MEHP Fellow Natasha Khursigara-Slattery, MD, a urology registrar at University Hospital Limerick in Ireland, says she remembers her intern year deeply. Now, she’s working to enrich the experience for other interns through enhanced coursework and programming.
Khursigara-Slattery has been working as a clinical fellow for the Mid-West Intern Training Programme, one of six networks for PGY-1 trainees in Ireland. The work entails supervising the learners’ clinical training and education as well as liaising with hospital management, training bodies, the Irish Medical Council, and the National Doctors Training and Planning (a branch of the Health Service Executive, the health-care system). About 70 to 100 trainees rotate through each year.
She originally signed on to orchestrate the basic curriculum already in existence but soon found herself initiating programs and teaching modules. “I had taken it on almost as a part-time role, but I just threw myself into it,” she says. “I really loved what I was doing and wanted to commit to it more thoroughly.” She subsequently enrolled in the MEHP program to better learn the foundations to curriculum development and evaluation.
One of the new offerings Khursigara-Slattery created is a point-of-care ultrasound course. “Those are skills that aren’t currently addressed in the intern year, and there is no curriculum for it in medical school,” she says. She applied for and received development funding from the Health Service Executive-National Doctors Training and Planning Development Fund to set up and then continue and presented the results of her work at the World Conference for Ultrasound in Medical Education. The course, which started as a pilot, has been adapted for more senior trainees as well. Additional teaching modules developed by Khursigara-Slattery focus on conflict management through managing difficult situations and on professionalism and professional identity formation.
Khursigara-Slattery says she pulls ideas for new curricula based on several factors: identifying gaps in intern training needs, intern feedback, and maintaining an awareness of best practices in other jurisdictions. “The extra fun part for me is when these overlap with areas of personal interest and expertise,” she says. Professionalism and professional identity formation generally are not covered in the intern year, and medical schools cover professionalism from a medical-legal perspective, she says: “There’s so much more to it in terms of what employees go through, like preparedness for practice.” Some of the coursework is slowly being transitioned from didactic sessions to simulation-based scenarios to train the interns, which Khursigara-Slattery says the interns have responded to well.
“You see where the interns are struggling or where they’re lacking,” she says. “At the end of the day, we want them to reach their goal by the end of the year of matching with whatever program they’re looking to match with. So whatever skills we can give them to improve that, that’s the impetus for where I come from.”
The intern curriculum in Ireland is now transitioning from a time-based to a competency-based model, with implementation of EPAs (entrustable professional activities). Khursigara-Slattery was selected to lead in developing part of the new curriculum that addresses competencies for professionalism. She sought and received funding to convene a two-day national conference to engage feedback from key stakeholders, and national and international experts. She proposed a framework for professionalism competencies and explored and recommended the integration of professional identity formation within competency-based curricula to the Irish Medical Council.
“Over the past year, this conference has led to collaborative work with international experts such as Richard and (the late) Sylvia Cruess, Yvonne Steinert and Robert Sternszus from McGill University in Montreal; Olle ten Cate from the Netherlands; and Stan Hamstra from the ACGME and University of Toronto; and to an invitation to deliver several workshops with these esteemed experts at the Canadian Conference on Medical Education in April and at the International Conference on Residency Education in October,” she says. “The MEHP has armed me with a wealth of knowledge and strategies – to develop and share my own ideas and experiences in wonderful and unexpected ways.”