If you are in the medical education business as a student, resident, staff person, or faculty member you’ve surely been there: having to provide feedback to somebody about their actions, skills, and competencies, or being at the receiving end (or, more likely, both). Feedback is often not easy to give, or receive.

Our upcoming Grand Rounds will feature Dr. Carrie Chen, Associate Dean of Assessment and Educational Scholarship and Professor of Pediatrics at Georgetown University School of Medicine, who is an expert on feedback in medical education. You can read her bio here: https://som.georgetown.edu/studentaffairs/thedeans#Chen

Her talk is titled: Feedback: What is the Evidence and What Should We Be Doing?

I asked her about giving and receiving feedback and about her sojourn in The Netherlands.

Mishori: Your talk is about giving feedback. It seems easier said than done. Why is that?

Chen: I think because it is really a skill that few of us ever received training to do, especially how to do it given our busy circumstances.  To do it well, it also requires some forethought.  We have to think about what message we want to get across, how best to word it, and how we can support the learner to receive and make use of the feedback.  Often we do not give ourselves the space to think about and plan for it.

Mishori: What is the worst feedback you’ve ever received?

Chen: I can’t think of the worst feedback.  Mostly I think of times where there was no feedback or very general non-helpful feedback.

Mishori:  Was there ever a time when you received negative feedback, was hurt at the time, but in retrospect feel it was beneficial to your career or even transformational?  

Chen:  I distinctly remember an episode of feedback from residency that came from one of my favorite attendings.  He told me that because I was a good resident, people did not give me much constructive feedback.  But because he cared and believed in me, he was going to tell me that I was capable of being better.  It was a bit of a shock and it took me a few days to process it, but it was the best and most helpful feedback I received during my entire residency.  He became one of my most important mentors and friends.  He would say things to me such as “This is going to be hard for you for x and y reasons, but this is important for you to do because it will help you develop in z way.”

Mishori:  Tell us about your time in Utrecht. How long did you live in the Netherlands for? 

Chen: I was there for a year on sabbatical after finishing my PhD.

Mishori:  What are some of the cross-cultural lessons you learned living in the Netherlands?

Chen: The Dutch are very direct and there is little hierarchy.  Students are comfortable speaking up and questioning the faculty in a constructive way.  Feedback was not unkind, but it was direct and left less room for misinterpretation.

Mishori: How many pictures do you have of yourself with a windmill in the background or on a bike? (and can you share any)?

Chen: Interestingly, I have many photos of windmills and bicycles and of other people in front of windmills, but can’t find one of myself in front of a windmill…  It is complicated by the fact that my computer was stolen (along with all my photos) over a year ago.

Mishori: what other photos could capture your passions outside of work?

Chen: It is of me learning how to make paella at a cooking course in Barcelona and the final product.  I love doing cooking courses and had done a weeklong one previously in Italy.

Mishori: Wow! May I ask what kind of feedback you received for this creation?

Chen: Ah, well, it was a group endeavor.  There were about 8 students in the class and we all worked on the entire meal together.  During the process, the teacher demonstrated techniques and as we practiced, we also gave each other feedback and tips.  Ultimately, we sat down to eat and discuss the meal together, which was a group self-assessment.  The entire thing was formative – no summative assessment.  🙂

To hear more from Dr. Chen about giving (and receiving) feedback, join us.

When:  Thursday, February 1, 2018 Time: 8:00am

Where: Georgetown University Medical Center, Building D, Warwick Evans Conference Room

Zoom: Can’t attend in person? Join us electronically through Zoom at 

https://georgetown.zoom.us/j/171728235

Refreshments will be served.

See you there! 

Our upcoming October 5^th Department of Family Medicine Grand Rounds’ guest, Dr. Alan Simon, recently published an article in Health Affairs about access to care, specifically as it relates to receiving government housing assistance. See the article “HUD Housing Assistance Associated With Lower Uninsurance Rates And Unmet Medical Need” here.

I asked him about his work in general, his career, as well as about his views on the Social Determinants of Health.

Mishori: You will be speaking about housing and its relationship to insurance status and access to care.  What should students/residents know about the effects of the ‘Social Determinants of Health’ on their patients’ health?

Simon: Understanding the impact of social determinants of health is incredibly important. When you spend a lot of time in the hospital as a student or resident, it is easy to forget that your patients have lives outside of the hospital, and social factors that impact on their lives influence whether they have health insurance, can obtain needed medical care, purchase and take their prescribed medications, and how likely they are to have risk factors for any number of diseases.    I think most physicians understand this, but keeping it in mind early in your career is harder to do.   After you see your next patient, spend a minute thinking about the social factors that positively and negatively impact his or her health.

Mishori: At what point did you transition from clinical care to public health? Why did you decide to make this transition?

Simon: After residency, I was a Robert Wood Johnson Clinical Scholar at Johns Hopkins for two years (http://www.rwjf.org/en/library/funding-opportunities/2017/clinical-scholars.html).   Following that training program, I went straight to the federal government.  I managed to continue working at a clinic at Children’s National Medical Center ½ a day each week until about 2 years ago.  I’ve always been a big picture person and I like to try to influence the health care system on a large scale.  The government can (sometimes) allow one to do that.  Nonetheless, I liked seeing patients directly as well and would like to go back to doing that at least a little bit at some point.

Mishori: How did you end up working for the government?

Simon: When I was looking for a job after the Clinical Scholars program, I had a few choices in the DC area where my wife and I lived.  A job at the National Center for Health Statistics sort of fell into my lap and I had to decide between that and being a hospitalist.  I also had very young children at the time and I thought that working for the government would be more family friendly.  For the most part, that has been true.   Also, I wanted to be able to concentrate on research and I thought that hospitalists were so busy that they didn’t have enough time to dedicate to projects early in their career.

Mishori: What does it mean to be a ‘medical officer’? What do you do at the Department of Health and Human Services?

Simon: Medical officer just means that you are an MD (or a DO).    I now work for the HHS Office on Women’s Health in the Office of the Assistant Secretary for Health.   I do a little bit of research still, but mostly try to keep programs running.   My responsibilities are fairly varied.  I am the lead for building a website that analyzes data from a variety of national data sets on the fly.    I work with the Indian Health Service on addressing the misuse of opioids in women.

Mishori: You have a profile picture of a mountain gorilla on your ResearchGate page, what’s the story behind that?

Simon: He is my spirit animal.   Actually, when I went to sign up for ResearchGate, I couldn’t get past the step where I had to put in a picture.   I didn’t have a picture of me on my computer, so I put in a picture of a puppy chasing a butterfly.  People seemed to really like the picture, but when I changed jobs and had to create a new account, I decided to go with the gorilla instead.   Maybe researchers all over the country think that I am a gorilla, but it seems unlikely.

Mishori: Finally, what advice can you give students/residents about selecting a specialty or a role within the healthcare system?

Simon: I’m sure everyone says this, but it is important to like the bread and butter of the field and make sure you spend time with people in that field that are not at the tertiary care center of your medical school.   The rare cases are always going to be rare and they are not usually enough to keep you interested in a field.

As a reminder, you can join Grand Rounds in person or via Zoom.

Thursday, October 5^th. 8am. Warwick-Evans room. Building D.

Join from PC, Mac, Linux, iOS or Android: https://georgetown.zoom.us/j/171728235

Or iPhone one-tap (US Toll): +16465588656,171728235# or +14086380968,171728235#

Or Telephone:
Dial: +1 646 558 8656 (US Toll) or +1 408 638 0968 (US Toll)
Meeting ID: 171 728 235
International numbers available: https://georgetown.zoom.us/zoomconference?m=fOw0aGrqLehmiRUYgrMHW_TEAYceFUJI

Or an H.323/SIP room system:
H.323: 162.255.37.11 (US West) or 162.255.36.11 (US East)
Meeting ID: 171 728 235

SIP: 171728235@zoomcrc.com

Or Skype for Business (Lync):
SIP:171728235@lync.zoom.us

By: Amber Robins, MD, MBA (Health and Media Fellow)

Dr. Robins speaking to a young student

Driving towards the building that I frequented so long ago brought me back to a time that being a doctor was only a dream. Flashbacks of wearing a blue color blazer with a white button down shirt and a khaki skirt as my uniform came to the forefront of my mind. Those were the days when I was a member of the Louisiana Leadership Institute, a non-profit organization for young minorities. Once I got out the car and walked towards the Louisiana Leadership Institute building, I felt excitement to speak to young people who looked just like me. When I joined the Louisiana Leadership Institute over 10 years ago, I knew very little about what it entailed. Headed by former Senator Cleo Fields, the focus of the institute continues to be to “build leadership, improve academic skills, and increase self-esteem and motivation in the Greater Baton Rouge Metro area students.” During my time within the program, I was gifted with exposure to some of the highest officials in the state of Louisiana while being taught leadership skills during my most integral years of middle and high school.

On Saturday, September 2, 2017, I was invited to speak to the current members of this prestigious organization, now, as a leader in my field in my own right: an MD, an MBA. In my speech, I discussed my memories of being one of the select few invited through the Louisiana Leadership Institute to the Rainbow Push Coalition Conference in Chicago, IL, where I had the chance of meeting Rev. Jessie Jackson, former President Bill Clinton, Cornell West, and Judge Mathis. It was an exhilarating time that brought me up close and personal to figures that I only had the chance to read about in books or see on television. As I got older and more engrossed in the institute, I continued on in the Louisiana Leadership Gospel Choir and toured around the state of Louisiana. All my experiences within this non-profit organization, helped me understand that my dream of becoming a doctor could be attained. When talking to the students on Saturday as an alumna, I wanted them to understand that being in such an organization is a gift that will continue to pay dividends throughout their lifetime and would even spread to our community of Louisiana. Hearing the aspirations of the current members to become doctors, lawyers, engineers, speech writers, poets, and political scientists, gave me excitement and hope in the future of Louisiana and our country.

Once my presentation was completed, I answered questions about life as family medicine doctor, on-air medical expert, and book author.  With much gratitude, I was humbled to accept the title of Ambassador of Louisiana Leadership Institute. It was a pleasure to give the attendees autograph copies of my book published in 2016 called “The Write Prescription: Finding the “Right” Spiritual Dosage to Overcome Any Obstacle” where I discuss my challenges and triumphs of being a minority in medicine. In each book I urged the reader to dream big and achieve their dreams. It was a wonderful time to return home to Baton Rouge, LA, but even more special to spend time with the future leaders of tomorrow.

For More Information About the Louisiana Leadership Institute: www.louisianaleadershipinstitute.org

Dr. Robins signing her book.

Amber Robins, MD, MBA is the Health and Media fellow at Georgetown University in the Department of Family Medicine.

We are very excited to welcome four new fellows to our department for this academic year.

Here are short summaries of who they are and what they will be doing this year.

1. Robert L. Phillips, Jr. Health Policy Fellowship

Dr. Rob Baillieu comes to us from The University of Texas Health Science Center in San Antonio where he completed residency in family medicine. Prior to this Rob lived in Australia, where he went to medical school and also undertook training in adult internal medicine. Rob will be practicing at Spring Valley and working the rest of the time with our partners at The Robert Graham Center and also HRSA. Rob has a passion for teaching, multidisciplinary care, protection of the underserved and also health policy reform, and he hopes to be able to further his skills as an academic clinician, educator, advocate and health policy agitator in the coming year. When not practicing medicine, Rob enjoys exploring new places, laughing with friends, reading, writing, going to the cinema, trying new restaurants, and advocating for change.

Dr. Hannah Jackson is coming to us from Yale University where she completed her residency in Internal Medicine-Primary Care. Hannah will be practicing at one of Unity’s outpatient primary care clinics (East of the River) and working the rest of the time with our partners at the Robert Graham Center and HRSA. She hopes to be able to work on areas of health policy that directly impact her primary care patients including payment reform, quality metrics, and practice re-design in the coming year. When not practicing medicine Hannah loves to spend time outdoors, travel, and play ice hockey.

2. Community Health Leadership Development Fellowship

Dr. Melissa V. See was born and raised in Panorama City, California, however, is more recently coming to us from Salt Lake City, Utah. There, she completed her medical education as well as her Family Medicine Residency training. Melissa will be practicing at East of the River/Unity Health Center and working the rest of the time with multiple community partners including Association of Clinicians for the Underserved (ACU), National Association of Community Health Centers (NACHC). She hopes to grow both personally and professionally by teaching residents and medical students, working with community partners, faculty development training, attending and presenting at multiple conferences in the coming year, and working directly with the underserved communities of Washington, D.C. in order to facilitate change not only in these local communities, but communities across these United States. When not practicing medicine Melissa loves to go hiking and take pictures of beautiful landscapes, visit her family and friends back home in LA, as well as, explore new cities through their food, museums, history, culture, and people.  

3. Health and Media Fellowship

Dr. Amber Robins is coming to us from the University of Rochester where she trained in Family Medicine. She also recently graduated with her MBA from Louisiana State University. 

Amber will be practicing at the MedStar Spring Valley clinic and working the rest of the time with our partners at The Newshour on PBS. She hopes to be able to bridge the gap between media and medicine in the coming year with a focus on health care disparities. When not practicing medicine she enjoys listening and playing music on the piano and saxophone. She also likes to spend times with family and friends.

We are so lucky to welcome Dr. Margot Savoy to Georgetown for our September Grand Rounds.

Among many other things, Dr. Savoy is the Medical Director of the Christiana Care Health System Department of Family & Community Medicine in Wilmington, Delaware.

She is very passionate about Vaccine Science and serves on several regional and national committees on immunizations, including The Advisory Committee on Immunization Practices (ACIP), which is a group of medical and public health experts that develops recommendations on the use of vaccines for the US population.

I wanted to know a little bit more about Dr. Savoy beyond her CV. 

Mishori: You were once the American Academy of Family Physicians’ (AAFP) “Vaccine Fellow”. What does that mean? What did you do?

 Savoy: Each year the AAFP selects 2 Vaccine Science Fellows to participate in a year-long fellowship to learn more about the development, research/science, policy and implementation of immunization and vaccination in the US. There is a helpful overview of the program from the just recently graduated fellows in AAFP News. My incredible year was summarized here: http://www.aafp.org/news/opinion/20140219vaccinefellowedl.html

 Mishori: You are known to always wear pearls, even while hiking on vacation. Why?

 Savoy: Pearls are classy and go with everything! They also serve as a constant reminder to me of the commitments I made as a member of Delta Sigma Theta Sorority, Inc.

Mishori: There is a long alphabet soup of credentials after your name:  MD, MPH, FAAFP, FABC, CPE, CMQ, FAAPL. That’s a lot! Can you tell us about what each one means? 

Savoy: I know you know what MD, MPH are already so I’ll skip those.

FAAFP signifies that I’m a fellow of the AAFP. It is an honor any established member of the Academy can apply after you have provided a certain number of years of service, leadership and membership activity.

FABC is the designation I received after finishing my mini-MBA/healthcare leadership  fellowship with the Advisory Board Company. We spent a year learning about healthcare management, politics and finances and how to practically apply them to our roles back home.

 CPE means I’m a board-certified physician executive. I completed a certain level of education, achieved milestones in physician leadership and passed a combination written and oral exam.

 CMQ means I’m board certified in medical quality. I’ve got an advanced degree, practical experience in quality and passed a written exam.

 Last but not least FAAPL means I’ve made enough noteworthy contributions to physician leadership field that I was recognized as a fellow for the American Association of Physician Leaders.

 Mishori: What’s your advice to medical students?

Savoy: My advice to medical students usually begins and ends with choosing the specialty and location that bring you joy. It’s hard work being a physician. Often days can be long and sometimes they can even feel unrewarding. If you choose a specialty you love and a setting to practice where you enjoy, even on your toughest day you will easily find people and moments to be grateful for. I love my family medicine family and if given the chance all over again I would have chosen Family Medicine all over again.

 Mishori: Finally, what’s so grand about Grand Rounds?

Savoy: :Grand Rounds are an opportunity to hear another perspective from outside of your comfort zone. Sometimes you will agree and sometimes not- but either way you will be thinking critically and assessing the topic put before you. The time to slow down and think deeply on a topic is a grand gift!

If you want to know more about Dr. Savoy, you can see her full bio here https://doctors.christianacare.org/details/1959. 

She also blogs, here: https://lifeofafamilydoc.com/

and is on twitter: @MargotSavoy

Join us for:

“The Advisory Committee on Immunization Practices: An Overview, An Update & The On-going Controversy Around Safety”

When: Thursday, September 7, 2017 at 8AM

Where: Georgetown University Medical Center, Building D, Warwick Evans Conference Room

Can’t attend in person? Join us electronically through Zoom at https://georgetown.zoom.us/j/171728235 

Or join by phone: Dial: +1408 638 0968
Meeting ID: 171 728 235