By Duretti T. Fufa, MD

In my brand new role as orthopaedic surgery residency program director, I’ve given a lot of thought to change in residency training. I decided to focus this perspective on notable shifts I have observed as well as what I think may be changes on the horizon.

One change has been the increasing discussion surrounding “wellness.” While some of this has been mandated by governing bodies, the societal lens on wellness, work-life balance, work-related stress, or burnout, and suicide, has certainly magnified. This increased awareness relates to all physicians, not just residents, and represents an important cultural shift from the days when skipping routine health maintenance and missing family engagements were the expectation.

Another observation is a shift in our traditional view of residency as an apprenticeship towards viewing the resident as an adult learner. Our understanding of how adults learn in 2018 (less knowledge retained through reading and passive lectures; more interest in mobile- and video-based learning) and duty hour restrictions have forced resident educators to develop new paradigms for engaging residents in their education.

While both of these shifts present challenges to our traditional model for resident education, they also represent opportunities to improve health and happiness, to modernize and make more efficient our academic institutions. Increasingly, residents have more autonomy over their learning process (flipped classroom, elective/research rotations, competency-based models) and receive much needed training in leadership and practice management.

As for the future, I am most excited by efforts to improve coaching and feedback for residents. Two initiatives we are pursuing towards this end include participating in the pilot of the ABOS resident surgical skills assessment program (resident-initiated, mobile-based formative feedback following cases) and providing objective evaluation of simulated surgical skill through an annual “Surgical Games.” Initiatives such as these not only provide residents with feedback, but also allow them to objectively monitor their progress over time and compare themselves to their peers.

I am very excited by the changes I have observed in residency education over the last decade since I was a resident and look forward to contributing to shaping the future!