When you speak with Dr. Fahad Alam, his passion for improving the resident experience is palpable. It is little wonder why he had a hugely successful run as the leader of the department’s Resident Experience Committee (REC). The department recently spoke with Dr. Alam about his time in the role, focusing on his experience, learnings, and future plans.
What is your background?
During my time in the residency program, I was part of the Clinical Investigator Program. My research focus was on medical education-based research. I have a graduate degree in knowledge translation, and I had also spent about six years on the Residency Program Committee, so I was very familiar with the resident perspective.
What led you to take on the wellness lead role?
A few years after I became a staff anesthesiologist, Dr. Lisa Bahrey started as the Director of the Anesthesia Residency Program. At that time, we had a conversation about implementing some wellness initiatives at the resident level. My idea had only been to start some initiatives, but to her credit, Lisa saw the need for more of a focus on wellness, and she asked me to become the wellness lead.
How was the Resident Experience Committee created?
I started the Resident Wellness Committee as the wellness lead, and we used that committee to learn what the trainees were dealing with and to break down the gaps between faculty and residents. When Dr. Soniya Sharma, a resident at the time, joined the committee, along with Lisa, we introduced more feedback documentation, which integrated more overall program feedback at more frequent intervals. After a few years, it became clear that the feedback we were getting went beyond wellness issues. We started to see more issues related to medical education problems and the curriculum and wanted a better way to address these issues. So, once again, I discussed this with Lisa, and we talked about how to gather this honest feedback in a nonconfrontational and safe way, and thus, the Resident Experience Committee (REC) was born.
How did the REC work?
The REC members visited all the fully affiliated sites associated with the Department of Anesthesiology & Pain Medicine at the University of Toronto to gain a better understanding of resident training experiences there. The frequency of these visits varied, and some sites were visited more based on feedback given to the committee. During the visits, the committee discussed various issues, such as education, civility and supervision, with residents and site leadership.
The key findings from the visits were then summarized into a two-page report and presented to the Resident Program Committee (RPC) for review. Action items from the report were delegated to the respective site coordinator to implement and support the changes to improve the learning environment. When matters could not be resolved, it was escalated to the department's Executive Council for further attention and resolution. The reports capturedstrengths and areas of improvement. We also gave feedback so sites could continue to develop and grow.
What was the main goal for the REC when you started?
Our goal was to use whatever information we received from those sessions to influence knowledge translation, action, and accountability with the department and the individual hospital departments. The purpose was Quality Improvement – we wanted to use those fly-in meetings to bolster our knowledge of the program and residents because the details gathered were more comprehensive and timely than feedback surveys.
Under your leadership, what was the most significant improvement or project the REC undertook?
I think the REC was itself a project. But I am most proud of the fact that we were able to give the residents a voice that went beyond just speaking to their site coordinator or department. We were their advocates. We made their views known, and that voice led to action and showed that their concerns weren’t falling on deaf ears. The REC and its work were positively highlighted by the Royal College of Physicians and Surgeons during the 2020 external review, which was also a significant moment for us.
I was also proud of the teamwork. For example, I want to acknowledge Lisa and faculty like Dr. Rebecca Moga, TWH Site Coordinator, who came on at the start of the REC and really took it to heart. We saw a culture shift where sites began to really anticipate the REC reports, which were seen as a valuable information.
What would be your advice to others on how to improve the resident experience?
The most important thing is to listen actively and continually. People change, and their feelings change, so yesterday’s feelings or behaviours may not be relevant today. And then, show that you will act on the feedback, or at least empathize with it in cases where action isn’t possible. It’s also important to remember that we are all on the same side and that we want the best for each other.
What’s next for you?
I agreed to continue as the lead of the REC and to sit on the RPC until a new wellness lead was brought on. Now, we have appointed Dr. Alia Busuttil as the new Wellness Lead, who is fantastic. I’ll be staying on for a bit longer to mentor and support her, and then I’ll hand the REC lead role over to her.It’s good to see thatthe wellness lead portfolio has been strengthened. There’s now much more access to resources and support, which can only enhance its impact.
As for me, my next goal is to continue my work in medical change-based research, but from a leadership, simulation, and continuing education perspective. I’m working with the Canadian Anesthesiologists’ Society and some other national committees, so I’m hoping to grow that further and find my role in that sense.
