Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. James Wyant, Program Director of Sentara and Eastern Virginia Medical School's newly established neurology residency program

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Dr. James Wyant, Program Director of Sentara and Eastern Virginia Medical School's newly established neurology residency program · Becker’s Healthcare - Clinical Leadership Podcast

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Hi, everyone. You are listening to the Becker's
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Healthcare podcast.
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Thank you so much for tuning into this
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episode where we are joined by doctor James
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Wyant,
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program director of a new neurology
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residency program supported by Centerra and Eastern Virginia
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Medical School.
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We're gonna be discussing today what it takes
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to get a new physician training program up
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and running, as well as the the retention
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piece and challenges within this process as well.
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Doctor. Wyant, thank you so much for joining
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us today. Excited to have you. Thanks for
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inviting me on.
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Yeah. Well, do you wanna start off let's
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start off with challenges. Can you share
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what you have found to be a big
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challenge in launching and growing the neurology residency
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program, and how has you and other leaders
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worked through it worked through that?
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There have been so very many challenges.
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The
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biggest overarching challenge is that this is a
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a monumental project. It's totally new to me.
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Never been a program director before.
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I work at Sentara,
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which is a regional
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medical provider group in,
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Southeastern Virginia.
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And the
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program is a a Eastern Virginia Medical School
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program, so there's a lot of collaboration between
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organizations.
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And,
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that that collaboration
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and the collaboration between all the very many
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stakeholders
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in this program have really helped overcome the
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biggest challenge, which is that,
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there are so many
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small pieces to
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starting a program like this. There's a a
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lot of paperwork that needs to be completed.
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You gotta develop a a curriculum for training
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the,
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residents that are coming on board. You gotta
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make sure that the faculty
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knows what they're doing. They're well qualified.
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They're invested
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in developing
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as mentors and teachers
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and,
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cultivating
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just a a culture where it's a good
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learning environment invested in in research.
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So your question was, what is the biggest
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challenge?
2:10
The biggest challenge for me has been
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getting a handle on the many moving parts
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and assembling that into one cohesive
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program.
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Yeah. Thanks, doctor Wyatt. Yeah. Definitely so many
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moving parts there, and I imagine that in
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and of itself just makes it so critical
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to have, you know, a great partner that
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that you are working with to stand this
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up.
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A sentiment that I do hear often from
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other leaders when when talking about
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residency programs and fellowships is securing
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buy in from local hospital teams on the
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ground,
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particularly when, you know, those facilities might be
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hosting residents for the the first time and
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then how that can be a real challenge
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at times.
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Have you encountered that dynamic? And if so,
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what lessons,
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have you learned in navigating it or a
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piece of advice you'd share?
3:03
Thank you for asking the question.
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I I very much fear
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that,
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that hesitancy to engage,
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because I know that all the all the
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faculty members, all all the team members that
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are helping make this program exist
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are already working hard at patient care.
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So
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their limited bandwidth
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to
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help start a program is something that I
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was worried that,
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I wasn't gonna get by in, but I
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haven't seen that. In fact,
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every person that I talked to to say,
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hey. Would you help us with interviewing candidates
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or hosting residents? It has been nothing but
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positive feedback.
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So I think I happen to
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land
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in a a community, a, a culture that
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was already
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fertile ground to start a a neurology program.
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So I haven't really faced that yet.
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That that's that's
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been to my benefit.
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You asked for advice that I would give
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to other people,
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facing that,
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trusting the process,
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convincing
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leadership.
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I think it would need to come in
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a top down approach, but convincing leadership and
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then,
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potential faculty members that the residents can add
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value,
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can assist with workflow rather than slow it
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down,
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is gonna be, essential
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to fighting that hesitancy
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to to buy into
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the program. Of course, there's gonna be a
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learning curve.
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Many of the
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faculty
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of my brand new program
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have not
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recently spent a lot of time engaged in
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teaching residents.
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And that's a tough thing to do because,
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medical students
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are still
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learning a lot of the basics of of
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medical care, whereas residents, they're kinda past that,
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and they're learning at a higher level. And
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so that means that the teaching needs to
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occur at a higher level, and that's tough.
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That can slow down,
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clinical workflow
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until you're certain that the residents
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have at least some experience,
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and then they still require supervision.
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But they can really add value. They can
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help see patients
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while they're learning.
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So both the patients
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benefit from that, the faculty members benefit from
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that, and the residents learn from that.
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So you asked the question about whether or
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not I've had trouble securing buy in. I
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have not. Thank goodness.
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Yeah. No. That's great to hear, and I
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think it's an interesting point just around
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where residents can add value. And one of
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the things I've heard too from,
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leaders in in academic medicine and teaching hospitals
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is,
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just seeing evidence to that, like, having residents
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on-site can improve quality.
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So it's interesting point.
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Doctor Wyatt, can you share a little bit
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about how the new residency program is expected
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to improve access to neurological
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care in the region? Obviously,
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you know, with the physician shortage, neurology is
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is a big part of that specialties,
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and what outcomes you're hoping to see.
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Yeah. Regionally
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and nationwide,
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probably globally, there's an insufficient
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amount of,
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neurologic care providers. And that's not just physicians.
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There's,
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not enough
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medical assistants and,
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advanced practitioners and, and nursing staff,
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physical therapists, occupational therapists, etcetera,
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that is required for the collaborative
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team based approach
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that is required for many
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neurologic conditions.
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The need for
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residency training programs is
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one component of,
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what I have seen
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Sentara
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engaging in, which seems like a,
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a concerted effort to
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safeguard the infrastructure for patients'
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access to care.
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So I I think starting this residency
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is going to help,
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expand and and safeguard the the clinical workforce
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years down the line by establishing a pipeline
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of of training.
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And then if we've got a a culture
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that,
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is
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supportive
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of the the residents' well-being,
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they will realize that Sentara and EVMS and
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ODU, it's a a good place to work
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and hopefully
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stay local and continue to provide care for
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for patients in this region.
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My
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direct administrators
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have done a great job
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of shielding me from
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major financial considerations
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here because I know it's a major,
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investment
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by Sentara and EVMS to start up a
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new program like this.
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The the business argument that we made to
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get approval to start this residency
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was that
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our patients need more
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local access to neurology.
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And it took very little convincing
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to get our administrators to recognize the value
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of starting this program.
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The
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Sentara credo is
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we improve health every day.
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And
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we're a medical care providing institution,
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so we're focused on how to best serve
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our community. And my hope is that this
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residency
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accomplishes that,
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improving health care every day
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for our local community,
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by having
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enthusiastic,
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compassionate
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care providers
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trained right here and staying right here.
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Yeah. Absolutely, doctor Weyen. I think
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interesting to hear too, like, the a little
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bit of what you shared there on the
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the business case side and really just sounds
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like it comes down to, you know, there's
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a regional need there for access, and this
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is a sustainable way to to build that
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and and provide that for patients filling a
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gap, so to speak.
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You started to talk a little bit as
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well about
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retention and and well-being and how, you know,
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as residents go through an experience, they'll see
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that this is a good place to work
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and this is where we want to stay.
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And obviously, you know, we see a lot
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of national data that speaks to where you
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train is where you end up practicing for
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a while. So
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how is the program can you talk a
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little bit more about how the program is
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structured
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or how you anticipate,
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Sentara will
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aim to support long term retention of trainees
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in the region?
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The two parts of your question are are
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closely tied. How how we crafted this program
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and how we intend
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to keep,
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our our trainees
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encourage them to remain local and care for
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patients locally. Although, I'm sure that some are
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gonna decide that they they wanna
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pursue careers
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elsewhere. My hope is that, a whole lot
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of them are gonna wanna stay stay here
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and find this to to be a good
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place to work.
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I think it comes down to,
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fostering
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good teamwork,
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and my leadership already does that within the
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department.
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When I joined this department a few years
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ago, because I haven't been here that long
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at at this particular
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location,
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I discovered that,
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all of my colleagues
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liked working with each other and communicated very
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well. And so it's gonna be easy to
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duplicate that model in our residency.
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EVMS
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cares about resident well-being.
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There's no two ways about it. Residency is
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very difficult. You gotta work hard. You're expected
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to do,
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a lot for a lot of people and
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also safeguard your own well-being.
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And EVMS
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and the,
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overarching
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graduate medical
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education,
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department
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is,
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insists that we build that into our, didactic
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curriculum.
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So residents are we're not just gonna be
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supervising them. We're also gonna be teaching them,
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hey.
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How do you become a good neurologist
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and also safeguard your own
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mental
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well-being
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so that you don't get burned out, so
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that you can continue caring for patients in
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your community for a really long time and
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have a a satisfying and fulfilling
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career.
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So that that's
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a wellness and,
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professional growth and
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teaching leadership skills from an early
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phase of the the residency,
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not
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just the clinical nuts and bolts competency
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of,
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how do you understand neurologic disease and come
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up with a game plan for treating a
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patient afflicted by a neurologic disease.
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Yeah. Thanks, doctor Weihen. I think interesting to
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hear on the well-being piece too. It's like
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sounds like it's owned by both, you know,
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stakeholders in terms of there's a a role
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that the university plays and then there the
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medical school, and then there's also a role
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that Sentara plays and it really needs to
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be something that's routine and something that is
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built into,
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the learnings that they're that they're going through.
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Yeah. Absolutely.
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Well, to close us out, doctor Wyant, what
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advice would you give to leaders at other
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hospitals or health systems that are planning to
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either debut a residency for the first time
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or expand their existing
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offerings?
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Advice?
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Good luck. It's a lot of fun, but
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it's a lot of hard work.
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The,
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emphasizing
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the importance of culture,
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is key.
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Don't try to do this alone.
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So
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engage with, faculty members, future faculty members,
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leadership,
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communicate constantly,
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and,
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try to celebrate your progress. It's a a
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huge undertaking. So, it's gonna be a whole
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bunch of small victories that that keep you
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going. Yes. I I crafted a curriculum.
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Yes. I I got
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the leadership to say that we've got the
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financials in place to,
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to pursue this project and,
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be impatient
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because,
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we have just started this residency program.
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So
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we're just barely getting the the project off
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the ground, and we've got a whole lot
14:11
left to go to maintain it and to
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start,
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producing some outstanding
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neurology,
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graduates.
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We've just,
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got our our first class. They're all interns,
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first year neurology residents,
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and
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we are extremely fortunate
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that,
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they're all compassionate and enthusiastic and and great
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people. And so I know that they're gonna
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make great neurologists.
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We are have started
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searching out and interviewing,
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candidates for our second class,
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and we're incredibly fortunate that the pool of
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talent
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is,
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enormous. We've had a lot of interest in
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our program even though it's a
14:58
a new program.
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So for those out there that are considering
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starting a program,
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it is worth it.
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And,
15:07
be patient and gather as many people around
15:11
you as you can that are willing to
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help in any kind of way because I
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definitely could not have done it without a
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whole lot of support. This is,
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in fact, I shouldn't even be using I
15:22
because this is not a solo project.
15:25
There are
15:26
so many people that deserve my
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thanks and admiration because I could not have
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gotten to where
15:34
we are yet without,
15:37
an enormous amount of assistance.
15:40
So
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those are those are my bits of advice
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is you need a lot of people to
15:45
help you is the main the main piece
15:47
of advice.
15:48
Yeah. Absolutely. I I imagine.
15:51
Before we go, do you mind just sharing
15:53
to the number of,
15:56
residents you have in this first class and
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how you anticipate that number growing next year?
16:02
Our our first class is, three residents. Going
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forward, we're gonna have four residents per year.
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So,
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once we fully matriculated,
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residents to fill every class and graduated this
16:14
first class, there'll be a total of 16
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neurology residents,
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here at any one time. And,
16:23
looking forward into the future,
16:25
we might develop some,
16:27
fellowship programs. I I hope that I get
16:29
to be a part of that,
16:31
and that might,
16:33
expand the number of, local trainees.
16:36
It's a
16:38
four year residency. Neurology residency is a a
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four year
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undertaking.
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So 16 total once we're fully up and
16:47
running, but three right now.
16:51
Well, doctor Wyant, thank you so much for
16:53
your time today. Appreciate you being on the
16:55
podcast for such an important topic.
16:58
Well, thank you for letting me talk about
17:00
it. I I love talking about it. It's
17:01
a whole lot of fun, and it's something
17:03
I'm pretty passionate about. So I appreciate you
17:06
asking me questions about it. Let me, spout
17:08
off about it.
17:10
Yeah. Absolutely. I look forward to connecting again.
17:13
Yeah.