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Fall 2020

Summer is almost over and Fall is in the air.  It’s a time for new beginnings, when many programs are welcoming their new cohort of trainees, often before the dust has settled from the previous cohort’s graduation.

I think we would all agree, this was a summer like no other. Between the COVID-19 pandemic, the tragic death of George Floyd, and the political headwinds of a presidential election year, there has been lots to be edgy about! And yet—remarkably—I see tremendous strength, resilience, and perseverance—dare I say joy! In the faces of both new and departing postgraduate trainees and the program staff that support them.

For the 2019-2020 residents and fellows, they leave having had the unique experience of shockingly rapid change in communities, clinical problems, and the way we deliver care. Telehealth moved from a “nice to have” option to the dominant way they interacted with patients for months. Program Directors quickly modified their programs where necessary, improvising to create specialty training experiences when off-site experiences became unavailable. Everyone pitched in to help with testing, community responses, and behavioral health support for their patients as they underwent enormous stressors.  And in the midst of all this rapid change, what stood out to me this year was the way both individual programs and the entire movement just kept moving forward. Remember—COVID-19 descended on us in March—right in the middle of most programs’ recruitment activities. A few program directors wondered aloud to me: will we see a decrease in applicants? Will programs close due to resource constraints? Will our candidates be able to graduate and get licensed/certified on time? And will they want to come into practice at this challenging time? While we were saddened to see a few programs take a pause for the upcoming year, the vast majority just kept right on going—and I heard from everybody, as always—that they were blown away by the quality and dedication of the applicants.

And what would summer be without the rituals of celebrating the completion/graduation/honoring events of the programs?

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I had the remarkable experience of attending seven “virtual” postgraduate training graduations around the country. Whether the graduation was in Hawaii or Rhode Island or anywhere in between, there were common themes.  I have heard the term “silver lining” used frequently lately. For me, the silver lining of travel restrictions and virtual graduations allowed me the ability to join several graduations around the country. How great that family and friends—from babies to grandparents—were able to join in from the comfort of their homes? Again—a silver lining brought to us by Zoom and the pandemic!

Margaret Flinter from the CHCI program in CT shared a photo of her delivering the graduation address to the inaugural cohort of the El Rio Community Health Center postgraduate NP residency program in Arizona from the back of a van filled with COVID testing supplies while she took a short break from COVID testing to join the El Rio team. We are truly a flexible and creative group! Listening to the Residents and Fellows, their preceptors and families, it was clear that graduation was a big milestone on an individual and a collective level.

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For me, it was very powerful to see CHCI in Connecticut, where I got my start, hit the “100” mark in alumnae/i as they graduated their 13th cohort, and 18 NP residents. Nationally, the Consortium’s accredited programs have graduated 272 residents and fellows and I know the Veteran Affairs Center of Excellence primary care NP residency programs have almost 200 alums themselves. All told, by our count (and we do try!) there are 242 postgraduate training programs, with about 133 focused on primary care. The theme that shone through most brightly for me during these challenging months is the HOPE I see in this up and coming generation of clinical providers and those who are supporting them.

I would like to end by sharing Dr. Alejandro Esperanza’s graduation comments with all of you. Dr. Alejandro Esperanza is the Chief Medical Officer from Holyoke Health Center in Massachusetts and they graduated their inaugural class of NP residents on August 28th.

“Residents, over the past year but more so perhaps over the last few months, you have been witness to not only what the pandemic threw at you but to an enormous amount of unrest within society at large, that no doubt has also affected you in various ways adding to the stresses you faced as providers. The ravages of poverty, injustices, racial tensions, tensions amongst co-workers, friends and families, and quite notable the glaringly disparities in our healthcare system.

In some strange way, could this pandemic be giving us the chance to rethink the world we live in? Rethink the world we want to live in? How we treat our neighbors? How we treat those less fortunate than us? How we treat our colleagues? How we treat ourselves? Has the pandemic changed us forever? I am not sure about that, but what I am sure of is that it has set the foundation from which we can build from if we choose to do so. What I can say is, we’ve learned a lot, and we have choices to make moving forward.

My father loved to say to me that history repeats itself and if we study past pandemics, it is evident that these singular events have forced humanity to start anew and rethink the future.

So, the choice for us is clear…. We can either choose to bring to this new and reimagined future our heavy luggage brimming with preconceived ideas, hatred, avarice and pollution or we can start anew and be ready to reinvent our world.

Graduates, if you want to grab hold of this moment and become an advocate, there are an immense number of options that could benefit from the actions you will choose to take today. As recently minted healthcare providers you now wield enormous power, and with that power comes even greater responsibility. I do not think I am overstating this when I say that you carry our hopes and dreams on your shoulders. Our world needs your voice and skills but most importantly your compassion, now more than ever. I know it is an enormous responsibility but one I know you will take head on.”

Congratulations to all the 2019-2020 graduates! And, welcome to all the 2020-2021 residents and fellows.