The GME @ Dentons Team is proud to bring you an interview with our colleague, Rosemarie Fisher, MD. Rosemarie joined the firm's Health Care group as a senior advisor in January 2017. She most recently served as the designated institutional official/director/associate dean of graduate medical education at the Yale-New Haven Hospital and Yale School of Medicine. Rosemarie continues her relationship with Yale as both director of resident/fellow well-being and a professor of medicine and pediatrics.
To help you get to know her better, we interviewed Rosemarie about her GME-related history and her other interests and passions.
Q: Tell us a little about your career path and what first got you interested in graduate medical education.
A: Throughout my undergraduate education and medical school, I
was always interested in teaching. This persisted into residency,
when I discovered that I was extremely interested in the structure
of training programs, the regulations surrounding training
programs, the clinical learning environment and the well-being of
When we hired a new chair in the Department of Medicine, there had been no program director. The chief residents basically ran the program with the department chair. We had had a near miss with a resident accident, and the chiefs were on their own, because the interim chair and the vice-chair were away.
It was at that point that I told the new chair that he needed a program director and I wanted to fill that role. Then, after 12 years as program director, the institutional requirements came into play, and the position of director/associate dean of GME/DIO appeared. I expressed an interest in the position, was offered it, and remained in that position for 18 years. That last role got me hooked on GME.
Q: What's your proudest GME-related accomplishment?
This is a bit difficult, as some of my proudest GME-related accomplishments were near misses. Getting an accreditation instead of a proposed probation. Starting a new program, after having accreditation withdrawn.
There were other great times—chairing the IM-RRC and taking that committee through a rewrite of the core and subspecialty requirements. Working to establish a peer support group. Assisting residents in trouble in achieving their goals. Being awarded one of the first ACGME Parker J. Palmer "Courage to Lead" awards. There are almost too many proud moments to talk about.
Q: What's your best piece of advice to DIOs?
Be sure that you want the job; it's a tough one and requires a lot of time and patience. Be prepared to work with an unbelievable array of people; dealing with all the personalities can be very challenging, but also very rewarding. Be prepared to encounter issues on both the institutional side and the program side that will upset you; they'll also motivate you. Learn that you cannot be a friend to everyone, and try not to take things personally, although that can be very hard at times.
Q: What topics do you think will be important to be on the lookout for in the GME world in 2018?
There is no doubt that the clinical learning environment will be at the forefront of GME issues. Blending the training of residents/fellows into the structure of the institution and including quality improvement and patient safety will take priority over detail-oriented requirements (although those will not disappear).
The other obvious area will be resident/fellow/physician well-being/wellness/resilience and burnout. Burnout is unquestionably on the rise, but we also know that medicine is a 24/7 business and we need to accept this fact and learn how to treat patients in this era. While the clinical learning environment is looking at residents and fellows, we need to also be aware of its effect on our faculty and especially the junior faculty. As our trainees leave the "protection" of the Sponsoring Institution and its programs, they are entering a world that has not changed its culture. Burnout among junior faculty is increasing, which will have a wide-reaching impact on our trainees. This problem needs to be addressed in the coming years.
Q: In what areas of GME do you most enjoy advising residency programs?
I most enjoy advising on communications, relationships and professionalism. I also enjoy helping program directors deal with learners who are having difficulties, not only in learning, but also in such areas as professionalism and communication.
Q: What's your passion outside of the GME world?
My husband and our children, our grandchildren, and travel (with my husband). Another passion is something that has lapsed for too long and is about to begin again–photography.
Rosemarie is part of a team of practitioners with robust GME experience, including Senior Advisors Linda Famiglio, MD and Pat Surdyk, PhD, and attorneys Lori Mihalich-Levin, Susan Banks, Holley Lutz, Charlie Luband, Allison Cohen and Clay Wortham. To learn more about the team's experience, click here. For an archive of all past editions of the GME @ Dentons newsletter, click here.