Mission Moment: Medical Residency Program

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The 40 doctors in the Shirley Ryan AbilityLab Medical Residency program — the clinical training home of Northwestern University Feinberg School of Medicine’s Department of Physical Medicine & Rehabilitation (PM&R) — are on a four-year journey in which they serve as integral members of the Shirley Ryan AbilityLab team and gain on-the-job training and qualify for the next phase of their careers.

Over their time with us, they treat patients throughout our continuum of care and across diagnoses, are the residents who serve on our Resident on Call ("ROC Stat") teams, develop educational materials for future residents, and contribute to research in their areas of interest.

Then, after graduating from our program — one of the largest such training programs in the country — they join our unparalleled alumni network. This group of more than 500 doctors practice and lead the PM&R specialty around the country.

Sarah Hwang, MD, director, Women's Health Rehabilitation, and assistant program director of the Medical Residency program — and, we can't forget to mention, a graduate of our residency program — explains how each year of medical residency works:

• "Year 1 is the internship year when residents focus on general medicine. They rotate in a hospital — on the wards, in the ICU and in other medicine electives — in order to build their knowledge. For most of our residents, Year 1 is completed elsewhere, though we do have four categorical residents who complete their internship at Northwestern each year."
• "Year 2 is our residents’ first year at Shirley Ryan AbilityLab. They focus on inpatient rehabilitation. They rotate through the various ability labs, seeing different populations we typically encounter, including brain injury, spinal cord injury and pediatrics. They also learn about the importance of the interdisciplinary team and the physician’s role in this environment."
• "Years 3 and 4 include rotations at the Jesse Brown VA Medical Center and a community hospital (Illinois Masonic); consultations at Northwestern Memorial Hospital; outpatient rotations such as Sports Medicine, Pain Medicine and Amputee Medicine; and five months of elective time."

Dr. Hwang explains that elective time available in Years 3 and 4 is a unique feature of our program that allows residents to tailor their educational experiences to advance their professional futures.

"Residents can also pursue specialized tracks. We have a research track — a five-year program for residents interested in a career in research. We offer a medical education track for residents who have an interest in education and teaching. This track is popular with the residents since so many of them go into academics after graduation," she said. "This year, we also added a leadership track that focuses on building leadership skills, including emotional intelligence, communication, networking and advocacy."

Residents not only play an important role in our Mission by providing high-quality patient care throughout the program. Dr. Hwang also notes the training they receive ensures they will continue to do great things after they graduate.

"Our mission is to develop the future leaders of PM&R by providing comprehensive training in our field," she says. "Our residents get to see how clinicians can work alongside scientists to provide the best care for our patients, while also treating a wide variety of complex conditions encountered in PM&R."

Read below to meet several of our medical residents!

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I was doing a lot of soul searching in medical school and realized it is most important for me to work with people through really hard circumstances. PM&R offers a plethora of opportunities to work with patients and see huge benefits, because patients are making such big gains. Another part about PM&R that I love is the interdisciplinary element: working with physical therapy, occupational therapy, speech therapy and more. I also like being in touch with a lot of different specialties and seeing how they are growing and how medicine is moving forward. In PM&R, you really get a pulse on medicine.

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I still remember Dr. Rho [Monica Rho, MD, section chief, Musculoskeletal Medicine, and director, Medical Residency Program] on the interview day, going over her philosophy of growth during residency. She drew this two-by-two table: one of the axes centered on how much you are challenged, the other represented how supported you feel. Dr. Rho explained how she wanted Shirley Ryan AbilityLab's residency to offer both challenge and support, because this creates the best learning environment. That really resonated with me.

I want to be challenged because I want to be confident that I'm going to be able to provide quality care when I'm an attending. Everyone has that fear about being challenged — "I don't know what I'm doing, how do I know that what I'm doing is right?" — but here, we have the network where we're both challenged and supported. It's really part of the culture. I feel a lot of autonomy in the decision-making with our patients, but I never feel that I'm alone. Attending physicians are always very available. They're very clear and explicit that they want to be brought in if there's ever a question.

The culture here embraces learning and is invested in the organization as a whole. A lot of the attending physicians trained here; some left and came back. It feels like a family. It's nice when people love the place where they work.

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I've been fortunate to be involved in research projects with Ishan Roy [MD, PhD, medical resident], Leslie Rydberg [MD, attending physician] and Prakash Jayabalan [MD, PhD, attending physician and clinician-scientist]. Now, I've been learning more about quality improvement. After seeing systems in the hospital change and adjust with the COVID pandemic, it's exciting to think, "How can we make the system better? How can we help patients be safer?" That is something I'm interested in exploring here.

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From my first rotation, I just really enjoyed the relationships I was able to form with patients. A lot of our patients have gone through either prolonged hospital stays or something fairly traumatic, or both. They come to us on the path home, but they don't know what their life is going to look like. They're asking, "What happened and what does this mean for me? How do I move forward?" We have the opportunity to help patients get to where they want to be.

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Residency is an interesting time in that we do something different basically every month. So by the time you feel comfortable doing one thing, and you have done it for a month or two, you switch and you get thrown into something new. I went from treating adults my entire first and second year of residency to caring for the pediatric population in my third year. It's been an adjustment, but it's nice to build on what I've learned.

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Coming here, I felt I would have the opportunity to train from the people that are on the forefront of rehabilitation. Then, wherever that took me in my life, I also would take that training. Another thing is that, for residents, conference attendance in encouraged. This program is very unique in that it encourages us to be part of the future of PM&R. We get support for conference travel and help covering patients. I think we had six out of the 12 PGY-2s at AAPMR last year. Every time I've wanted to do something like that, it's been encouraged.

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I grew up playing sports and played soccer in college. I explored many different avenues in medicine: I looked into physician assistant school and athletic training, and ultimately decided to go to medical school. I really enjoy musculoskeletal medicine, so I'm going to pursue a fellowship in sports medicine.

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In medical school, neurology, psychology and musculoskeletal medicine caught my interest. Of all the fields in medicine, PM&R does the best job of combining these three areas. I was also drawn to PM&R because of the foundational theme of improving a person’s function in the most conservative manner possible, ideally through exercise or therapy. PM&R doctors seemed to be the best specialists with helping patients achieve independence.

I came to Shirley Ryan AbilityLab for a few reasons. First, the field of PM&R is very broad, and I wanted to train at a program where I would have a robust experience in each subspecialty area. Also, this program offered an opportunity to train at the cutting edge of rehabilitation. Lastly, I had a really high interest in contributing to the new hospital’s novel approach of embracing translational research. I didn’t think I would have another opportunity in my career to be part of something this unique.

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Each inpatient rotation has had formative and affirmative moments. Shirley Ryan AbilityLab is a leader in PM&R because we push the boundaries of who can thrive during inpatient rehabilitation. During training, I’ve cared for patients that have taught me the real meaning of resilience and perseverance, and their caregivers have demonstrated true selflessness and love. Residency consistently reminds me that I made the right choice for my development as a physician and person.

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The first three years tend to have structured rotations. In the fourth year of training, we choose most of our clinical rotations. This flexibility provides an opportunity to learn more in our career area of focus. For me, that is musculoskeletal medicine. I'm applying for sports medicine fellowships, and I am dedicating some of my final months of training time to the specialty: working with orthopedic surgery, pediatric musculoskeletal, and urgent care to improve on fracture and suturing management. I also spent a week with Matt Oswald, MD, on the inpatient medically complex service to refresh my inpatient provider skills.

I also will be making some memories with trainees, including our winning our intramural kickball league!

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The residency group feels like a big family. With this many people, you learn many different approaches and perspectives to problem-solving, which has been great. Like all families, there are great memories and times when we had to work through challenging circumstances. The COVID pandemic represented one of the more difficult problems we faced, and I am proud of how our group of residents rose to the occasion to help our city through this pandemic. I have made lifelong friends here.

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Dr. Rodericks completed her residency in June 2020, and is now a Sports Medicine Fellow at the Hospital for Special Surgery in New York City.

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I found that Shirley Ryan AbilityLab was one of the few programs that had balance. It’s competitive and has all the qualities of an elite program — like training in techniques that aren’t required and are not even offered at every program. But the big thing that set it apart was that the attending physicians were so approachable, down to earth, and open and welcoming. I love talking to people and I love having a work environment where I feel comfortable being able to speak my mind.

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In our second year, we do basically all the inpatient coverage. It can be a rigorous 12 months right after our intern year, where we were pretty much doing the same thing. That was the most challenging year, but I also saw a breadth of patients in terms of diagnoses and severity, from very acute patients to very stable patients. I saw everything that year.

Then, in third and fourth year, I got to move more toward my interest of sports medicine. The sports medicine curriculum here is fantastic. Dr. Rho is a great example and leader in the sports medicine world, and as a program director.

In my fourth year, while interviewing for fellowships and talking to other people from other programs, I realized how special the Shirley Ryan AbilityLab residency program is.

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When I started residency, I already had an inkling that I’d go into sports medicine, but my experience in brain injury almost changed my mind. When you make your schedule, you put down your preferences in order. I picked brain injury first, because I was thinking there was no way I was going to do brain injury — I figured it would be a good first rotation to get my feet wet, understand how the hospital works and get it out of the way. And then, I ended up loving it! I just loved the patients. I had a patient who came in a minimally conscious state and then basically walked out of of the hospital. It was a complete night-and-day experience. So yeah, brain injury almost stole me away — and then I went back to sports and remembered, “Oh, this is my calling.”

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We see so many cases that stand out. There are people I still remember from my very first year. I remember their names and their spouses’ names. That's one of the nice things about the inpatient side of things — you see the same person every single day and you see them recover. I built such great relationships.