Doug Jacobs

Next Generation is a BWH Clinical & Research News (CRN) column penned by students, residents, fellows and postdocs. If you are a Brigham trainee interested in contributing a column, please email bwhclinicalandresearchnews@partners.org. This month’s column is written by Douglas Jacobs, MD, MPH, a resident in the Department of Medicine, who, along with colleagues across several training programs, helped create the Brigham House Staff Council. Jacobs is the council’s inaugural president.

At the Partners HealthCare intern retreat in 2017, several residents and I had a startling realization: This was our first opportunity outside of work to spend time with peer residents across different training programs throughout Partners.

Despite our different paths in medicine, we soon realized that we share similar goals and aspirations for ourselves individually and the Brigham as a whole. We want to spend more time with our patients. We want to help reduce the high rate of physician burnout in our fields and the daily stressors that contribute to them. And we want to develop lifelong friendships and connections across residency programs to sustain us as health care professionals.

We discovered that, though residents have long sat on several committees, at the time there was no resident-only committee focusing on resident issues. Following the retreat, a group of us got together and decided to change that.

In addition to holding working group meetings last year to chart our path forward, we met with members of the hospital leadership team and received input from several residency program directors. Based on these conversations, we drafted a constitution for the Brigham House Staff Council (HSC), outlining how we wanted the group to function.

Witnessing Hard Work Pay Off

From the beginning, our goal for the HSC was to serve as a representative body of residents to help improve resident camaraderie across training programs and facilitate collaboration to improve patient care. In creating the HSC, we hoped that hospital leadership would find the council to be an asset – a direct link to medical trainees at the Brigham. We also hoped that if a resident felt powerless or lost in the bureaucracy of a large academic medical center, they could turn to the HSC to discuss issues that are important to them. We realized that if we better knew our peers across different training programs, paging a consulting resident to aid in a case would be more like an earnest discussion with a familiar colleague rather than an urgent request for someone we hadn’t met before.

By early 2018, our work had paid off. The constitution was unanimously approved by the working group and then endorsed by residents across the Brigham’s residency programs, and the Brigham’s first House Staff Council was born. Thirty-nine residents were elected to the HSC from across 18 residency programs, and our first HSC meeting took place in February. During the meeting, the energy and excitement were palpable. I could barely keep up with jotting down notes. As ideas freely flowed from one resident to another, we realized we had a lot in common despite our different training paths. We aired our hopes and grievances, and, through open dialogue, brainstormed solutions to the complex issues of the day. “How can we tackle the implicit biases against female physicians?” “How can we build camaraderie across training programs?” “How can we improve the employee benefits available to us?” “How can we streamline consults?” The newly elected representatives stuck around long after our meeting ended to make new friends and to continue the vibrant discussion.

Forming Meaningful Partnerships

Thanks to many partnerships that the HSC resident representatives have formed throughout the hospital, we amplified our voice as residents and colleagues asked how they could help.  The accomplishments we list here resulted from team efforts (some of which were underway before the HSC formed); many people and groups were key in getting each of these initiatives approved and implemented.

A priority of HSC has been to create new opportunities to break down siloes within our residency programs. The HSC held its first House Staff Mixer in May, with over 80 residents from across the hospital attended to meet one another in a casual setting. We contributed to a grant application that recently received funding to pilot a new program that provides free meals to residents every evening, beginning at 9 p.m. As residents often work night shifts, it can be socially isolating from friends and family –but we think sitting together for dinner may help build our community. The pilot is possible thanks to support from the Brigham and Women’s Physicians Organization, Food Services, the Partners Trainee Well-Being Task Force, the Partners GME and others.

The HSC joined the Partners Resident/Fellow Well Being Council and other trainees in advocating for a new (portable) disability insurance option. Partners GME had brought this to Human Resources (HR), and the HR team helped identify a new disability policy that becomes available to current residents beginning Oct. 1, 2018. By partnering with former Chief Medical Officer Stan Ashley, MD, “doctor” badges were funded for all residency programs so that female physicians wouldn’t continue to be misidentified as non-physician staff members. We also advocated for extra-small scrubs, a size that was unavailable at the Brigham and will hopefully be made available shortly.

We’ve also tried to improve inter-residency communication at work. The HSC created new “consult primers,” which describe how to tackle the most common reasons for consulting and attached them as reference sheets in Epic. Additionally, we are working with the IS team to revamp the Partner Paging Directory to make it more organized and user-friendly to ensure that pages get to the right person as fast as possible.

The HSC is effective because of the dedicated residents who take time out of their busy schedules to attend the HSC meetings and discuss pertinent topics, and because of the much-appreciated support of Brigham leaders and administrators.

With the election of new representatives earlier this fall, our first year as a House Staff Council has ended. But even as residents move on to illustrious careers in different fields of medicine, this time, our ideas will stay a part of the foundation of the Brigham and Women’s House Staff Council.

If you are a resident and are interested in joining the HSC, we invite you to participate in our elections every September (residents should have received an email with the candidates in your program already this year) or contact us via your program’s representative (email your chief if you don’t know who it is!) Even if you are not an elected representative of your program, all residents are welcome to join our monthly meetings.