The University of Michigan Hospitals – Michigan Medicine and its Ann Arbor Medical School – boast some of the highest rankings in the nation for their hospital performance and anesthesiology program. With its dedication to diversity, education, and a culture that encourages excellence, the deserving group of anesthesiologists, residents, and students make a strong case for leading with intention. Through clinical bootcamps, mentoring, and a leading research facility, the programs at University of Michigan Hospitals attract a diverse, robust group that stand at the forefront of the field.

Accolades

Among other distinguished rankings, the University of Michigan Hospitals – Michigan Medicine has been ranked #11 for Best Hospitals Honor Roll, the #1 Hospital in Michigan, and the #1 Hospital in Detroit. Its Ann Arbor Medical School boasts the honor of #15 in Best Medical Schools and #6 for Best Anesthesiology Program. But while these rankings are impressive, and certainly something to be proud of, George Mashour, MD, PhD, Department of Anesthesiology Chair and Robert B. Sweet Professor of Anesthesiology, neuroscience graduate program faculty member, and Professor of Neurosurgery, said the aspect of his facility he is most proud of is the culture. “Not only do I regard my team members as outstanding clinicians, educators, and researchers, I also regard them as outstanding human beings,” he said. “In our department, we care about the quality of our accomplishments, but we care more about the quality of our relationships with one another.” In a nutshell, Dr. Mashour said the team at University of Michigan Hospitals strives to be elite, but not elitist.

George Mashour, MD, PhD

George Mashour, MD, PhD

Matt Wixson, MD, Associate Chair for Diversity, Director of Medical Student Education, University of Michigan, Ann Arbor Medical School, said that the greatest strength the system has is the collaboration of many strong individuals working together. “We continually boost each other up and become stronger by working together,” he said. Emily Peoples, MD, Associate Residency Program Director and Internship Director, University of Michigan – Michigan Medicine, added that the honors are a testament to the collaboration across the disciplines and teams to realize the strategic pillars driving the mission at Michigan Medicine: people, discovery, care, service, and education.

Emily Peoples, MD

Emily Peoples, MD

Prioritizing education

Within those pillars, the team's dedication to education both in its medical school and its hospital walls is evident. The anesthesiology program at Ann Arbor Medical School was ranked #1 in NIH funding in 2020, allowing residents to enjoy unparalleled access to research mentors and support that lays the foundation for a career in academic anesthesiology that will continue to advance the field, Dr. Peoples said. But whether the anesthesiology team is working with its medical students or residents, the focus remains the same: continuous improvement, innovation, and a curriculum that is fresh and relevant, she added.

When students enter the anesthesiology program, they are met with educators who are honest and open about their own journeys through the field, who want to invest in students, and who take the time to get to know students and their dreams, Dr. Wixson said. “We are intentional about knowing our students well, giving honest feedback and review, and walking alongside them as they go through their own journey into the field,” he said. As residents, that journey includes opportunities to further develop their passions and position them for leadership positions, including participation in departmental committees pertaining to patient safety, quality improvement, wellness, and education, Dr. Peoples said. In addition, residents have access to GME programs at the University of Michigan such as the Community of Medical Educators in Training, Healthcare Administration Scholars Program, and Health Equity Scholars Program.

The health system's internship curriculum includes the Community-Led Interpretation for Medical Equity, or CLIME, program. The CLIME program integrates experiences to develop skills in communication, cultural humility, leadership, interprofessionalism, motivation, empathy, and emotional intelligence, achieved through collaboration with other units and departments across the Michigan Medicine health system to leverage the breadth and depth of expertise of the larger team, Dr. Peoples explained.

For example, “Interns spend time shadowing anesthesia techs and perioperative nurses for their interprofessional experience to learn firsthand the scope of work carried out by these critical team members and engage in discussions about how we as anesthesiologists can help cultivate a thriving team dynamic to optimize patient care,” Dr. Peoples said. Through the use of trained professional actors, interns have the opportunity to practice delivering serious news and having compassionate conversations with collaborators, she added. The team provides bystander training and hosts a series of journal club discussions focused around health care disparities that provide direct connections to the care provided as anesthesiologists. A focus on wellness and coping skills is achieved through sessions addressing the emotional impact of clinical care and secondary trauma arising from unexpected clinical outcomes.

After completing their CLIME rotation, interns progress on to their OR anesthesia orientation, which has been nicknamed “bootcamp.” That bootcamp involves intraoperative anesthetic care provided by an intern paired with a senior resident mentor, along with procedural simulation, emergency scenario training, and didactics on foundational anesthesia topics, including the most commonly used perioperative medications, she said. Following bootcamp, the interns are prepared for promotion to their CA-1 year and the associated clinical anesthesia rotations.

Leading through diversity: the RADAR initiative

Throughout that journey, a focus on diversity is maintained, including empathy and understanding exercises. Dr. Peoples explained that interns interact with a patient panel to hear their stories and shadow patients through their perioperative experience to gain the patient perspective. Of course, that training is just one element of the University of Michigan Hospitals' dedication to diversity and inclusion. Dr. Peoples attributes the health system's ability to provide better-informed patient-centered care to the institution's intentional focus on fostering a vibrant, diverse, and inclusive environement.

To foster that value, the University of Michigan Hospitals developed the Raising Anesthesiology Diversity and Anti-Racism (RADAR) initiative, a priority among the anesthesiology teams both in the hospital and medical school. Dr. Wixson said the team is taking a comprehensive look at what it takes to lead in the diversity space in the U.S. “Racial and socioeconomic unrest exposed fault lines in the U.S., where disparities, including in medicine, are present,” he said. “The goal of RADAR and its board is to understand these multi-faceted problems and live up to the ideals of patients with racial, gender, geographic, and socioeconomic diversity.” Dr. Wixson added that part of that effort involves discussing what equity means, how to create diverse and cohesive departments, and how to cultivate a group of leaders within the field that will develop inclusive policies and procedures. Dr. Wixon said he hopes the RADAR initiative will be a catalyst for significant growth within the University of Michigan Hospitals and the Ann Arbor Medical School, and beyond in programs around the country. “We are marching forward to create a diverse and inclusive environment where members feel valued, respected, and supported in their individual personal and professional goals,” he said.

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Kelly Jong is a freelance writer with over 10 years of experience in medical journalism. She holds a master's degree in organizational psychology from Pennsylvania State University.