DGTL Medical Education (ft. Cynthia Kelley, DO)

Thanks for tuning to Digital Voices podcast, where we chat digital transformation, challenges, and opportunities across healthcare and life sciences. And now, your host, Ed Marx. Welcome to another drop of Digital Voices. Super excited about today's guest. And before we get there, I just want to say thank you to all of you listening. I know you have a lot of different choices what you can listen to. different podcasts like I do, uh, different music and all that kind of stuff. But you've chosen some time to spend with us, and I thank you for that. And in return, you're gonna get awesome content. We have no commercials, no sponsors, just pure content. So with that, I want to introduce Dr. Cindy Kelly from Summa Health. Cindy, welcome to Digital Voices.

Thank you, happy to be here.

Yeah, this is so cool. So I think my audience already knows, but just for self-disclosure, I am a board member of Summa Health, but I'm super, super proud of what Summa Health does. And being on the board, I often get some insights that I wouldn't have had otherwise. So sometimes my guests are from Summa. I'm obviously prejudiced for Summa. And so that's why these guests are here, because I get to hear great things about the quality work that we do and the great leadership and all that sort of thing. So Cindy, you're the Vice President of Medical Education at Summa Health and also the chair of the American Academy of Graduate Medical Education?

Very, very close. I am the Vice President of Medical Education at Summa Health, and I also am a volunteer with the Accreditation Council for Graduate Medical Education, which goes by the acronym ACGME. And in that capacity, I serve as the chair of one of the review committees.

Yeah. All right. That's cool. That's a volunteer position, like you mentioned. And yeah, I was trying to get the A and C. Like, I knew it was GME, but I was trying to get the A and C. I took a guess, but thank you for straightening me out. So, the first time we met, I think probably goes back 2 or 3 years ago when I first started at the board of Summa Health. You come in regularly and give updates on GME. And I was always impressed with you, just your style, your ability to communicate, your presentation. And then also you showed a lot of data about all the improvements you were making in GME. So I think that's the first time we met.

Oh, well, thank you for that.

Yeah, it was very cool. And so the main question we ask everyone, Cindy, probably the one that people are the most interested in, is what are the songs on your playlist? So when you have downtime, what kind of music do you listen to?

You know, it's funny. I listen to all kinds of music and I really find that For me, music is— can really be transformational. And I— and it is— it's so powerful in that it can get you out of a bad mood, or, you know, so, um, or it can— it can help you get into sort of a more pensive mood if that's kind of, you know, how I'm feeling. And so I have playlists for almost every mood. I have, um, a walking playlist. I like to do a lot of walking for exercise and, you know, You know, that is just entirely fun songs, and it's everything from the '80s and '90s, you know, Janet Jackson, Prince, Mariah Carey, to Rob Base and Run DMC and everything in between. So that's my— those are my— the songs I listen to when I'm walking. And then every morning I put on— I don't know, it's on one of the— I can't remember if it's on Pandora or what, but like a spa I have an a playlist just to kind of start my day and I do my journaling. I listen to music at work and that's more of a, maybe has a little bit of a beat there, but nothing too distracting. So, I just have music kind of going all the time.

Yeah, I love music. It's a big part of my life as well. What about your life message or mantra or words that you live by? Is there some words that you live by that you can share with us?

You know, I think, When I think of that, I think of the phrase, and I think it's attributed to Walt Disney, keep moving forward. I think if I kind of reflect back on my, my life, my personal life, my career, that just sort of rings true to me. And it's not, you know, whatever's happening, just put your head down and just like a bulldozer, just keep going forward. It's not that. It's You know, things are going to come at you. They always do. That's, that's life. And whatever it is, you kind of have to take a pause, assess it, and just find a way to keep moving forward. And, and some days, you know, some things we deal with, the best you can do is just to not go backwards, just to kind of stay steady.

Yeah.

Um, but, uh, I, I think, um, that, that kind of, I, I think is something that I've kind of lived my life by, just trying to keep moving in a positive direction forward.

Yeah, yeah, I think that's, that's great. So Cindy, I didn't do much of an introduction other than sort of your titles with Summa and your volunteer work at AC. You got it. And, and so share with us a little bit about yourself and personally and professionally and, you know, all the way up to today, like what you're doing So I was born and raised in Akron.

I'm from this community. Our family first came here back in the '70s. Actually, my father was the first board-certified neonatologist to Akron. After his fellowship at Cincinnati, he was recruited to Akron Children's Hospital, and he helped start the neonatal intensive care unit.

Wow.

And I grew up You know, back in the '80s when you were allowed to do such things, I'd tag along with him to rounds and in the ICU and to high-risk deliveries. And I just, I loved being, I loved being in the hospital. I loved watching him, you know, reassure these families and take care of these patients and the impact that he was able to have on kind of guiding them through some of the scariest times of their life. You know, when you have a sick baby, Wow. And so— so— but I went to high school here, spent a couple years out in Maryland. My mom got remarried and lived in Western Maryland for a few years which was really beautiful. Came back to Ohio for undergrad at Miami University. Went to medical school at Ohio University Heritage College of Osteopathic Medicine. And it was, um, then that I decided to, um, pursue family medicine. And I, um, matched in residency at, at Summa Health. And, uh, I haven't left. So I completed my residency from 2001 to 2004, and I was lucky enough that there was a faculty position open when I graduated. And, um, so I stayed as a faculty member for 11 years. And then my current position became available in 2015, and it was my dream job, still is my dream job. And so I'm, I'm very proud to be able to do this work at my, at my home institution in my hometown.

Yeah, that is pretty cool, right? It's like you're, you're, it's a homecoming, like you, when you never really left except for a couple years there. But yeah, you're, you're a local person and you got to Got to stay. Yeah, it's a great community, and I'm glad there's individuals like you providing care in that community. So yeah, that's pretty cool. So how did you develop an interest in GME?

So it was in medical school. Ohio University had this wonderful opportunity. They sort of called it this fellowship, although most fellowships happen, you know, after graduation, but they had this sort of undergraduate fellowship whereby you could extend medical school for 1 year and spend time working with a family medicine physician. So you'd spend 6 months just working with that physician and seeing patients in his office and also teaching. And so I was able to get exposed to all kinds of teaching. So small group discussions, writing cases, big large lectures, You know, in the big auditoriums and kind of all of that. And I really fell in love with teaching. And I, I, the only reason I applied for the fellowship was I knew the physician, his name is Jack Brose. I really thought a lot of him and I thought, well, if there's an opportunity, you know, to, to work more closely with him, I think that would be, that seems like a good thing for me to do. So, and it was probably one of the best decisions I made because I kind of got the teaching bug then.

Yeah.

And so that was when I knew that medical education would be in my future. I did think that after residency training, I would go out into practice and do private practice for a while before coming back and teaching. I thought, I need to go learn something before I teach it. But we didn't have a lot of turnover in the faculty positions at that time. And when this one became available, I thought, well, it might be now or never. I talked to my husband because it was a position. I mean, it was full-time. It also included OB-GYN, so I would be delivering babies, which is, oh, you know, a lot, a lot, a lot on the weekends, a lot of the evenings. We had already started our family, so, and he is an emergency medicine physician, so shift work. So it was definitely a family decision, but I decided to go for it, and I've been in GME my entire career, and I just love it. It's such a challenge, and it's so rewarding to try to— you try to envision what tomorrow's physicians need to be, what skills they need to have, what world are they going to be practicing in, and then back it up and try to provide that education and that support to them now. And it's really wonderful and really rewarding. Really gratifying.

Yeah, no, that's cool. And you know, I was just thinking, Cindy, that perhaps not all my audience knows GME. Can can we step back and just sort of explain?

It's very confusing. I think too. I remember trying to understand it, you know, even when I was trying when I was younger and trying to understand what my dad was doing and where he was and all of these steps along the way, and it just. It was a jumbled mess to me. So, you know, you go to college, you know, and then you go to medical school. That's 4 years of medical school that everybody has to go through if you're going to be a physician. And then at the end of the medical school, of medical school, it's kind of funny. I mean, you're a doctor, but you can't do anything. You have no skills. But, you know, you've gone through training. So then in the period of residency is when you specialize. And so I did a family medicine residency. That's graduate medical education is the post-medical school time. So in graduate medical education, you become either a family doc or an OB-GYN or a surgeon. So that's residency. And that can be anywhere from 1 year to 3 years to 5 years depending on the specialty. And then if you want to further subspecialize after that, you can go into of fellowship training. So, um, like a cardiologist would do internal medicine residency and then a cardiology fellowship. And then if they want to do interventional cardiology, then they could do an interventional cardiology fellowship and keep going. So that's— so what I oversee is those residency and fellowship programs, um, that are, that are training residents and fellows, um, at Summa. For that post-medical school time.

Yeah, yeah, yeah. I, I don't know that people realize sometimes, you know, how much training. And like you said, in a subspecialty, right, you could be in your 30s if you started, uh, medical school at 18 or college at 18 and then medical school. You could easily be in your 30s, right, before you're actually practicing, depending on your, uh, how many fellowships you've had and things like that.

Absolutely. It's a— it's— it can be a very Yeah. Yeah.

I've, I, I respect it quite a bit. Uh, have you had other, uh, GME roles like in the organization? Uh, I know that you're, we just talked about how you are in the position, uh, related to the Institutional Review Committee. Have you had other roles within the, uh, GME organization?

Uh, that's really the only, um, role that I've had within the organization. formal, formal role that I have is serving on the Institutional Review Committee. And that's a, that's a 6-year term. And so I'm just, I'm halfway through my, my term on the committee and just moved into the chair position. So I have 3, 3 years as the chair.

Yeah, I like the fact that the commitment's that long. Because, you know, sometimes in organizations, if it's only a year or two, there's not a lot, not enough consistency and to really move things forward. So I kind of like that. So yeah, so we've talked about it already, but share with us what the ACGME does.

So the ACGME, again, that stands for the Accreditation Council on GME, Graduate Medical Education. It is the organization that accredits all residency and fellowship programs in the country. And it even has an international arm as well. And so, and it also accredits the institutions that sponsor residency and fellowship programs. So what that means is every specialty, you know, has a set of requirements that the programs have to follow. And it has to do with, you know, you have to be able to provide these resources like a certain number of surgeries have to happen in order to train a surgeon, right? And, and you have to have a certain number of admissions and a certain number of procedures. And all of that is sort of prescribed by the ACGME in these program requirements. And so that is the body that, that says, yes, you meet the requirements to train, you know, surgery residents or emergency medicine residents or what have you. And then in addition, there are requirements just to be an institution To have residents and fellows. So that's separate from the specific programs, just as an institution. So that can be a hospital, it can be a clinic, but there have to be certain rules that you have to follow in order to just have residents and fellows there. So the ACGME writes all of those requirements, and then every single year, every institution and every program gets an accreditation decision. Um, and so that's, that's the body that sort of manages all of that.

Yeah. Do they come on? Is it sort of like JCO where they come on site periodically and do like get in depth? It's not like a survey you're filling out.

Yep, they, they do. Um, it's, it's, they sort of transitioned from a model of, okay, you're good for 3 years, we'll see in 3 years. And, you know, people would get everything all perfect and have this big giant visit with thousands of tomes of paper and do a visit, and then they'd say how good you were and when they would come back. They really transitioned away from that to what they call the Next Accreditation System, where every year we upload data into their website and they look at the data. And from that, as long as everything is looking good, you might not have a site visit for a long time. If certain things are triggered, then they might say, wait, we either need a little bit more information, or maybe we need to go do a site visit and see what's going on. So a site visit might be triggered and come out and take a look. And then they also do like every 10 years, every institution will have a site visit no matter what, just to come out and see how things are going. So it definitely, yeah, that is definitely a part of the accreditation is the site visit in that process.

And so if I understand the history correctly, you know, from our last board meeting when you were sharing, the news of your appointment to this position. We've struggled. SUMMA has struggled in the past with a little bit of this. And so, but obviously you've come in, you've corrected it, and now you're sort of leading part of that area, right? If I understand it correctly.

Yeah. I mean, it is, it is. You said earlier, it's a little bit ironic and it is. I mean, we did have some accreditation difficulties back in 2017, with one of our residency programs and as an institution as a whole. And so, you know, we had to— I mean, that was a very difficult time to kind of navigate. But I mean, we did it through saying, okay, what is our situation? What are we in violation of? I mean, what requirements are we not meeting? How are we going to meet them? How are we going to Come into compliance. And, you know, we just worked through it together. Uh, you know, I have a graduate medical education committee, which is comprised of our program directors, our coordinators, residents. You know, we all came together and said, where have we missed the mark? And, and how can we, how can we right this ship? Um, and, and we did, and we really, you know, turned it around within that same year. We were back really in, in good standing. Yeah. As we often do when those things happen. Right.

Yeah, absolutely. What— how does— does the ACTME have a position at all on sort of digital or technology? Like, is that something that they think about, you know, as, as we evolve with technology and things like that? Does that become part of this whole process?

Very much so. I would say that the ACGME, I think, you know, for an accrediting body, which I think a lot of accrediting bodies kind of have this reputation of sort of being slow to adapt and kind of, you know, but the ACGME, I think, is a very forward-looking institution, and they engage in a lot of strategic planning and, They, they came together several years ago and wrote a paper about, well, what does an institution look like in 2025 that is sponsoring GME? And they, they didn't anticipate everything that came with the pandemic, but they definitely anticipated an increase in consumerism, the influence of tech, the influence of artificial intelligence. You know, think about these things, think about how AI is going to influence the practice of medicine, and then how you train a physician. So I would think that it's very much embracing, embracing these different factors and trying to figure out how, how we incorporate it and how it's going to impact medical education in the future.

Yeah, that's good. And that's great to hear. I figured as much, but, you know, I was really curious about that. Well, let's switch over to just leadership. So I appreciate the insights there on GME and how important it is, what a role it plays in healthcare. It really helps ensure that we have high standards, right, in our country for everyone who practices, and everyone is sort of judged on the same type of metrics. Where do you draw inspiration from, Cindy? So you obviously have to be As a leader, you know, sort of creative, innovative, and these other volunteer positions that you have, is there a particular place where you draw inspiration other than the music, the '80s music?

You know, I really draw inspiration honestly from everything around me, to be honest. You know, I see our residents and our fellows who are taking such great care of our patients and, you know, they're While they are honing their own craft, right? And so every time I get an email about, you know, this great care that a patient felt that they received from one of our residents, or, you know, they really stepped in and managed this really difficult situation with skill, I mean, that just makes me so proud. And it really makes me want to work even harder to support them and provide the environment that they need. So that they can go on and thrive in their careers. And, you know, the physicians who are, you know, doing the work and the nurses who are taking care of our patients, I mean, I saw my own, you know, patients for many years, and now I'm more of an administrative role. I'm kind of behind the scenes supporting them, but the real work is out there, you know, on the floors, in the ER, in the ORs, helping our patients. And so just seeing them, do their work just makes me want to work even, even harder, harder for them. I also, I mean, I love to solve problems. And so, you know, when you start to hear these themes happening about, why isn't this working? Why do we do that? Why don't we do that? You know, there's just, that inspires me to try to find ways to do things better. And I, and I feel like, particularly at our, our institution where Like, we're not huge, huge, so you don't have to ask a whole bunch of people, you know, can we try this initiative? But we're large enough so that we have some scale and some resources to do things. So that, that really makes me excited to keep finding ways to, to make improvements and do things better. And I think the last, the last place I really look for inspiration, it's in my family. I have 4 girls, and you don't get glimpses of it a lot. But every once in a while, you know, they say something or they tell you, or they maybe write you a note or something, and you realize how much they're watching you and what they're picking up. And it just makes me, you know, and I'm so proud of them. It just makes me want to be even better for them. So that's a big place that I draw inspiration from, just my family.

Yeah, I can relate for sure. So I have 5 kids and yeah, I learn Everything from them, all my technology, any savviness that I have all comes from them, you know. And they still today, you know, they're young, young adults and they're still like teaching me all the time. So, uh, that's pretty cool. Now, when you went through this challenge with, uh, the GME situation at Summa and you've fixed that up and, and you went through that process, takes a lot of leadership and transformative leadership. Is there one or two things, and you did a great job just describing A little bit of what you had to do. But were there one or two things that you learned from a leadership perspective when you did that?

You know, absolutely. I learned pretty, pretty early in that whole time that you really have to get vulnerable as a leader. You have to, well, yeah, get vulnerable and open yourself up to the inputs that are coming to you. So, you can say that This is wrong. This isn't fair. I didn't mean that. Your interpretation isn't right. That's not what happened. I mean, you can do that all day long. And I did for a little while, and I was sort of butting up against everything. I mean, everybody was upset. The residents were upset. The medical staff was upset. I certainly had already gotten the information from the accreditor saying, you guys are off track here. So I, I, um, once I— and, and it was a process. I mean, I actually got wonderful advice from one of our residents and, and other, other, you know, sort of inputs coming in. But once I kind of switched my mindset and said, okay, this is our situation. I can say it's not right, not fair, not all these things. That isn't helping anything. Um, what do I need to hear? What are people telling me? Because that's the reality. It's not my reality. The reality is, is what is happening, and it's reflected back to you. And once I was able to kind of just stop and listen and just pause, everything changed. And I could have a different relationship with the people I was working with to try to fix the issues. I could focus on solutions and stop spinning about whatever, you know, I thought or Whatever. And, and I— that was a really valuable lesson, and that's helped me a lot moving forward when I find myself in a situation where I'm just frustrated and I think the way I'm viewing something is the right way, but something isn't working. I stop and I just open myself up and hear, OK, what, what's the world trying to tell me? And how do I need to shift and move forward? And I have found that that's been such a, such a key to, to leadership, just to be able to open yourself to what people around you are trying to tell you. Because even if, you know, even if what you're hearing, you're like, yeah, that's not right, there is a shred of truth in almost everything. And so you have to hear it and then, and then identify the issues, put solutions in place and go forward. I think that's probably the biggest lesson.

Yeah, I love that, Cindy, because you're right. Because I think if more people were like that, I think we'd solve a lot more problems collegially. Uh, you know, we, we tend to be defensive, and, and we have to realize, like you did, okay, I am being defensive. I'm going to let down my guard, be vulnerable, be transparent, and really try to work with others and solve problems. That's, that's the really good way to doing it. Otherwise, you know, it doesn't accomplish anything. It doesn't help anything if everyone's being obstinate and not willing to Yeah.

And you know what I really found was, um, because people, I mean, people can identify with that and everybody, I found that people, you know, when you say, okay, I messed up, I shouldn't have done that thing, I shouldn't have sent that email or taken that step or whatever. I mean, I think people fundamentally are very forgiving and they go, okay, I mean, what's there to still be angry about? You know, we're all on the same page. People are very forgiving, and it sort of diffuses everything just to say, you know, let's work through this together. I mean, I found that things just moved incredibly, incredibly quickly in a positive direction once we kind of got to that place.

Yeah, it only takes one person to start that process, you know, be that way, and it helps solve tough challenges. So, wow, we've talked about a lot of different things here, everything from '80s and '90s music Uh, you know, uh, to all things GME. So if anyone ever had a question about GME and how that works, I think we certainly solved that. And then, and then we ended sort of on this leadership. And, and so it's been really fascinating. Is, is there something that I missed, or is there anything that you want to double down on? I'll give you the last word.

Um, I guess the only other thing I'd say is, um, I spent a lot of a lot of time thinking about this as a, as a leader in, in organization. And I'm, I'm definitely an introvert. And sometimes, you know, my style, I have felt sometimes early on in my career, like maybe I don't belong here. I don't belong at this table. Or because, you know, a lot of the values that we ascribe to, you know, leaders tend to be more of the sort of extroverted kind of values. But I guess the only other message I, I really want to share is that I do believe there's a place for all of us at the leadership table. I think we all have something valuable to bring, and it's something that only we ourselves can bring forward, right? You can't be somebody else. You should never try to be somebody else. So I really believe that, and, and I, and I appreciate that I've been able to, you know, find myself on this journey. journey and, and bring, um, bring my ideas and, uh, you know, forward, um, at Summa and, and be part of, part of our organization and moving it forward.

Yeah. And not just at Summa now, every health— every hospital in healthcare.

Right.

Yeah. So that's a great reminder, 'cause I know there's a lot of leaders out there or aspiring leaders that are listening and, and they always think, oh, I need to be like that person because they're loud, boisterous, or, You know, they love, they thrive on sort of being, you know, center of attention, things like that. But that doesn't make them a leader. It's, it's really the content and what people can do and impact and make change. And I just want to support you, Cindy, because, you know, I sit there at the board meetings, I see all types of leadership. And whenever you come in and when you leave, there's like this sense of confidence, like she knows what she's doing. She's a great leader. And so I really appreciate that.

Thank you so much.

Well, Cindy, thank you for being with us. Super, super informative.

Thank you for having me. It's really been, been a lot of fun.

All right, that wraps up Digital Voices. Thanks for listening. Thank you for listening to Digital Voices podcast with Ed Marx. If you enjoyed this episode, subscribe on your preferred streaming service and leave a rating and review. And most importantly, thanks again for listening.