To our graduates: Your moment has come! Just three years ago, you were afraid to order Tylenol, unsure why patients should follow your advice, and shocked that seniors and attendings believed the information you gathered. Three years later, you’ve mastered procedures, absorbed troves of facts, and earned respect for your skills and judgment. You’ve been recognized in raves and shout-outs. You’ve won prizes at national meetings, and you’ve served on committees and distinctions. Most importantly, you’ve always done the right thing, even when no one was looking, even while knowing that your most important work won’t gain public recognition. You provided the best care imaginable and you improved patients’ lives. Your impact on our program will be felt long after your names fade into residency lore. I hope many of you will return some day as faculty to teach the next generation of Yale Traditional Residents.
So, what does it mean to “graduate?” I remember being a new attending in clinic, thirty years ago, facing my first patient with interstitial lung disease. I was comfortable with asthma, COPD, pneumonia, and ARDS, but when it came to ILD, I was clueless: simultaneously board certified and out of my depth. It was time to phone a friend, a senior faculty mentor to walk me through the challenge.
If you remember anything from my remarks tonight, let it be this: graduation is not a culmination but the start of your lives as trusted physicians.
You are now internists. You can sit for the Boards. After this month, your notes will no longer need to be co-signed. We trust you to make life and death decisions, and to know when to seek help. We trust you to honor your commitments: to return phone calls and messages, and to show up when your presence is expected.
You are ready for professional independence. We trust you to study, stay up to date, hone your skills, know your limits, and learn from mistakes. We trust you to prioritize the needs of your patients and avoid conflicts of interest.
We trust you to take care of yourselves: to eat, sleep, exercise, and socialize. To take care of your patients, you must take care of yourselves.
We trust you to promote quality and safety, advocate for vulnerable patients, and speak up when something is wrong. And when you do speak up, identify yourself as a physician and leverage your knowledge and credibility.
We trust you to speak honestly, accurately, politely, and compassionately. As the role of AI in medicine grows, it will be up to you to distinguish truth from hallucination. As AI helps us become more efficient, remember the notes you sign are your responsibility; your signature says you endorse the words above your name.
Of course, there are limits to self-regulation. The ABIM will test your knowledge this summer and throughout your careers. You will be required to meet the requirements of licensing boards, privilege committees, and future employers.
But you will exceed expectations, just as you have from the start of internship. Your knowledge runs deep. You are sophisticated clinicians and superb teammates. Your ethics and communication skills are beyond reproach. Your patients are fortunate to call you their doctor. You’ve become exceptional internists, not because you were told to do so, but because you set those expectations for yourselves.
You are starting your careers at a challenging time, during an era of social disruption, uncertain research funding, and fragile support for a fragmented and fragile healthcare system. But with the contributions you are bound to make, better days will come.
In your long careers, you will encounter changes beyond anything we can predict tonight. But whatever changes come, we trust you to uphold the timeless principles you mastered during residency: to promote science and social responsibility, to teach, to collaborate, to grow, and above all, to put patients first. In the proud tradition of our residency, may you always uphold our cherished motto, to be “as good as any, nicer than most.”
Thank you, and congratulations, everyone!
Mark
Mark
P.S. What I’m reading:
Trivia and ‘Jeopardy!’ Could Save Our Republic By Ken Jennings
Forget Speed. Finish Strong. By Mark Robichaux
What Happens When People Don’t Understand How AI Works By Tyler Austin Harper
The Doctors Made the Difference By (our very own) Katherine C. McKenzie, MD
America is ceding the lead in creating the future By H. Holden Thorp
Anthropic C.E.O.: Don’t Let A.I. Companies off the Hook By Dario Amodei
The Heaven & Earth Grocery Store By James McBride
We Saw Medicaid Work Requirements Up Close. You Don’t Want This Chaos. By Kevin De Liban and Trevor Hawkins
Backyard Mountain Laurel
