The Value of the Resident Voice: An Interview with the Outgoing Chair of the ACGME Council of Review Committee Residents

Kristy Rialon, MD is an assistant professor in pediatric surgery at Texas Children's Hospital. Dr. Rialon was the resident member of the ACGME Review Committee for Surgery from 2015-2017. She is currently completing her term as Chair of the ACGME Council of Review Committee Residents (CRCR), and has also served on the ACGME's Sponsoring Institution 2025 Task Force and the Common Program Requirements Phase 2 Task Force.

As Dr. Rialon winds down her tenure as CRCR Chair, we sat down to discuss the Council’s role and vision, and the significance of the resident/fellow voice in the work of the ACGME.

ACGME: What brought you into medicine? What is your “meaning in medicine”?

Dr. Rialon: I find meaning in the joy of helping patients and their families. I work with children in many emergency situations, and being able to have a significant impact on their lives has been important to me. I got into GME as a resident because I felt there was a need in my program and institution for improvement in resident mentoring and education.

ACGME: Why did you want to volunteer with the ACGME?

Dr. Rialon: I was really interested in improving resident education beyond my local institution. The ACGME does so much more than duty hours, and I wanted to be a part of the national dialogue on ways to improve the clinical learning environment.

ACGME: Why did you want to be involved in the CRCR?

Dr. Rialon: I was interested in improving GME at my home institution and that led to my nomination to be on Review Committee [for Surgery]. All the residents on the Review Committees are invited to be on the Resident Council. It is important for residents to be involved nationally in issues that impact them, including accreditation and program requirements.

ACGME: From your perspective, can you explain the role of the CRCR?

Dr. Rialon: The role of the Council is to bring the resident voice to critical discussions and to bring up issues important to residents that the other ACGME Councils or committees may not have considered. The Council is a diverse group of residents that focuses on national GME issues, including topics such as well-being and leadership training for residents. Over the last several years, we have focused on improving meaning in medicine.

We have focused discussions at our meetings on specific topics and solutions. These proposed solutions are then submitted to the Board of Directors or Task Forces, as applicable.

ACGME: What topics has the Council discussed and how have those been explored?

Dr. Rialon: Resident voices have been really important to getting national attention on burnout in physicians. Residents are a critical part of medical care and we need to make their well-being a priority. With the Board’s support, the CRCR helped launch Back to Bedside, and many of the residents on the Council are actively involved in that advisory group.

Other topics have often resulted in conference sessions, articles for JGME, or contributed to other work:

  • resident leadership skills were presented at the ACGME’s Annual Educational Conference for the past few years
  • diversity in medical education was a focus of one recent meeting
  • parental leave discussions have led to an upcoming paper
  • Annual Resident Survey changes have resulted from our group’s input
  • we had resident representation on the Common Program Requirements Task Force that revised the requirements

ACGME: What are the CRCR’s current goals and plans?

Dr. Rialon: We are working to develop a leadership curriculum that could be used by any resident at all levels. The CRCR is also focused on parental leave for residents, and how the ACGME could influence current policies.

ACGME: Has being involved in the CRCR changed how you view residency?

Dr. Rialon: I have reflected on the culture that I did not realize at the time needed to be changed to make it better for residents. So much of training is ingrained and no one questions how you do it. Sometimes there are better ways to train people that address quality of life and work-life balance.

ACGME: What has surprised you from your time on the CRCR?

Dr. Rialon: I have been surprised that these issues are so universal. Sometimes you think that it is just impacts your specialty. The Council allows [us] to come together to identify different issues and consider how to fix them.

I have also been surprised by how many people have experienced discrimination because of gender or ethnicity across different parts of the country and different specialties. It is surprising because it is not only coming from physicians but also from other members of the medical team and patients. It is a hard discussion to have, given the importance of patient satisfaction surveys.

ACGME: What about volunteering with the ACGME has been valuable and significant to you?

Dr. Rialon: The work the CRCR has done to bring attention to well-being and burnout has been the most important thing I have been involved with. We were successful in getting the Board of Directors to fund the Back to Bedside initiative. There is still more we know we can do, and every meeting we brainstorm new ways we can combat this issue.

ACGME: Why should residents consider getting involved?

Dr. Rialon: The legacy of the Council is that we are a passionate group that works to entertain discussions at a national level, providing a broader perspective that includes convening a diversity of individuals and specialties. I would encourage residents to become involved because it is a unique opportunity to bring broader perspective to important issues.

ACGME: Anything else you’d like to add?

Dr. Rialon: Many people may not realize how involved residents are at the ACGME. But our Council is quite active, and I think the Board appreciates our work and listens to our voices.