Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How Trainees Improve The Care of Patients

"While we are both subspecialist pediatricians, we are also the parents of an amazing three-year-old boy."


While the experience of being a trainee doesn’t always feel impactful, from our perspective as attending physicians and parents of a sick child, know that what you do matters.

While we are both subspecialist pediatricians, we are also the parents of an amazing three-year-old boy who spent the first month of his life sick in the neonatal intensive care unit. Our son received outstanding care from the doctors, nurses, nurse assistants, and various therapists that cared for him over the course of his admission. We were incredibly grateful, but not surprised by the excellent care. These are the colleagues we work alongside every day and see the expert and compassionate care they provide to all patients. What did surprise us, as junior attendings who recently completed residency, was how strongly we felt about the trainees that were part of his care team.


We vividly remembered often feeling not very impactful as trainees. While we spent a lot of time with patients and families, we also remember all the time spent writing notes, placing orders, and not feeling very helpful. So it caught us both by surprise when we realized that the people we looked forward to seeing the most each day were the residents. While all of our son’s healthcare team was wonderful, ultimately it was the residents that we felt were his best advocates and our biggest source of support and continuity.


After spending the first few nights of our son’s life sleeping at his bedside, we were exhausted, but couldn’t bring ourselves to leave him. It was one of his residents that came to us that afternoon and said, “I’m on call tonight, I’ll keep an eye on him.  You should go home and rest.” We trusted her, and we knew she meant it, so that night we went home and slept. Days later a new supervising physician came on service and proposed a change in plans from the one the previous medical team had created in collaboration with us. It was our son’s primary resident who spoke up and challenged the attending to advocate for the plan she knew we supported. This can be an incredibly difficult thing to do and that brave resident is now part of our family lore.


Here are a few of the things that our son’s residents did that were hugely impactful in his care:


1. Taking ownership.

Trainees often know the patient just as well or even better than the attending. This should empower you to advocate for your patients when needed.


2. Actively listen on rounds.

We were reassured when any resident from our son’s team was on call at night because they were present on rounds every day and knew what the plans would be. Families recognize all the members of the team and it is reassuring to see familiar faces after hours.


3. Check in on your patients.

This can be challenging when days are especially busy, but it stood out to us when our residents checked on us after rounds and in the evenings. Circling back helped close the loop from rounds and also allowed us to ask new questions. It shows that you care to get to know us and our child.


An obvious question for us may be whether our son got better care because we work at this hospital. Working here, we see how hard the trainees work for all patients every day. We know training can be hard and sometimes it feels like you are underappreciated. Know that you do matter and that the smallest action can make a world of a difference for your patients and their families.



This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.