Adam Banks, MD, is the chief resident for internal medicine at the Durham VA Medical Center. Dr. Banks helps run the general medicine service at the VA, plans Medicine Grand Rounds and, teaches residents, which he says is his favorite part of the job.
Banks earned his undergraduate degree at Vanderbilt University and attended the University of Texas Medical School at Houston. He will resume his fellowship in cardiovascular disease at the end of year. Keep reading to learn more about his teaching philosophy, his love for residency and how he ended up at Duke.
Q: What are your main responsibilities as chief resident?
A: My responsibilities are unique as the VA Chief. I help run the medicine service at the Durham VA and have the opportunity to coordinate care with outside VAs, hospitalists, and the general medicine teams. The rest of my job is a combination of teaching, rounding on the ward services, and administrative time organizing the general medicine schedules at the VA and Duke. My favorite part of the job is getting to teach the residents and students. This year we have been trying to overhaul the noon conference series to a more active learning model, and getting to be part of the case conference has been the most rewarding part of the job.
We also have fantastic opportunities to meet with leaders in medicine inside and outside of Duke. We meet with Ralph Corey, MD, vice chair for education and global health in the Department of Medicine, every Tuesday and Mary Klotman, MD, chair of the Department of Medicine, on a monthly basis to discuss the residency and our career plans. All of the chiefs also invite a speaker of their choosing for Medicine Grand Rounds to get different perspectives from leaders in medicine outside of Duke.
Q: What makes you a good fit for this role?
A: I loved residency, and I think you have to be excited about what you are doing and believe in the program and the process to be a good chief resident. I think it is important to be a good communicator and to have the humility to see other people’s view point, even when you don’t necessarily agree. You have competing interests sometimes because you want to do what’s best for the patients and hospital, but also what is best for the residents as learners. Sometimes those things coincide and sometimes they compete against each other so conflict resolution and communication are important for all the chiefs.
Q: What do you hope to accomplish this year?
A: I have a tremendous sense of gratitude for the training I received at Duke. My biggest goal is to educate the residents as much as I can, whether that is at case conference or on the wards. My co-chiefs and I came in at a unique time where there is a lot of opportunity for change, so being innovative was a big goal for us. Having just gone through the fellowship process in cardiology, I have been a mentor and role model for residents interested in that specialty and have shared advice that I was given just a couple years ago.
More personal goals of mine were to keep expanding my knowledge of general medicine and cardiology and start to develop some research projects that I can move forward with as I transition back to my cardiology and research fellowship. It goes without saying that patient care always comes first. At the VA particularly, as we make changes to the residency, we make sure we maintain the outstanding patient care that’s always provided.
Q: What is your approach to leading and working with residents?
A: I like to lead by example. It’s always tough because we are fairly close to the residents and knew a lot of them before starting chief residency. You want to be their friends but at times you have to tell them when they need to change certain isolated behaviors. When I do talk to residents I always emphasize that they have these outstanding strengths but there may be one area that they need to work on or improve. We are really fortunate as chiefs to have the assistant chief resident role because the interns and residents see how they behave on their rotations and see how an excellent physician works.
Q: How do you give residents the confidence they need to be successful?
A: I think it has to be individualized for the resident. What I emphasize is that all of our residents are outstanding and everyone has a different learning curve when they start, but everyone gets there by the end of intern year. Despite if you are struggling now, you’re going to get there. One thing that I think is great about our rotations is that we have our flagship rotations on General Medicine at the VA and Duke. I think it’s really important that we have those rotations twice during the year. These rotations automatically give the residents confidence because the second time around is so much easier than the first time. Even if they do have doubts, they see how far they came within a matter of months and that promotes confidence. The other thing I always emphasize to people is that it’s easy to feel alone in the hospital, but you always have multiple levels of back up. Once you realize that you become more confident in making your own decisions.
Q: Do you remember a key teaching moment from your training that helped you become a better doctor?
A: I am somebody who needs to get my feet wet before I feel completely comfortable, and looking back I remember being an intern on Gen Med VA, and it was a day when my senior resident happened to be off. My attending was available but wasn’t immediately around, and we had a sick patient, who throughout the day was decompensating. I was the one managing him medically and having detailed complex discussions with family members. For me that was one time when everything clicked and I realized I can be a great physician. That was probably 8-9 months into intern year, and after that everything got easier. It’s one thing to learn about something in conference, but when you see a disease state in a patient and learn how to treat, manage and diagnose it, you never forget it. Those things stood out to me.
Q: What is it like working with this group of chief residents?
A: It’s been fantastic. It was interesting because we all knew each other from residency, but didn’t necessarily hang out frequently outside of work. Quickly before chief residency started we started to meet and everything just clicked, and now we have developed into great friends. I think we will be colleagues and friends for life. We each have our own specialty, and we bounce questions off of each other when we are talking or doing sign outs with residents, and we have had a lot of time to have fun together. We really had a blast with the Christmas party, and I think that was something that made us closer and that we will look back on fondly.
Q: How did you end up at Duke?
A: I’m from Houston. When I was looking at residency I thought I wanted to stay in Texas or go to California because I love the outdoors and all my family is in Texas. I didn’t really have Duke on my radar that much, but I was encouraged to apply by some of my mentors in medical school. Then when I was here for my interview I knew this would be the best place for my career. I was blown away by the leadership – Aimee Zaas and Dave Butterly – on interview day and how close they seemed to be with the residents, and how open Dr. Zaas and Dr. Klotman were about being great advocates for the residents both during the program and looking further in their careers. At the resident dinner and throughout the day, I recognized how close the residents were as colleagues and friends. During the interview I knew I wanted to pursue cardiology and that this would be an amazing place to train in both internal medicine and cardiology. I ended up really loving the program and Durham. I honestly thought Durham would be a downside but after getting here, I loved Durham as well. I like going to Eno River and Umstead state parks for hiking and to run. I’ve taken trips to Asheville and checked out some of the new breweries that have been popping up in the area.
Q: What was that extra piece of the puzzle for you during residency?
A: I was an assistant chief resident for two months during my third year. It was a great opportunity to teach the medical students and residents. I also took a lot of opportunities to work with medical students when I could. When I came here I had really done very little research and so coming to Duke, I really got to see what doing clinical research was all about. I got to do a couple projects during residency that I really enjoyed. I wrote a review chapter with Ralph Corey, and I worked on a meta analysis with Schuyler Jones on peripheral arterial disease. The biggest project I worked on starting intern year and throughout residency was with Rob Mentz. I have an interest in exercise in cardiovascular disease, and I worked on a study looking at exercise and heart failure patients with diabetes. I was fortunate to get that started late intern year and developed it through our ClinEpi rotation and finished it third year and got it published, which was a rewarding process. It was an interesting article but more than anything just to see how the research process works, and how to start with a question, develop a proposal, work with a statistician and all the way to writing a paper.
Q: Did you always want to go into medicine?
A: Fairly early on I knew I wanted to go into medicine. I am the first person in my family to graduate from college, so I didn’t have exposure to it or know what to think about it, but very early on I was interested in cardiopulmonary physiology. My path to medicine was initially an interest in exercise physiology because I ran cross county in high school and then in college I worked in several exercise physiology labs. Initially I was a biomedical engineer, and majored in that because I knew I was interested in the physiology and innovation. But early in college I had some opportunities to work in a lab with a biomedical engineer and also had an opportunity to shadow in a pediatrics clinic, where I got to go to pediatrics case conference and round on teams briefly. I quickly realized that I enjoyed the patient interactions and clinical medicine. Once I was interested in medicine I was almost Immediately interested in cardiology because of the physiological, hemodynamic, and innovation aspect of it.
Q: What do you want to do after your chief resident year?
A: I did one year of cardiology fellowship so I’ll go back next year. My eventual plan is to do interventional cardiology and then structural heart disease, which is a fairly new specialty focusing on valvular and congenital heart disease. I know I want to stay in academic medicine for both the clinical education and the research aspect. I enjoy formulating new research questions and ideas that could improve the field of medicine and cardiology, as well as having the opportunity to mentor rising students and residents.
Q: What do you like to do for fun?
A: The main thing I like to do is running or hiking. I ran in high school and college, and I absolutely love it. It’s how I clear my head, and I tried to keep up with it as much as I could during residency and chief residency. I like to be outdoors as much as possible, especially hiking. My wife, Lisa, and I like to hike here at Eno River State Park and the Washington Duke trails. Whenever we travel we try to hike. Most recently we went to Havasu Fall and travelled to Yosemite last May for our honeymoon. I also like to explore new restaurants and breweries in Durham.