John Paul Shoup, MD, is serving as the 2018-19 Durham VA Medical Center chief resident for quality improvement and patient safety. In this role, Dr. Shoup is part of a network of chief residents across the country who lead quality improvement projects and receive expert training from mentors. Shoup is a graduate of the Franciscan University of Steubenville, he received his MD from the University of Connecticut and came to Duke for his internship and combined Internal Medicine-Pediatrics residency.
How did you end up at Duke?
I went to medical school at UConn but then applied for a combined Internal Medicine-Pediatrics residency. I wanted a program that was not in a big city but had the level of clinical experience, research exposure, and other opportunities that come from a major medical institute. When I looked for that combination there were few places left on the map. In addition to the institution itself, Durham appeared to be (and is!) such a wonderful place to live that it made it an easy decision to apply here. But what sealed the deal for me was seeing the comradery of the residents when I came down for my interview. I knew then that I was coming to train in an area that I liked, in a program that would give me the training I needed, and with a group of people I would really enjoy.
Did you always want to go into medicine?
It was always on my radar screen, but I had other interests and throughout undergrad there were other opportunities on the table. After undergrad I was actually working in a restaurant as a pantry chef and was very interested in the restaurant business, but I saw better opportunities to make a difference through medicine, so I decided to go for it.
Is Quality Improvement new to you?
It is something that I have come to know through my medical training. I was exposed to quality improvement in my medical school curriculum; UConn ensured all medical students were involved in QI work. I was very attracted to the concept of a systematic, realistic approach to tackle problems we all experience in our day-to-day life. During my residency, I had the opportunity to work with several different projects across the health system. Applying QI methodology on different scales- from individual practice to system changes, convinced me that this is something that I wanted to incorporate into my career.
What are your main responsibilities as chief resident?
The Chief Resident for Quality and Safety (CRQS) is a position that was created by the VA to learn about and focus on quality improvement and patient safety work. I participate a longitudinal curriculum focused on quality improvement with other CRQSs across the country over this next year. I also have specific mentors at the VA, especially Dr. Joel Boggan and Dr. David Simel. I work within the VA to improve care for our veterans there. The last piece of my role is with the residency program, helping to lead the educational curriculum for the medical residents, leading the resident Patient Safety and Quality Council, and working with residents on their individual quality improvement projects.
What most interests you about Quality Improvement and Patient Safety?
My main area of interest is applying quality improvement to health systems, especially within the arenas of clinical innovation and population health. Essentially, working to answer the question: How can we restructure our healthcare systems in a way that helps patients flourish, not only when we are seeing them in an individual office encounter or hospitalization, but also outside the walls of traditional clinical care?
Do you remember a key teaching moment from your training that helped you become a better doctor?
There have been many, but one that stands out was during a rotation in the Medical Intensive Care Unit. At a critical point in the patient’s course, our attending, Dr. Peter Kussin, turned to the resident team for us to make the decision of how best to care for the patient. In that moment, I felt the weight of what it means to be a physician and of all the responsibility that comes with the privilege to make decisions like that one. Those moments inspire you to work as hard as you can to have the knowledge, skills, and compassion to be able to fulfill that responsibility.
What is your approach to leading and working with residents?
The residents that we have here are so incredibly talented, gifted, smart and dedicated that I think my role is much less ‘leading’ and instead trying to empower, mentor and do whatever I can to help the residents succeed. They’re really an amazing group; I’ve learned more from my co-residents over my four years here than any other single group of people.
How will you give your residents the confidence they need to be successful?
I think one of the biggest boosts early in your career is recognizing that you have something important to contribute. Something that may seem like an obvious idea to you could be something that no one else has tried before. I want residents to recognize that they can be active participants in the health system to improve care not only for their own patients, but for all patients in the system.
What makes you a good fit for this role?
I have a willingness to listen to others and to learn from them. I’m never the smartest person in the room and I am always excited to learn from those around me. I think that I will have lots of opportunities to do that during this coming year.
What assets did you look for in your chief resident that you plan to bring forward during your chief year?
One of the most valuable things my chiefs provided was informal mentorship during training. Not necessarily formal sit-down meetings, but little opportunities to teach, to encourage someone, and to remind each resident- in the midst of all the difficulties of training- of their unique human value and amazing skills. Those small acts encouraged me immensely in my training, and I hope to be able to do the same for others.
What do you want to do after your chief resident year?
Clinically, I will practice Primary Care as both an Internist and Pediatrician. I also plan to work on a system level to improve the population health for patients, especially focusing on transitions of care between settings and among providers. I think that by working to coordinate care around our patients we can really help our patients do much better.
What do you like to do for fun?
Spending time with my family - my wife and three kids - doing anything from playing in our neighborhood pool, to spending time with our church community, to visiting the Museum of Life and Science here in Durham. I also like to road bike, so I try to squeeze in a ride in the beautiful areas surrounding Durham whenever I can.
Is there anything else that you'd like to share with the Medicine faculty or residents?
My door (and my email) are always open, and I am thrilled for any opportunities to collaborate or do whatever I can to move projects forward.
Written by NyAsia Harris, communications intern for the Department of Medicine.