Prepare to be Inspired

Hello everyone,

Please forgive me for turning today’s PD Note over to you. This weekend I have 38 letters of recommendation for fellowship to write and, one way or another, they will be posted on ERAS by tonight. That’s all the writing I can do before my tank runs dry.

You won’t be surprised to learn that the letters extol our trainees’ accomplishments in clinical care, research, and leadership, but by far the richest portions are the quotes lifted from faculty and peer evaluations, which portray our residents’ deep intelligence, creativity, dedication, selflessness, and compassion. They’re profoundly moving and remind us of the wondrous things that can be accomplished when we aspire to high ideals.

Here are some choice examples for your reading pleasure. Pour some coffee and prepare to be inspired:

• When thinking of the proper words to describe Dr. YTIMR*, for some reason the phrase "super awesome" comes to mind. Maybe it's her incredible clinical skills and the way she is able to care for the sickest of patients seemingly effortlessly. Or maybe it's the thoughtful and supportive way she cares for her colleges on even the most stressful of days. Possibly it's the valuable and insightful contributions she consistently makes during morning didactics. Regardless of the reason, it is clear that super awesome is an appropriate way to describe this exceptional resident.
• Dr. YTIMR is a legendary resident. The type of resident who brings her colleagues sushi and coffee on their busy admitting days, and the type of resident who goes down to the stress test lab to place an US guided IV on a patient with difficult access. In addition to her dedication to her colleagues and patients, she is a brilliant and gifted clinician who is able to take care of critically ill patients, seemingly with ease. When it comes to her role as a medical educator, she is a wonderful instructor to interns and medical students. During a code blue she noticed our medical student in the corner and made a clear effort to keep her involved in the care of the patient. Overall Dr. YTIMR is an exemplary resident and I look forward to working with her again.
• What a star! Dr. YTIMR is an extraordinary resident and obviously at home in the fast-paced critical care environment. Although she is a PGY2, her knowledge base and clinical skills are impressive and easily on par with our first-year fellows, who are excellent in their own right. She is a natural leader and a fantastic role model for her interns. Her communication skills are superb.
• Brilliant, dedicated, well-read, compassionate. She is a fierce advocate for her patients. Even in the infancy of her intern year, she functioned at a level that I wished that I had attained at the end of my intern year. She was loved by the nurses and ancillary staff. I shall never forget the moment she prayed with a dying man in the ICU. Her voice may well have been the last that he heard comprehendingly. I learned a lot from watching her practice medicine with intellect and humanity.
• Dr. YTIMR was a real pleasure to work with. She was one of the strongest interns I've worked with in my two years as a resident. She has mastered the "intern" level jobs, and was effectively able to manage a large list of complicated patients on the Peters service…She has a great work ethic and an infectiously-positive attitude, which she spreads to all team members. She will no doubt make a great resident and will succeed in whatever field of medicine she chooses.
• Truly outstanding. Every single family with whom this intern interacted considered Dr YTIMR their doctor. Families bought cards and food to say thank you. I hope she never loses this compassionate and caring demeanor which is both unique and vanishingly rare.
• I LOVED working with Dr. YTIMR. I don’t have the words to describe what a wonderful resident and human being She is! Let’s see, Dr. YTIMR is so fun to be around, she’s positive and joyful and intrigued by medicine- and her spirit is infectious! She teaches at every possible moment, willing to take the time to learn as much from each patient. She was fairly hands off, letting me work through differentials and think on my own. She was uplifting! And she seems to know everything about everything- her medical knowledge is astounding! But also humble. Seriously, you’re awesome Dr. YTIMR, and you made this difficult rotation one of my favorites!
• Dr. YTIMR is an exceptional intern and she really impressed me with her performance on her first inpatient rotation. She has an impressive fund-of-knowledge, presents beautifully, and writes concise, targeted, thorough progress notes. She has wonderful interactions with patients and speaks to them with care and compassion. Dr. YTIMR will go far and has an uncommonly bright future ahead of her.
• Dr. YTIMR is an outstanding physician. He performed exceptionally well on this MICU rotation and exhibited a degree of thoughtfulness that I typically only see in Renal and Pulmonary attendings. He is very intellectual and able to think on his feet and understand complex concepts with seemingly no effort on his part. He easily completed the daily tasks and was efficient and thorough in completing his work, which reflects inherent organizational skills and dedication to excellence. Because he was so consistently prepared for rounds, we could dedicate a substantial amount of time to bedside teaching which allowed me to educate him and the team about ventilators in a much more substantive and meaningful way than usual. He was an avid learner who made teaching a pleasure. The other thing about Dr. YTIMR that I really appreciated was his strong sense of patient ownership. He developed his own plans and clearly did substantial reading about each case. He clearly thought of himself as each patient's physician and took their progress personally. This is also a level of maturity and commitment that is sometimes lost on task oriented individuals and I really appreciated that Dr. YTIMR was 200% trustworthy and reliable
• Dr. YTIM was one of the very best residents I have worked with so far. Her positivity and enthusiasm set an excellent tone for the rotation; I genuinely looked forward to coming into work. She absolutely nailed the balance between autonomy and support, which was critical to my transition from intern to resident just a few months later. She also gave excellent feedback that even further prepared me for this transition. Finally, despite all of the higher-level demands of being a resident, patient care remained her #1 focus; she made an effort to spend as much time at the bedside as possible, and went above and beyond to improve patient experience (even something as small and as powerful as tracking down a patient's cell phone charger so he could Skype with his family abroad).
• Absolutely phenomenal resident. He is so incredibly knowledgeable--I don't think there's anything that he doesn't know--and he is an amazing teacher. He is also so kind and friendly. He is welcoming to all members of the team; moreover, he never hesitates to offer to help. It was a wonderful experience to work with him!
• Dr. YTIMR is a truly extraordinary intern, functioning at the level of a PGY2 on the first rotation of his internship. He is appropriately confident, he is a great team player, and his fund-of- knowledge is as deep as any intern I've ever worked with. He was able to present multiple patients in a row without notes. He has sophisticated insights and is already showing great promise as a teacher. His potential is unlimited. A true star.
• In short, Dr. YTIMR is tremendously devoted to his patients. He brings a joy and energy to the team that truly was the fuel to keep us going. He is optimistic, understanding, and conscientious with patient care. He was well loved by nursing staff and patients. He does whatever it takes to get the necessary tasks done. On one post-call day, Dr. YTIMR was paged regarding a patient's questions about restarting home medications. Dr. YTIMR could have easily deferred this question to the day team, but he completed what he needed to finish and then rushed to the patient's room to counsel him. Patients' families would routinely use the word "love" to describe how they feel about Dr. YTIMR.
• Dr. YTIMR’s dedication her craft is inspirational - in an era of cynicism and corner-cutting she unfailingly goes the extra mile for her patients and pushes herself to understand every detail of their care. This inquisitive spirit will undoubtedly make her an exceptional clinician through her training. I was particularly taken in, however, by her humility; she is clearly endowed with a superb grasp of fundamental medicine and yet she is always willing - better yet, excited - to learn from her peers. This is a rare quality to commended and emulated. Of course, she also possesses a scintillating personality that makes the workroom a brighter place for everybody involved, but this will have been documented by many of my colleagues already.
• Dr. YTIMR’s performance on Peters was incandescent. An intern given to introspection, she was concerned that she had burned out in the MICU. And yet, the extent to which she went for her patients rendered null and void any concerns I had about her burn out. She called families regularly and they relied on her updates and were grateful for them. Her progress notes are concise and among the best in the program. She asked me to teach her things big and small and showed curiosity even on busy days. Her clinical fund of knowledge is where it should be. I think she lives up to the Oslerian tradition of dedicating her formidable head and beautiful heart to the service of the humans lucky enough to be under her care.
• Dr. YTIMR is such a lovely physician. She leads by example, setting a wonderfully accessible tone for interns to aspire to while at the same time maintaining a sense of order and commanding respect. She listens incredible well to patients and encourages them to share their stories, and in doing so, she encourages interns to do the same. She is wonderful doctor who leads by example.
• It was such a pleasure to work with Dr. YTIMR. When I stepped into the CCU it was my first time in an ICU setting and I was overwhelmed. She was so supportive and made me feel very comfortable asking questions and expressing my concerns. She really looked out for me as an intern, considered my wellbeing, and I will remember that and use it as an example of how I would like to treat my interns when I am a senior. In addition, she was very knowledgeable and I trusted her medical opinion
• Dr. YTIMR is an exceptional intern. He is so incredibly knowledgeable--I don't think there is anything that he doesn't know, and he is an excellent teacher. Moreover, he is incredibly kind toward his counters and residents. He goes out of his way to help his co-residents in a way that is truly unparalleled--he never hesitates to pick up an extra patient, to assist with notes/orders, etc. He is so caring towards his patients, and I feel like he really treats them as if they are members of his own family. He is one of, if not the best, interns that I have ever worked with, and it was a pleasure to be on a team with him. He will go far in whatever specialty he selects.
• Dr. YTIMR is one of those residents that interns become excited to work with. She's an absolute team player. Never feels like work for patients is "scut" or "intern only tasks." Never see her without a smile on her face.
• Dr. YTIMR is one of a kind, gentle, smart, friendly and she gets her stuff done in a tremendously effective way. She communicates with her patients in a truly unique way and always manages to deliver complex messages in a soft and clear fashion, her patients truly love her and they are actively asking for her to be in the room when she happens not to be which is a huge compliment. Dr. YTIMR also has a unique sense of humor and is a true pleasure to work with. A friend, a good teacher and colleague, yet another great resident in this medicine program but at the same time a phenomenal and unique individual, truly one of a kind.
• Dr. YTIMR is an incredibly thorough and diligent intern who cares deeply for her patients even beyond the time they are directly under her care. We had a patient who was very skilled at origami and bored with her hospital stay. With extra time at the end of the day, Dr. YTIMR sat and did origami with her instead of going home early, which meant a lot to her patient.
• To put it simply, Dr. YTIMR is an amazing intern. I thoroughly enjoyed having her as an intern. She is capable of handling complex patients and navigating family dynamics. Her patients really felt she was her main doctor and would tell me about they appreciated her care. I witnessed her many times at the bedside, holding her patients’ hands, and caring for them, providing compassion that is oftentimes forgotten during residency. She has a strong clinical foundation and enjoyed watching her growth in a cancer sub- specialty area throughout the rotation. She maintained a level head and enthusiastic work attitude even during long hours and stressors. She is very impressive.
• Dr. Dr. YTIMR was an incredibly supportive resident over the course of two weeks in the CCU. He consistently kept me smiling even during the most stressful of days. When it came to cardiology Dr. YTIMR clearly has an exceptional fund of knowledge and consistently provided valuable contributions on rounds and throughout the day. He is a resident who truly goes to bat for his interns and I felt very supported at all times. When one of our favorite patients developed cardiogenic shock Dr. YTIMR was wonderful with the patient's family, provided clear communication to the rest of the team, and took the initiative to debrief with everyone after the event. In addition to being exceptional towards his interns, Dr. YTIMR was wonderful with our medical student. He would frequently find opportunities to teach our student and support her while also providing her with the autonomy to make decisions and call consults.
• Dr. YTIMR was the perfect senior resident to have in the MICU. She has a sense of tranquility that puts others around her at ease, which made a normally stressful rotation an extremely enjoyable experience. She is so kind to her colleagues, patients, and staff- always with a smile on her face. She is a strong leader- always willing to help out where needed, protecting her interns, and rising to the occasion of handling difficult patient situations with poise. I am so fortunate to have worked with her!
• What I admire the most about Dr. YTIMR is her relaxed, calm, and professional approach to everything she does. In even the most stressful or overwhelming situations, Dr. YTIMR always has a smile on her face, and as an intern, it allows me to also feel calm and know that if I'm on a team with Dr. YTIMR, no patient care issue will be too challenging
• It was such a pleasure to work with Dr. YTIMR for the second time this year. She has a sixth sense for knowing the precise balance between supervision and autonomy required by each intern, which allowed me to grow immensely as a clinician during our time together. She was able to push me to troubleshoot cross-cover issues as they came up, but never let me feel unsupported or unsupervised. When we admitted patients together, she allowed me to make my own decisions, gently redirected me when I was on the wrong track, and equipped me with a systemic approach to situations where I had trouble envisioning the next step. Above all, Dr. YTIMR has embraced her role as a team leader while maintaining a sense of humility. She spoke with authority when she was comfortable with the clinical scenario and was not afraid to ask for help when confronted with new or challenging cases - which meant we got to collaboratively read and troubleshoot together. "I don't know - let's find out" was a common mantra overnight in the CCU. Lastly, I performed my first central line as the primary operator with Dr. YTIMR, and she could not have been a more helpful or supportive supervisor. She was calm and patient, gave clear and precise instructors, and only stepped in when absolutely necessary (which thankfully was very little).
• One of the best residents I've seen in terms of making strong relationships with nursing and ancillary staff. All staff clearly respected, liked her, and saw her as one of their colleagues. Even though she wasn't my resident, she also made sure to include me in learning opportunities in the CCU, especially teaching me how to do procedures. She had excellent rapport with patients and their families, and I could tell that her patients always appreciated the way she would interact with them
• Dr. YTIMR was a star intern and I think is a star resident. She is well rounded in all areas. I will mention a few here. She is super kind and empathetic towards her team and patients. On her on call day, she told her co-resident to stay at home as she (the co-resident) was starting a tough rotation the next day. The rotation was full of other several other examples of watching out for her team. She is very conscientious of her work and makes sure that she leaves no work for her co-resident and offers to help her interns so that they can all get out on time. She provides the same dedication and care to the patients on her sister team. I can never tell which patients belong to which resident. She never hesitates to take on extra work (including patient re-assessment) that helps patient care. On her last call day, she did bedside US on a patient with a complex fluid status and was able to get guidance from the US findings to help us manage the patient better. She was great patients who recognized her on post call days when we walked in. I enjoyed Dr. YTIMR as an intern and I continue to enjoy working with her and seeing her blossom into a great resident.

Enjoy the sunny weather, everyone.

Mark

*YTIMR: Yale Traditional Internal Medicine Resident (if you couldn’t guess)