Purpose:
The Gold Foundation is interested in developing a new ritual for residency years that will be a meaningful touchstone for residents as they begin this phase of their medical education, helping to inspire them to maintain and strengthen their humanistic care of patients.
The objective of the Residency Ritual – Oath Creation Pilot Program is to promote and support humanism in medicine among incoming residents through the use of reflection, group discussion and public oath taking. The program was developed and piloted at Penn State Medical Center in 2009, and the Gold Foundation is seeking additional pilot sites to undertake the program.
This program is to create a ritual to mark the transformation from student to resident, with all of the attending patient care responsibilities. The residents will work together to create their own oath that can serve as a guiding professional compass regarding the care of patients, relationships with family, obligations to the community and the contract with society, and self-care.
The following structure was developed and piloted at Penn State. While following the structure was successful, individual institutions may need to make modifications to best meet their own needs.
Penn State Structure:
• Faculty mentor meets with entire incoming residency class as a group during orientation, or early weeks of residency for ½ day, or in several smaller time segments. Speakers are brought in (attendings and PGY3 residents) to talk about and hold discussion on what it means to be a compassionate, humanistic physician in a busy teaching hospital.
o Class is divided in to small groups (approximately 10 residents each) to create an oath. They are provided flip charts. Each group appoints a representative who records the oath from their group.
o Small groups were given wide latitude but advised to structure their oath to begin, “To our patients” and then to create other categories as desired.
• Representatives then meet together to forge one oath for the class over 90 minutes. Class reconvenes on a subsequent day to finalize the oath.
• Oath is printed on a poster as well as individual pocket-sized copies.
• Entire residency class and their families gather for a dinner, luncheon or even a simple reception. Upon entering, each resident signs the oath poster and receives their laminated pocket-sized copy. The group takes the oath in front of their families and participating faculty.
• The poster is hung in a central hospital location, visible to the residents, hospital staff and patients. The poster remains hanging for the 3 year duration of the residency class. Space for 3 concurrent posters should be available.
• Residents revisit oath either individually, by department or as a class during subsequent years. The sponsoring faculty member assesses the use of the oath during this time.
Grant Process
The Gold Foundation is offering a three-year grant to undertake the Residency Ritual - Oath Creation Pilot Project. Funding of $5,000 for year one, $3,000 for year two and $1,000 for year three will be available.
To apply for a grant as a pilot site, please submit the following:
• 2-4 page proposal stating your intention to generally follow the program as outlined above and, as a pilot site, to potentially modify as appropriate for your particular circumstances.
• an identified faculty mentor for the program
• a timeline for implementation
• statement of willingness to participate as a pilot site, providing comment on your experiences, suggestions for changes and improvements, and feedback from resident participants
• statement of willingness to participate in the Gold Foundation’s overall evaluation of this new program
• a letter of support from the Dean of GME (or appropriate Designated Institutional Official) stating the institution’s willingness to 1) provide time during orientation or early weeks of residency for this new program to take place, and 2) consider adoption of this new program on an on-going basis if it shows value during the pilot stage.
Submit proposals electronically to: proposals@gold-foundation.org
For questions call Ann Bruder, Director of Programs, 201-567-7999
