Resident Leadership Research Articles

Resident Leadership at Neonatal Resuscitations (Research Abstract)

A key goal of residency training is leading multidisciplinary teams in neonatal resuscitations. Resident competency in neonatal resuscitation program (NRP) and leadership skills may be compromised by insufficient exposure to neonatal resuscitation events.

Two sides of the same coin: The New Communities’ Program, grassroots organizations, and leadership development in two Chicago neighborhoods

ABSTRACTStudies on community development have demonstrated that the presence of local nonprofits with ties to political and economic power holders may lead to a silencing of community voices or a narrowing of civic activity. These studies often overlook intra-neighborhood dynamics and the multiplicity of local organizational responses to broader development initiatives. Using a case study of the New Communities Program (NCP) in 2 low-income neighborhoods of Chicago, I analyze the strategies, programming practices, and tactics implemented by 2 distinct types of community organizations: nonprofit lead agencies and grassroots organizations. Whereas the lead agencies focused on NCP goals of social service provision and relationship building, the grassroots organizations combined community development practices with community organizing in order to expand local development and increase resident leadership skills. These processes, though complementary, also highlight the growing divide between formal development policies that aim to transform the individual and local responses that aim to transform structural inequities.

Black Women Resident Assistants: Seeking and Serving as Bridges, Mentors, Advisors, Filters, and Community Builders

This article reports on a phenomenographic study of Black women undergraduates who were resident assistants in a predominantly White institution (PWI) of higher education. Critical race feminism, namely intersectionality, was used to explore how they navigated the responsibilities of their position and social identities. Findings are that participants navigated the resident assistant leadership role and their social identities by (a) engaging in relational service, (b) tentatively negotiating the expression of their social identities and related oppressions, and (c) seeking support responsive to their multiply intersecting social identities. How they navigated their status identities and social identities varied according to their sense of obligation to serve residents and sense of risk in expressing (some) social identities and related experiences. Recommendations for continued professional leadership development of resident assistants are provided.

Whither the Pulmonary Ward Attending? Preserving Subspecialty Exposure in United States Internal Medicine Residency Training.

Twenty years ago, the term "hospitalist" was coined at the University of California-San Francisco (San Francisco, CA), heralding a new specialty focused on the care of inpatients. There are now more than 50,000 hospitalists practicing in the United States. At many academic medical centers, hospitalists are largely replacing subspecialists as attendings on the inpatient medicine wards. At University of California-San Francisco, this has been accompanied by declining percentages of residency graduates who enter subspecialty training in internal medicine. The decline in subspecialty medicine interest can be attributed to many factors, including differences in compensation, decreased subspecialist exposure, and a changing research funding landscape. Although there has not been systematic documentation of this trend in pulmonary and critical care medicine, we have noted previously pulmonary and critical care-bound trainees switching to hospital medicine instead. With our broad, multiorgan system perspective, pulmonary and critical care faculty should embrace teaching general medicine. Residency programs have instituted creative solutions to encourage more internal medicine residents to pursue careers in subspecialty medicine. Some solutions include creating rotations that promote more contact with subspecialists and physician-scientists, creating clinician-educator tracks within fellowship programs, and appointing subspecialists to internal medicine residency leadership positions. We need more rigorous research to track the trends and implications of the generalist-specialist balance of inpatient ward teams on resident career choices, and learn what interventions affect those choices.

Emergency Medicine Faculty Are Poor at Predicting Burnout in Individual Trainees: An Exploratory Study.

Burnout is common among emergency medicine (EM) physicians, and it is prevalent even among EM trainees. Recently proposed Accreditation Council for Graduate Medical Education requirements encourage faculty to alert residency leadership when trainees display signs of burnout. It remains uncertain how trainees experiencing burnout can be reliably identified. We examined if EM faculty advisers at one institution can accurately predict burnout in their EM resident advisees. In this cross-sectional, exploratory study at a single institution, we measured EM trainee burnout using the Maslach Burnout Inventory through a confidential, electronic survey. We subsequently asked EM faculty to predict if their designated advisees were experiencing burnout through a separate confidential, electronic survey. Burnout results were dichotomized from each survey and compared using a 2 × 2 contingency table and Fisher's exact test. Thirty-six of 54 (66.7%) eligible EM trainees completed the burnout assessment. Eleven of 19 (57.9%) eligible faculty advisers completed trainee burnout predictions, resulting in 30 of 54 (55.6%) trainees who completed the burnout assessment and had a faculty burnout prediction. Trainees reported an overall burnout rate of 70.0% (95% confidence interval [CI] = 53.6% to 86.4%). Cumulative faculty predictions of trainee burnout resulted in an overall burnout rate of 16.7% (95% CI = -5.3% to 38.7%). The sensitivity and specificity of faculty predictions of trainee burnout were 19.1% (95% CI = 5.5% to 41.9%) and 88.9% (95% CI = 51.8% to 99.7%), respectively. Faculty prediction of trainee burnout had a positive predictive value of 80.0% (95% CI = 28.4% to 99.5%) and a negative predictive value of 32.0% (95% CI = 15.0% to 53.5). The difference between trainees' reported rate of burnout and faculty predictions of trainee burnout was significant (p < 0.001). Emergency medicine faculty prediction of trainee burnout was poor. Education on recognizing burnout and other methods of identifying trainee burnout may be necessary.

Practices and attitudes towards radiation risk disclosure for computed tomography: survey of emergency medicine residency program directors.

The purposes of this study were to evaluate the frequency with which emergency physicians involved in residency leadership disclose potential malignancy risks from computed tomography (CT), assess comfort with these discussions, and evaluate factors influencing risk disclosure. We surveyed emergency medicine residency program directors and associate/assistant directors. Primary outcome was the proportion who "almost always" or "most of the time" discussed potential risks. Two hundred and seventy-four (50.6%) of 542 eligible physicians responded. There were 82.1% (95% CI 76.8%, 86.6%) who reported almost always or most of the time discussing potential risks for patients ≤18years; proportions for adults 19-40, 41-65, and >65years were 50.6% (95% CI 44.4, 56.7%), 20.7% (95% CI 16.0, 26.0%), and 5.2% (95% CI 2.9, 8.5%), respectively (test for trend, p<0.001). The proportion reporting being "extremely" or "very" comfortable discussing risks was 57.1% (95% CI 51.1, 63.2%). Patient/family CT request that the physician felt was not indicated was of "very high" or "high" importance for driving risk discussions in 86.4% of respondents. For 75.5%, patient/family query about radiation risks was of "high" or "very high" importance. Among 57.4% of respondents, the patient being elderly and/or having a reduced life expectancy was of "high" or "very high" importance in the decision not to discuss risk. Emergency physicians involved in residency leadership report frequently disclosing potential malignancy risks from CT at frequencies inversely proportional to patient age. About half are comfortable with discussions, and many discussions are driven by patient requests. Opportunities exist to optimize and standardize emergency department CT radiation risk disclosure practices.

The University of North Carolina Medical Center pharmacy resident leadership certificate program.

The development and implementation of a certificate program for pharmacy residents are described. University of North Carolina (UNC) Medical Center met the call for increased efforts in the area of pharmacy residency leadership training through the design, implementation, and evaluation of a leadership certificate program. The purpose of the UNC certificate program is to develop leaders who will serve others, improve their communities, and advance the profession. The program is designed to (1) foster self-awareness, social awareness, and altruism, (2) provide transferable and individualized leadership experiences, (3) enrich other residency components through integration of leadership development opportunities, and (4) create role models for departmental leadership. A team of preceptors and residents implemented the certificate program by integrating program components into the existing pharmacy residency infrastructure. The certificate program includes required and flexible components to allow residents to set and achieve their determined leadership development goals. Overall, residents are satisfied with the program and perceive it as worthwhile. During the first 3 years since implementation of the certification initiative, program facilitators improved the feasibility of, participant engagement in, and sustainability of the program. Future directions include an effectiveness evaluation and a "scale-up" to other institutions. The need for a pharmacy residency leadership certificate was met by designing, implementing, and evaluating such a program at UNC. Through its first 3 years, the program was feasible, sustainable, and valued by program participants.

Resident and Early Career Leadership Track

Resident and Early Career Leadership Track

Demographics and Fellowship Training of Residency Leadership in EM: A Descriptive Analysis

IntroductionEmergency medicine (EM) fellowships are becoming increasingly numerous, and there is a growing trend among EM residents to pursue postgraduate fellowship training. Scant data have been published on the prevalence of postgraduate training among emergency physicians. We aimed to describe the prevalence and regional variation of fellowships among EM residency leadership.MethodsWe conducted an online anonymous survey that was sent to the Council of EM Residency Directors (CORD) membership in October 2014. The survey was a brief questionnaire, which inquired about fellowship, secondary board certification, gender, and length in a leadership position of each member of its residency leadership. We separated the responses to the survey into four different geographic regions. The geographic regions were defined by the same classification used by the National Resident Matching Program (NRMP). We defined residency leadership as program director (PD), associate PD and assistant PD. Residencies that did not complete the survey were then individually contacted to encourage completion. The survey was initially piloted for ease of use and understanding of the questions with a select few EM PDs.ResultsWe obtained responses from 145 of the 164 Accrediting Council for Graduate Medical Education-accredited EM residencies (88%). The fellowship prevalence among PDs, associate PDs, and assistant PDs was 21.4%, 20.3%, and 24.9% respectively. The most common fellowship completed was a fellowship in toxicology. Secondary board certification among PDs, associate PDs, and assistant PDs was 9.7%, 4.8%, and 2.9% respectively. Eighty-two percent of PDs have at least five years in residency leadership. Seventy-six percent of PDs were male, and there was a near-even split of gender among associate PDs and assistant PDs. The Western region had the highest percentage of fellowship and or secondary board certification among all levels of residency leadership.ConclusionThere is a low prevalence of fellowship training and secondary board certification among EM residency leadership, with the most common being toxicology. Assistant PDs, the majority of whom had less than five years residency leadership experience, had the highest percentage of fellowship training. There may be a regional variation in the percentage of residency leadership completing postgraduate training.

A landscape analysis of leadership training in postgraduate medical education training programs at the University of Ottawa

There is growing recognition of the importance of physician leadership in healthcare. At the same time, becoming an effective leader requires significant training. While educational opportunities for practicing physicians exist to develop their leadership skills, there is a paucity of leadership opportunities for post graduate trainees. In response to this gap, both the Royal College of Physicians and Surgeons of Canada and the Association of Faculties of Medicine of Canada have recommended that leadership training be considered a focus in Post Graduate Medical Education (PGME). However, post-graduate leadership curricula and opportunities in PGME training programs in Canada are not well described. The goal of this study was to determine the motivation for PGME leadership training, the opportunities available, and educational barriers experienced by PGME programs at the University of Ottawa. An electronic survey was distributed to all 70 PGME Program Directors (PDs) at the University of Ottawa. Two PDs were selected, based on strong leadership programs, for individual interviews. The survey response rate was 55.7%. Seventy-seven percent of responding PDs reported resident participation in leadership training as being "important," while only 37.8% of programs incorporated assessment of resident leadership knowledge and/or skills into their PGME program. Similarly, only 29.7% of responding residency programs offered chief resident leadership training. While there is strong recognition of the importance of training future physician leaders, the nature and design of PGME leadership training is highly variable. These data can be used to potentially inform future PGME leadership training curricula.

Leadership for All: An Internal Medicine Residency Leadership Development Program.

Developing effective leadership skills in physicians is critical for safe patient care. Few residency-based models of leadership training exist. We evaluated residents' readiness to engage in leadership training, feasibility of implementing training for all residents, and residents' acceptance of training. In its fourth year, the Leadership Development Program (LDP) consists of twelve 90-minute modules (eg, Team Decision Making and Bias, Leadership Styles, Authentic Leadership) targeting all categorical postgraduate year (PGY) 1 residents. Modules are taught during regularly scheduled educational time. Focus group surveys and discussions, as well as annual surveys of PGY-1s assessed residents' readiness to engage in training. LDP feasibility was assessed by considering sustainability of program structures and faculty retention, and resident acceptance of training was assessed by measuring attendance, with the attendance goal of 8 of 12 modules. Residents thought leadership training would be valuable if content remained applicable to daily work, and PGY-1 residents expressed high levels of interest in training. The LDP is part of the core educational programming for PGY-1 residents. Except for 2 modules, faculty presenters have remained consistent. During academic year 2014-2015, 45% (13 of 29) of categorical residents participated in at least 8 of 12 modules, and 72% (21 of 29) participated in at least 7 of 12. To date, 125 categorical residents have participated in training. Residents appeared ready to engage in leadership training, and the LDP was feasible to implement. The attendance goal was not met, but attendance was sufficient to justify program continuation.

Teaching leadership in trauma resuscitation: Immediate feedback from a real-time, competency-based evaluation tool shows long-term improvement in resident performance.

Limited data exist on how to develop resident leadership and communication skills during actual trauma resuscitations. An evaluation tool was developed to grade senior resident performance as the team leader during full-trauma-team activations. Thirty actions that demonstrated the Accreditation Council for Graduate Medical Education core competencies were graded on a Likert scale of 1 (poor) to 5 (exceptional). These actions were grouped by their respective core competencies on 5 × 7-inch index cards. In Phase 1, baseline performance scores were obtained. In Phase 2, trauma-focused communication in-services were conducted early in the academic year, and immediate, personalized feedback sessions were performed after resuscitations based on the evaluation tool. In Phase 3, residents received only evaluation-based feedback following resuscitations. In Phase 1 (October 2009 to April 2010), 27 evaluations were performed on 10 residents. In Phase 2 (April 2010 to October 2010), 28 evaluations were performed on nine residents. In Phase 3 (October 2010 to January 2012), 44 evaluations were performed on 13 residents. Total scores improved significantly between Phases 1 and 2 (p = 0.003) and remained elevated throughout Phase 3. When analyzing performance by competency, significant improvement between Phases 1 and 2 (p < 0.05) was seen in all competencies (patient care, knowledge, system-based practice, practice-based learning) with the exception of "communication and professionalism" (p = 0.56). Statistically similar scores were observed between Phases 2 and 3 in all competencies with the exception of "medical knowledge," which showed ongoing significant improvement (p = 0.003). Directed resident feedback sessions utilizing data from a real-time, competency-based evaluation tool have allowed us to improve our residents' abilities to lead trauma resuscitations over a 30-month period. Given pressures to maximize clinical educational opportunities among work-hour constraints, such a model may help decrease the need for costly simulation-based training. Therapeutic study, level III.

The Residency Leadership’s Role in Resident Support and Well-Being

The Residency Leadership’s Role in Resident Support and Well-Being

Design and Feasability of a Service-Free Resident Leadership Curriculum

Design and Feasability of a Service-Free Resident Leadership Curriculum

Rating the Quality of Entrustable Professional Activities: Content Validation and Associations with the Clinical Context.

Entrustable professional activities (EPAs) have been developed to assess resident physicians with respect to Accreditation Council for Graduate Medical Education (ACGME) competencies and milestones. Although the feasibility of using EPAs has been reported, we are unaware of previous validation studies on EPAs and potential associations between EPA quality scores and characteristics of educational programs. Our aim was to validate an instrument for assessing the quality of EPAs for assessment of internal medicine residents, and to examine associations between EPA quality scores and features of rotations. This was a prospective content validation study to design an instrument to measure the quality of EPAs that were written for assessing internal medicine residents. Residency leadership at Mayo Clinic, Rochester participated in this study. This included the Program Director, Associate program directors and individual rotation directors. The authors reviewed salient literature. Items were developed to reflect domains of EPAs useful for assessment. The instrument underwent further testing and refinement. Each participating rotation director created EPAs that they felt would be meaningful to assess learner performance in their area. These 229 EPAs were then assessed with the QUEPA instrument to rate the quality of each EPA. Performance characteristics of the QUEPA are reported. Quality ratings of EPAs were compared to the primary ACGME competency, inpatient versus outpatient setting and specialty type. QUEPA tool scores demonstrated excellent reliability (ICC range 0.72 to 0.94). Higher ratings were given to inpatient versus outpatient (3.88, 3.66; p = 0.03) focused EPAs. Medical knowledge EPAs scored significantly lower than EPAs assessing other competencies (3.34, 4.00; p < 0.0001). The QUEPA tool is supported by good validity evidence and may help in rating the quality of EPAs developed by individual programs. Programs should take care when writing EPAs for the outpatient setting or to assess medical knowledge, as these tended to be rated lower.

A medical school's approach to meeting the challenges of interdisciplinary global health education for resident physicians.

Following a similar trend among United States (US) medical students, US resident physicians are increasingly interested in pursuing global health education. Largely, residency education has lagged behind in addressing this demand. Time and curriculum requirements make meeting this need challenging. The Office of International Activities (OIA) at University of North Carolina-Chapel Hill (UNC-CH) was founded to provide support to students and residents in the area global health. In order to more fully understand resident physicians' attitudes and educational needs, a survey of incoming residents was undertaken. The OIA administered a survey for incoming first-year residents of all specialties in July 2012. The survey was administered over one month using Qualtrics® and the response rate was 60%. Although 42% of residents had had an international experience during medical school, only 36% reported they felt prepared to address issues of international public health, including travel medicine and immigrant health. Significant barriers to involvement in global health opportunities in residency education were identified, including lack of time, finances and mentorship. As has been previously documented for global health education for medical students, this study's residents saw significant barriers to international electives during residency, including lack of elective time, finances and family responsibilities. In response to the survey results, an interdisciplinary educational initiative was developed at our school. This included obtaining buy-in from core residency leadership, establishing a pathway to arrange experiences, competitive scholarships for travel, and initiation of interdisciplinary educational opportunities. Results may serve as a useful model for other academic centers in developed countries.

Capsule Commentary on Lafreniere et al., Burned Out at the Bedside: Patient Perceptions of Physician Burnout in an Internal Medicine Resident Continuity Clinic.

L afreniere et al. 1 found that physicians with higher reported rates of depersonalization were perceived as more empathic and enabling by their patients. Also, higher physician emotional exhaustion scores did not significantly correlate with patient perceptions of empathy or enablement. Internal medicine resident physician burnout is common, and has been the focus of many interventions over the past several years. The revamping of resident duty hour restrictions in 2011, among other goals, was implemented with the intention of limiting physician burnout and therefore improving quality of care provided to patients. Subsequent studies have shown that burnout did not significantly change after the 2011 duty hour restrictions were implemented, which makes this study by Lafreniere et al. all the more meaningful. As we continue to tweak duty hours and empower residency leadership to actively focus on reducing resident physician burnout rates, the intended outcomes may be years in the making, and it is important to consider whether resident perceptions of burnout are affecting their delivery of patient care. This study suggests that patients do not consider their burnt-out resident physicians to be providing them with inadequate care. While minimizing burnout is important for residents’ wellbeing, it is reassuring that patients’ rating of empathy does not appear to be suffering, regardless of the degree of emotional exhaustion reported by resident physicians. Given the nature of the study, it is difficult to ascertain whether resident depersonalization is what is being perceived as empathic or enabling by the patient, or whether the strongly empathic residents are those that rate their own emotional exhaustion more critically. It would be useful to establish whether a causal relationship exists between residents reporting higher levels of depersonalization and being perceived as more enabling because they are, in fact, not as emotionally involved in the shared decision-making process, resulting in patient perceptions of increased enablement. Future research could help to establish causality, although this would be difficult given the inherent lability in perceptions of emotional delivery.

How Do Emergency Medicine Residency Programs Structure Their Clinical Competency Committees? A Survey.

The Accreditation Council for Graduate Medical Education (ACGME) recently has mandated the formation of a clinical competency committee (CCC) to evaluate residents across the newly defined milestone continuum. The ACGME has been nonproscriptive of how these CCCs are to be structured in order to provide flexibility to the programs. No best practices for the formation of CCCs currently exist. We seek to determine common structures of CCCs recently formed in the Council of Emergency Medicine Residency Directors (CORD) member programs and identify unique structures that have been developed. In this descriptive study, an 18-question survey was distributed via the CORD listserv in the late fall of 2013. Each member program was asked questions about the structure of its CCC. These responses were analyzed with simple descriptive statistics. A total of 116 of the 160 programs responded, giving a 73% response rate. Of responders, most (71.6%) CCCs are chaired by the associate or assistant program director, while a small number (14.7%) are chaired by a core faculty member. Program directors (PDs) chair 12.1% of CCCs. Most CCCs are attended by the PD (85.3%) and selected core faculty members (78.5%), leaving the remaining committees attended by any core faculty. Voting members of the CCC consist of the residency leadership either with the PD (53.9%) or without the PD (36.5%) as a voting member. CCCs have an average attendance of 7.4 members with a range of three to 15 members. Of respondents, 53.1% of CCCs meet quarterly while 37% meet monthly. The majority of programs (76.4%) report a system to match residents with a faculty mentor or advisor. Of respondents, 36% include the resident's faculty mentor or advisor to discuss a particular resident. Milestone summaries (determination of level for each milestone) are the primary focus of discussion (93.8%), utilizing multiple sources of information. The substantial variability and diversity found in our CORD survey of CCC structure and function suggest that there are myriad strategies that residency programs can use to match individual program needs and resources to requirements of the ACGME. Identifying a single protocol for CCC structure and development may prove challenging.

Public Health and Preventive Medicine Meet Integrative Health: Applications of Competency Mapping to Curriculum Education at the University of Michigan.

The University of Michigan School of Public Health Preventive Medicine Residency (UMSPH PMR) Integrative Medicine Program (IMP) was developed to incorporate integrative medicine (IM), public health, and preventive medicine principles into a comprehensive curriculum for preventive medicine residents and faculty. The objectives of this project were to (1) increase the preventive medicine workforce skill sets based in complementary and alternative medicine and IM that would address individual and population health issues; (2) address the increasing demand for evidence-based IM by training physicians to implement cost-effective primary and secondary prevention services and programs; and (3) share lessons learned, curriculum evaluations, and best practices with the larger cohort of funded IM PMR programs. The UMSPH PMR collaborated with University of Michigan IM faculty to incorporate existing IM competencies with those already established for preventive medicine and public health residency training as the first critical step for IMP curriculum integration. Essential teaching strategies incorporated didactic and practicum methods, and made use of seasoned IM faculty, along with newly minted preventive medicine integrative teaching faculty, and PMR resident learners as IM teachers. The major components of the IMP curriculum included resident participation in IMP Orientation Sessions, resident leadership in epidemiology graduate IM seminars, resident rotations in IM month-long clinical practicums, resident participation in interprofessional health system-wide IM clinical case conferences, and PMR faculty enrollment in the renowned Faculty Scholars Program in Integrative Healthcare. This paper describes the novel interdisciplinary collaborations and key curriculum components that resulted in the IMP, as well as evaluation of strengths, weaknesses, and lessons learned.

Calling All Resident-Fellow Members!

Back to table of contents Previous article Residents’ ForumFull AccessCalling All Resident-Fellow Members!Lara Cox, M.D.Lara CoxSearch for more papers by this author, M.D.Published Online:19 Feb 2015https://doi.org/10.1176/appi.pn.2015.2b40APA’s annual meeting has been one of the highlights of each year since I was in medical school. I remember feeling so welcomed by everyone I met, from the other students in PsychSIGN to senior members of APA. I gained an understanding that I am part of an extensive community of psychiatrists who are dedicated to their patients, their work, and their profession and that APA brings all of these physicians together. As a resident-fellow member (RFM), I have discovered even more of the opportunities that the organization has to offer, including the many RFM-specific events at the annual meeting.Some of the offerings for RFMs, including MindGames, the Chief Resident Leadership Conference, and the two student and resident poster sessions, have been around for a number of years (see schedule below). The Resident Track was formally established during the 2014 meeting and consists of sessions designed by and for RFMs. This year, the track includes a number of talks on professional-development topics, ranging from becoming a therapist and getting started in practice to becoming involved in scholarly activity and developing skills for media writing, giving a lecture, and use of social media. There is also a particular focus on physician wellness, including trainee mental health. Dr. Ravi Shah, the RFM trustee-elect, will be co-leading a forum on resident mental health with Dr. Matt Goldman. “Residency is an important time to intervene,” commented Dr. Shah, “since it is a particularly formative moment in a physician’s career in which we begin to establish patterns of balancing work, life, and our own well-being.”Last year, Dr. Renȳe Binder, APA’s incoming president, joined us for an RFM caucus meeting that became an incredibly productive discussion about technology and communication at APA. In 2015, Dr. Paul Summergrad, APA president, will be holding an official session for conversation with RFMs; I also plan to invite current and incoming leaders from the Board of Trustees and the Assembly to join us at the Resident Resource Center to give RFMs the chance to communicate directly with the organization’s leadership. Along with serving as a gathering place and lounge (with a comfortable place to charge your phone!), the Resident Resource Center will host many other informal events specifically for RFMs. The Resident Resource Center will be located in in the Toronto Convention Centre in Room 809, Level 800, South Building. Many other career development and networking activities will be scheduled at the center. We will be inviting the leaders of the subspecialty professional organizations to join us for lunch each day, which is always a wonderful opportunity to hear about their career trajectories and how to get involved with the subspecialty groups. We will also be holding a CV bootcamp with the Association of Academic Psychiatrists to help RFMs polish their CVs for fellowship applications or the job hunt. And we will be holding other informal sessions on several topics, potentially including issues such as finances, contract negotiations, residents as teachers, transitioning from resident to attending, and meditation and wellness in medicine. If you have ideas for a session or would like to participate in leading one, please contact me at [email protected].With the ever-growing number of designated resources and mentoring and leadership opportunities that APA has to offer, this is an amazing time to be an RFM. And the annual meeting in Toronto will be no exception. I can’t wait to see you all there! ■Lara Cox, M.D., a fourth-year resident at New York University, is the resident-fellow trustee on the APA Board of Trustees. ISSUES NewArchived