Compassion: Our Most Important Competency
By A/Prof Raymond Goy, Program Director
As a Program Director, two questions are always asked of me.
The first being "What are the up and down-sides of Residency?" Describing the upside of Residency is an easy task, I can think of many significant improvements instantly.
The ACGME-I Residency is the best change our Ministry of Health has made to the Postgraduate Education System in Singapore. As a Supervisor of Training for our local BST/AST as well as Australian training system of 8 years, I am heartened by the opportunities we are empowered as Faculty Educators to bring forth new structured changes to our education system. The ACGME-I Residency replaces the opportunistic learning of our pre-existing BST/AST system. The elements of formative Resident and Faculty evaluation and feedback are enhanced. There are competency milestones upon which our trainees work towards in their route to Specialization.
It is no longer just about teaching and receiving of information. It is about taking ownership of a Resident's successes and challenges, their professional and ethical development. Compassion must be the hallmark of all NUHS Residency Programs.
Of course, excellent Education and Training will require additional effort, attention and resources. It is understandable that these new focuses will take people out of their comfort zone (like any new policy will do). In NUHS, our Educators challenge ourselves each day to move out of our pre-conceived comforts to bring forth the best for our Residents.
What about the downside? There is only one I can think of, that is the Residency 'rat-race'. My advice to our young doctors is that unless you are certain of your career choice, it is perhaps prudent to take a step back and try out new options before embarking on a Residency track. I must have interviewed or met more than 100 Residency hopefuls in the past 2 years. Our young doctors must realize, in whatever we do, in all our pursuits, hopes and expectations, we first have to be Compassionate Physicians.
This leads nicely to the 2nd question, "How do you choose your Residents?"
I am looking for a unique group of compassionate individuals who care genuinely for their patients, fellow doctors, the Program, Institution and Specialty. I look beyond just academic excellence or previous anesthetic work as selection criteria. I believe firmly that a solid Residency Program can achieve these goals in any interested Resident. However, no comprehensive training program can take the importance of instilling values of compassion in our young doctors.
I would like to stress that the foundations of Anesthesia do not lie in fancy operating theatres or advanced equipment. Teamwork and vigilance provide the best possible care for our patients. Teamwork and communication stimulate cooperation and push each of us to the best that we can be. Teamwork and dedication help us nurture the next generation of Anesthesiology Specialists. I would expect all my Residents to possess our NUHS Core Values TRICE – Teamwork, Respect, Integrity, Compassion and Excellence. All Residents must show commitment to the care of our patients and education of our next generation of doctors.
Dr Irene Lim has often being praised by her patients, peers and Faculty for being a dedicated and compassionate doctor. Hence, I challenged her with an assignment to let us know what being a Compassionate Physician involves, and her response proves to me that she is indeed a NUHS Anesthesiology Resident:
What Compassion Means to Me?
By Dr Irene Lim, CA-1 Anesthesiology Resident 2012
"People become the stories they hear and the stories they tell.”
– Elie Wiesel
Two children ran around boisterously in a fast food restaurant, screaming and laughing as they went about their games. Their father was sitting on a couch in a corner, sipping his coffee slowly, as though oblivious to the din they were creating. His gaze was in their direction, yet his eyes seemed to look beyond them. He made no attempt to quieten them down.
Unable to tolerate with the ruckus, a lady diner charged up to the man. In a most displeasing tone, she said, “Could you please tell your children to behave themselves?!”
To this, the man broke into a small smile and calmly replied, “My wife had just lost the battle with cancer a few days ago. When she was still around, she always reminded the children that life should go on as usual even after she had left. Today, they were just living out her wishes and I couldn’t bear to stop them.”
"You never really understand a person until you climb into his skin and walk around in it."
– Harper Lee in ‘To Kill a Mockingbird’
In the healthcare profession, we are always reminded of the aphorism, “To cure sometimes, to relieve often, to comfort always.” Indeed, while faced with an uphill battle against sickness and death, we remain comforters regardless of whether we can cure diseases or relieve suffering. A good comforter seeks to understand the patient’s and their families’ views. Undoubtedly, this is driven by compassion, rooted in love.
Compassion — an entity so intangible yet so readily felt, so impalpable yet so warmly embraced. It goes beyond sympathy and empathy, but instead is also accompanied by a strong desire to sooth.
Oftentimes, an outstanding physician is remembered not just for his knowledge and skills, but also the compassion and loving kindness he showers his patients and their families with.
While residency training emphasizes the six core competencies outlined earlier, let us not forget “Compassion” — a value so indispensable in this profession. In time to come, may we have memorable stories to inspire upcoming generations of physicians, stories of our own… stories we live by… stories we share.
