38.5%) |
19 (27.9%) |
|
PGY-2 |
9 (24.3%) |
7 (26.9%) |
22 (32.4%) |
|
PGY-3 |
12 (32.4%) |
5 (19.2%) |
25 (36.8%) |
|
PGY-4 |
10 (27.0%) |
4 (15.4%) |
2 (2.9%) |
|
No response |
1 (2.7%) |
0 (0.0%) |
0 (0.0%) |
|
Faculty | |||
|
Age (years) | |||
|
<35 |
5 (15.2%) |
6 (7.9%) |
7 (6.0%) |
|
35–44 |
12 (36.4%) |
12 (15.8%) |
53 (45.7%) |
|
45–54 |
8 (24.2%) |
14 (18.4%) |
29 (25.0%) |
|
55 or older |
8 (24.2%) |
44 (57.9%) |
27 (23.3%) |
|
Years post-training | |||
|
<1 |
3 (9.1%) |
5 (6.6%) |
3 (2.6%) |
|
1–5 |
10 (30.3%) |
6 (7.9%) |
17 (14.7%) |
|
6–10 |
6 (18.2%) |
4 (5.3%) |
31 (26.7%) |
|
>10 |
14 (42.4%) |
61 (80.3%) |
65 (56.0%) |
a UW Psychiatry University of Washington Psychiatry Residency Program, HL Psychiatry Harvard Longwood Psychiatry Residency Program, UW Medicine University of Washington Internal Medicine Residency Program, PGY postgraduate year
Table 2
Ownership themes common to residents and faculty members from medicine and psychiatry
|
Themes |
Number (%) |
Representative quotes |
|---|---|---|
|
Physician actions | ||
|
Advocacy |
20 (5.6) |
‘… to be their advocate when the clinical course is smooth or rough’ |
|
Communication, care coordination |
175 (49.2) |
‘maintaining communication with other care providers so that continuity will be as smooth and seamless as possible’ |
|
Decision making |
56 (15.7) |
‘taking responsibility for clinical decision making’ |
|
Follow through |
87 (24.4) |
‘I am the one who will follow through and make sure the work on that patient gets done as expected. Things will not fall through the cracks on my watch.’ |
|
Knowledge of the patient |
51 (14.3) |
‘knowing the patient stone-cold’; ‘learning as much as one can about the patient’s condition’ |
|
Leadership |
12 (3.4) |
‘taking a leadership role in the care of one’s patient, whether by being the ‘sole’ person in control, leading a team or appropriately delegating tasks to others’ |
|
Physician attitudes | ||
|
Above and beyond |
18 (5.1) |
‘going the extra mile’; ‘a commitment to do more the minimum’ |
|
‘Buck stops here’ |
17 (4.8) |
‘you are not tagging along behind an attending … you are ‘it’’; ‘I’m responsible for seeing that my patient gets good care and if there are lapses, it’s ultimately on me’ |
|
Patient outcome |
26 (7.3) |
‘feeling invested in whether the patient gets better or not’ |
|
Responsibility (feeling) |
25 (7.0) |
‘to ‘own’ our patients really means, in my view, to feel responsible for their care, to feel the gravity of our interactions, decisions, and actions on their behalf’; ‘Losing sleep if something goes wrong’ |
|
Physician identity | ||
|
Primary care provider |
36 (10.1) |
‘I am the first person that the nurse and case manager contact … I am also the person who represents the treatment team to the family’ |
|
Physician qualities | ||
|
Initiative |
38 (10.7) |
‘taking initiative to suggest initial treatments and alterations in treatments where necessary’; ‘Being proactive … rather than assuming someone else has done it’ |
|
Quality of care | ||
|
Best care |
13 (3.6) |
‘following the golden rule, e. g. am I delivering care that I would want to deliver to a family member or myself’ |
|
Comprehensive |
30 (8.4) |
‘as a physician it means taking ultimate responsibility for every aspect of a patient’s healthcare’ |
|
Longitudinal |
11 (3.1) |
‘the physician … takes the long view … and avoids seeing patient care in terms of a specific, isolated episode’ |
|
Patient-centred |
29 (8.1) |
‘eliciting the patient’s perspective’; ‘trying to help empower the patient in making decisions about their medical care’ |