At 2019 Bud Baldwin winner Middlesex Health, resident physicians are part of a small-town community

Each year, the Gold Foundation and the Accreditation Council for Graduate Medical Education (ACGME) recognizes institutions that foster a respectful, humanistic environment for resident physicians by awarding the ACGME and Gold Foundation DeWitt (Bud) C. Baldwin Jr. Award. The recipients of the 2019 DeWitt C. Baldwin Jr. Award are Henry Ford Hospital in Detroit, Michigan; University of Massachusetts Medical School in Worcester, Massachusetts; and Middlesex Health in Middletown, Connecticut. This story is part of a series examining each winning institution and their best practices, in hopes of spreading these techniques and encouraging other institutions to focus on fostering a humanistic culture. 

Middlesex HealthFrom the beginning of their residency to their capstone projects, resident physicians at Middlesex Health become part of the community. The 28 family medicine physicians are immersed in Middlesex Health’s Family Medicine program and its hospital located in Middletown, where programs such as Humanities in Medicine and the Center for Mindfulness and Compassion in Healthcare bolster the environment of support.

This special humanistic culture at Middlesex Health helped the institution to win the ACGME and Gold Foundation DeWitt (Bud) Baldwin Jr. Award in 2019. Only three institutions were selected out of a pool of more than 800 ACGME-accredited sponsoring institutions of residency programs.

With 28 residents, the program is small and entirely focused on family medicine. Over and over, the residency program is designed to create human connections – with patients, with fellow residents and physicians, with the entire organization’s staff, and with the community at large.

By the time the residency program is over, about half of the residents choose to stay at Middlesex Health. And about 70 percent stay in Connecticut.

Dr. Alan Douglass, the ACGME DIO and the director of the Family Medicine Residency Program, came to Connecticut from California and has stayed at Middlesex Health for nearly 30 years.

What makes Middlesex Health so special?

“I think it’s all about the people, to be really honest,” said Dr. Douglass. “If you put your focus on the people you work with and really invest in those human relations – the rest all falls out from there.”

The introduction to the community begins early. At the start of their residency, the new physicians will climb aboard a bus with community leaders, such as the chair of the Chamber of Commerce, a member of the Middlesex Health Board of Directors, or a leader in the local schools. The bus will wind its way through the town of 45,000 people, stopping at sights like the local community health center and its garden on Main Street.

Befitting its name, Middletown is in the middle of Connecticut, along the Connecticut River. The area was home to Native American tribes and become a busy port in colonial times. Wesleyan University opened in 1831. The town later shifted to manufacturing, and went through a factory boom and decline. Today, the town thrives with diverse businesses and a revitalized downtown with many restaurants. Middlesex Health is a major employer.

Later in their four-year program, each resident will develop a capstone program over two years. Examples include a girls empowerment program at the high school.

Middlesex Health was the first in the country to adopt a four-year timeline for residency, said Dr. Douglass. Their residency program is designed very deliberately, with periods of high intensity and the low intensity. “I think there’s great value in mixing it up,” he said.

Now Middlesex Health is part of a broader pilot of four-year residency programs, titled the ACGME Length of Training Pilot. Results from the pilot are expected in 2020.

“Innovation is fundamental to who we are – we are always looking to be at the forefront of family medicine,” said Dr. Douglass.

In selecting residents, Middlesex Health looks for Gold Humanism Honor Society members, a designation listed on the Electronic Residency Application Service (ERAS®) form.

“Three of our incoming seven residents are GHHS members, which is typical,” said Dr. Douglass.

The Gold Humanism Honor Society is made up primarily of medical students who were selected as role models of humanistic care by their peers. Created by the Gold Foundation in 2002, GHHS now has chapters in more than 160 medical schools and 35,000+ members in education and in practice.

Dr. Douglass also recommended Schwartz Rounds, in which people from throughout Middlesex Health gather to discuss difficult social and emotional issues that arise from caring for patients. “Those can be very meaningful and are very well done,” he said.

Middlesex Health has also been recognized by the American Nurses Credentialing Center (ANCC) for nursing excellence and named a Magnet® organization for five consecutive times, a feat that only about 20 hospitals in the country have achieved.

In the end, the secret to Middlesex Health’s close-knit, humanistic residency program seems to come down to kind people, shared values, and ongoing innovation.

“With culture – you can’t stand still. If you are standing still, you are sliding backward,” explained Dr. Douglass. “We believe you must always be moving forward.”