Emergency Medicine

Class of 2015 Graduation – “Legacy and Learning in a Time of Growth”

With the transition from June to July we officially said goodbye to the Class of 2015 and welcomed the Class of 2018 to the UNMC EM family. Below are comments I made at our graduation ceremony this year. We look forward to seeing this new class grow and develop a legacy of their own. After spending a month with them during orientation they are off to a strong start! I’m already planning what to say when they graduate in 3 short years. . .

 There is a predictable beat to residency. Every July we welcome new interns. They are filled with unbridled excitement and boisterous confidence.  They are doctors now and as of July 1, full-fledged emergency medicine residents – something they have been anticipating for at least a year if not longer. As they make it through orientation and embark on their intern rotations, that excitement turns to anxiety, jubilation, exhaustion, sometimes nausea and a whole host of other emotions. They learn for the first time, in many cases, what it means to work 80 hours in a week, to devour the mountain of medical knowledge they will need to do their jobs, all while trying to remember what the outside of the hospital looks like. Second year residents start off in a similar whirlwind. They are asked for the first time to be truly responsible for the flow of the department and the first line in caring for critically ill medical and trauma patients. As the year progresses, their confidence grows and falters and grows and falters until usually (sometime just before third year) they start to get a little swagger because they know what to do most of the time. As third  years, they refine their practice, fill in the gaps in their knowledge, teach younger residents and students and impress us with their management skills. The anxiety of intern year returns at some point in time when they collectively realize they are about to practice full time with no net. But, then a quiet confidence develops in the months before graduation. Because they know (as we do) that they have this down and are ready to be solo practicing emergency physicians.  This brings us to graduation: a day in which we celebrate all that they have achieved, congratulate them for their hard work, thank their families, friends and co-workers for their sacrifices and support, and wish them all well in their future endeavors.

 For many graduation marks the last time we will work with them. For none is it the last time we will think of them. Graduates live on in anecdotes, tall tales, and admonitions to future classes. We amuse or terrify every new class with fables of amazing saves and heartbreaking losses. We recount the triumphs and struggles of each class in order to teach the next class that while the road from student to graduate is not easy, it is achievable and that they too will be able to command a department like the outgoing third years someday soon.

 The legacy the residents leave is far more than individual narratives and good patient stories. Each class as an aggregate leaves a legacy; each class has a personality. As anyone who walked through our department this year (and saw the creative hallway patient storage) can attest, we were busy. We saw the largest number and the sickest percentage of patients our department has ever seen. There were more procedures performed by our graduates than in any other year. We treated more trauma patients than ever. And we did it all without compromising the care our patients received. The legacy of the Class of 2015 is this: when the tsunami hit they figured out how to push themselves faster and do the job better. They did not complain (at least not loudly). They did not throw up their hands and declare that this was too much. During every shift, they rose to the challenge, working harder, smarter, and faster until every last patient was seen and well cared for.  Then they came back for more. The legacy of this class is the embodiment of one of the most amazing qualities our specialty exhibits: whatever you throw at us, we will figure out how to deal with it. Five trauma patients at once? Got it. So many people treated in the ED that the he last hallway bed is actually a rolly chair next to the charge nurse? Got it. Breaking personal records for patients seen in a month? Got it. What felt overwhelming in August, felt almost mundane in May.  In every single one of the graduates’ evaluations this year  a colleague stated how much they admire him/her and wish to be as competent, as confident, and as calm as the graduate. They are a clinically strong group of people and the communities they will serve will be better off by having them.

How did the class of 2015 handle our record year? With a grace, flexibility, patience and level of skill we could not be more proud of.  We look at the class of 2015 and are honored to have them as part of our history.

                                                                                                                                            – Dr. Claudia Barthold

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