Clinical Excellence in Graduate Medical Education: Program Directors Describe their Most Outstanding Residents

Abstract

Objectives: Because limited research has been performed to characterize clinical excellence in graduate medical education, we used qualitative methods to characterize elements most pertinent to excellence in patient care delivered by residents across all medical and surgical specialties.

Methods: Annually, each residency training program director at our large academic medical institution is asked to identify their single most clinically excellent resident and submit a nomination letter for the Frank Coulson Resident Clinical Excellence Award. One hundred and five nomination letters for award-winning residents, as submitted by 38 residency program directors from 2012 to 2018, were independently analyzed by two researchers to identify themes related to clinical excellence.

Results: Seven recurrent themes emerged in these letters: professionalism, being knowledgeable with superior clinical judgment, endearing personal attributes, communication skills, humanism, a commitment to discovery and advancing systems, and effective collaboration with others. Professionalism was described most frequently (261 total mentions), while being extremely knowledgeable and having superior clinical judgment was cited in the highest percentage of letters (86%). The examples depicted in the letters usually included anecdotes from patient care, personal impressions from program directors, and comments from colleagues.

Conclusions: In showing how residency program directors think about excellence in clinical care delivered by their residents, it may now be possible to define clinical excellence in residency training. This work may inform the goals and learning plans of trainees, as well as coaching by faculty, in order to help residents to realize their aspiration to move towards clinical excellence during their training.