By Aaron Costerisan, MD
The residency academic year has its cycles and rhythms. Recruitment of new residents is more or less an ongoing effort, but it is escalating now toward its peak during interview season, which typically starts in October. I say “typically” with pre-pandemic recruitment seasons in mind. The new reality is that recruitment processes and timelines are in flux.
Like everyone else, we are striving to carry on with our work in a virtual sort of way. One of the highlights of our recruitment activities is the annual trip to Kansas City for the American Academy of Family Physicians (AAFP) National Conference. Once again, instead of road-tripping down with the resident recruitment team, meeting scores of energized students, and finding the best KC barbecue spots, we gathered in front of a computer screen to text, email, and videoconference with some of these students – reconciled to the technological clunkiness of it all. Not nearly the same, but still fun and (we hope) fruitful.
In spite of the differences between “typical” and virtual recruitment, the questions from potential applicants have been largely the same. I think maybe because these interactions have been so technologically mediated I have been paying more attention to one of the common, important questions: “What do you look for in a potential resident?”
This one is easily anticipated, yet consistently makes us pause and fill the conversational space with utterances like “hmmm” and “good question.” How do we sum up what leads to the match between a resident and our residency? How do we account for the breadth of experience, approach, and interests among our 30 residents? Isn’t it obvious that we want residents who are compassionate, dedicated, hard-working and team-oriented? But maybe if it was obvious we wouldn’t keep getting the question.
One of the reasons I value being involved in recruitment is that it prompts me to reflect on how family medicine keeps drawing me in. In our circles, we talk a lot about the full spectrum of family medicine. We want to be known as full-spectrum family physicians in a full-spectrum training program. (Here’s a shameless plug for anyone considering family medicine residency: Our residency thoroughly prepares doctors to be family doctors!)
What we usually mean in self-assigning this label is that we practice and teach the breadth of a family physician’s possible clinical activities – ambulatory primary care, treatment of adult and pediatric inpatients, obstetrical services, procedures, sports medicine, and so on. But I think there is another dimension to the full spectrum of family medicine that we don’t recognize as often.
Our work as family physicians is not limited to those traditional medical contexts. Actually, our day-to-day work regularly makes us confront opportunities and problems that can’t be dealt with adequately from within those contexts.
Here are just a few examples:
- giving advice to a family member while still encouraging them to be connected with a primary care provider;
- treating an inpatient whose reason for admission is directly connected to homelessness;
- advocating for insurance coverage that extends into the postpartum period;
- determining where people are most affected by poor access to food in order to direct resources most effectively;
- struggling to understand the perspective of a patient with vastly different life experiences;
- recruiting a group of providers who better represent the diversity of a community;
- mentoring a medical student who can’t decide between family medicine and another specialty.
We are family doctors whether our work for the day places us in the clinic, hospital, rural health center supported by visiting clinicians, community organization board meeting, parent-teacher conference, church pew, or at home with loved ones. The clinical full spectrum may not occur in each family doctor’s practice, but the potential impact of our work is multidimensional in comparison to our usual categories.
How does a multidimensional perspective on full-spectrum family medicine guide us in recruitment? It still comes down to connecting with individual applicants. But at the very least, we are also intentional in looking for breadth and depth beyond clinical experiences.
Does an applicant recognize that they will fall short in caring for patients? Have they thought through how they will deal with disillusionment brought on by systems that seem to ensure bad outcomes for certain patients? Do they talk about the contributions of their team members as much as they talk about their own accomplishments? Do their goals extend beyond the hospital bed or exam table?
Finding answers to these questions as I am interviewing applicants is difficult. Yet that is not necessarily the most challenging part of the recruitment process. Because if I am paying attention, these questions consistently turn on me. Do I recognize that my obligations are not confined to clinic rooms and hospital floors? Am I living up to the broad calling of family medicine?