Fixing an ankle fracture in the Osler-era green-walled operating room, I silently decided that teaching, research and service would be my life’s work. I had already recognized, as a senior resident, how much fun it was to help a junior resident learn performing a surgery as well as I could have done it myself.
The opportunity to serve the underserved also played a role in that epiphany a quarter century ago. The majority of my role models in residency were in academic medicine (although we rotated with a great group of private surgeons, smartly named “the Four East Group”). I saw great surgeons in both worlds, but I always empathized with the underserved. Being as broke as most of my patients, I had no sense of entitlement and realized early that my life’s work should be for them. Money had to be a very small part of it anyway, as there was little to go around in academics in 1990. I found research interesting, and I published, but my greatest interest was helping people who had no other place to go.
What closed the deal for academics was my wife. Trish liked what I was doing a heck of a lot more in academic medicine, and she has never once complained. The lack of money actually strengthened our marriage, as we lived for what we were doing and took very simple, joyful vacations while scrimping every step of the way to pay for our five children’s needs. While financial times in medicine have generally changed for the worse, they are, remarkably, better in academics these days.
But what really keeps us in academics is the knowledge that we professors have the best teachers: our residents. Where I once taught the repair of simple ankle fractures, evidence-based medicine and decades of experience with complex knee surgery gave me something unique to teach. But the energetic modern resident, who absorbs information like a sponge, is a spectacular teacher as well. My residents routinely update me on the minutiae of areas outside of my expertise – anything that can be clicked, downloaded, or searched. They are perpetual fountains of youth.
In January, I operated on a tragically injured 11-year-old in the middle of the night and was ever so grateful that I could help. That evening, I spoke with Erica, a pony-tailed orthopaedic intern wearing salmon-pink running shoes, who told me the child needed to go to the OR immediately (she was right). Later that night, I worked with Judd, a third-year orthopaedic resident, to surgically manage the child’s mangled extremity. I was humbled by his amazing postoperative care, serious approach and persistent bedside manner.
I am grateful for these experiences as a teacher but also for the way things have changed for the better. In the 1980s, a professor was never questioned. I, on the other hand, am excited to learn from my students. I have stayed in academic medicine because of the opportunity to learn: the orthopaedic resident who spends five years in residency is my key teacher.
Breaking down much of the hierarchy in resident-faculty interactions has yielded real benefits. Students are not as anxious about the possibility of being wrong, (which so often gives rise to the need to always be right). Academic departments—the good ones—focus more on the lives of the med students, residents and faculty. We’re a little like television’s Modern Family—a family with a healthy co-dependency.
In many ways, I view my residents as junior faculty and myself as one of the senior residents. Luckily, we are able to compensate faculty and residents better than what I saw 30 years ago. We do it, in part, by caring for all but with a respectful sense of stewardship.
Modern-day, academic medicine has had a comeuppance, especially at UNM. We are family oriented. We are respectful. We teach, publish and serve all. Amazingly, our professors are teachable.
Bob Schenck
P&C
UNM Department of Orthopaedics & Rehabilitation
