Coral Giovacchini, MD, started in her new role as chief resident of internal medicine at the Durham VA Medical Center this month.
Dr. Giovacchini says this is a role she is particularly excited about because it offers many teaching and learning opportunities.
There are several things that make the Durham VA a unique place for residents to train, Giovacchini said. This year, for example, rotations for junior assistant residents at the Durham VA will return to the 24-hour call structure, so JARS will have more continuity with their patients overnight.
“The Durham VA is an exciting place to train, because you get autonomy earlier, within a framework of support,” Giovacchini said. “Your attendings and chief resident are always available, but what I really enjoy most about being at the VA hospital is the fact that you have the opportunity to lead a team early in your career.”
This opportunity to lead is an example of the type of hands-on learning Giovacchini found valuable when she was a resident and, as a chief resident, still values, as a teaching tool.
This year residents will have another unique hands-on learning opportunity at the Durham VA in the newly established Simulation Center. In the Simulation Center, residents will have opportunities to run simulated procedures and other challenging clinical scenarios to better prepare them for work on the wards and in the ICU. The planned curriculum will include education on basic ultrasound skills, central venous catheter placement and a variety of other ultrasound guided procedures, Rapid Response and Code Blue simulations, as well as an optional emergency airway management course, among other things.
“Rather than getting thrown into learning how to do procedures in real time, we hope to help the residents develop a solid foundation of clinical tools in a safe environment prior to translating this into their practice on the wards. I hope that this will not only improve the residents’ clinical skills sets and confidence in patient care, but also improve resident-to-resident teaching for the future, and potentially even translate into improved patient outcomes,” Giovacchini said.
Giovacchini is looking forward to other teaching opportunities at the Durham VA, especially the one-on-one time she has with residents during evening “sign out” rounds that will allow her to focus on individual learning.
“Part of my role as chief resident is figuring out how other people learn,” Giovacchini said. “Teaching isn’t always about having a structured approach to teach one topic to everyone, but rather involves adapting to individual learning styles and finding how you can best teach each of your learners.”
Though residents also will have larger group learning sessions, Giovacchini hopes that the case-based learning during her one-on-one time with on-call teams will be beneficial.
Giovacchini said one of her goals for the year is making sure interns and residents know how approachable she is.
“I want to focus on making sure that education in our program is accessible. We have very high standards for our residents, but I hope to facilitate a friendly and functional environment in which people can ask questions and not feel like they are supposed to know everything about internal medicine walking in the door,” she said.
Giovacchini said she remembers what it feels like to make the transition from medical school to residency.
“As an intern, you’ve prepared, you’ve gone to medical school, you’ve done a lot of book learning and have some clinical experience, but all of a sudden you are thrown into this new role of being an actual doctor where you are the point person for your patient and that can be intimidating,” Giovacchini said. “It’s important for everyone to know that they have help. There is nothing wrong with asking for help when you need it.”
During Giovacchini’s first week as an intern at Duke, she remembers being on the general medicine ward and taking care of a very sick patient.
“I got called because my patient, who had been admitted for a urinary infection, had a low blood pressure” she said. “I remember working through my algorithm to resuscitate the patient, but I got to a point where I felt a bit in over my head as a first week intern.”
Giovacchini discussed the case with one of her chief residents, Brian Griffith, MD, who was happy to help, lending an extra set of eyes and hands during a critical patient care moment.
“I think everyone has that moment early in their career when you need a bit of reassurance and validation of your plan, and it is nice to know that, at Duke, you will always have back up when you need it.”
Besides encouraging residents to ask questions and seek out help when necessary, Giovacchini said she would also recommend that they try to find balance between medicine and their personal lives. When Giovacchini was a resident, she said her goal was try to try to learn one thing every day and spend a previously set amount of time reading every day, then that was it.
“It is important to take care of yourself, so that you can continue to take good care of your patients. I think as long as you set ground rules for yourself coming in and make an effort to actually stick to them, it makes a big difference during residency and is an important skill going forward in your career.”
Outside of medicine, Giovacchini likes to spend time on creative interests, including photography, and staying active outdoors with her friends, husband and large dog, Sumo.
Giovacchini majored in anthropology at Harvard University and got interested in medicine when she studied evolutionary biology. Her undergraduate research involved the effects social interactions on physiologic responses of great apes. This ultimately branched into human endocrinology studies, and through that she became interested in human physiology and medicine. Giovacchini attended The Ohio State University for medical school and then came to Duke for internal medicine residency. Giovacchini spent last year as a fellow in Pulmonary, Allergy and Critical Care Medicine.
She will complete her fellowship after her chief resident year.
Meet the chief residents:
- Nilesh Patel, MD, MS, chief resident of internal medicine, Duke University Hospital