When Jennifer Geiger started her general surgery residency at UC Davis School of Medicine four years ago, she confronted a problem not easily solved.
Geiger noticed that, when preparing for emergency surgeries, many of her patients or their families could not articulate the type of health care they wanted to receive in the event they could no longer make decisions on their own. Geiger at times felt helpless. She, and many of her fellow residents and faculty, lacked formal training in palliative care skills or the time needed to guide patients into critical conversations before surgeries with uncertain outcomes.
But thanks to her concern, future residents at the School of Medicine will be better prepared for these difficult situations.
The Association for Academic Surgery and its foundation (AAS/AASF) awarded Geiger a grant to create and implement a formal palliative care curriculum for surgical residents. It will include an emphasis on communication skills to better meet the needs of their patients.
The $30,000 grant allows Geiger to dedicate a year of full-time research to developing the much-needed curriculum.
Geiger is one of just three surgical residents in the U.S. to receive a 2021 AAS/AASF research award.
“I am ecstatic and extremely grateful to have received the 2021 AAS/AASF Trainee Research Fellowship Award for Education for my proposal,” said Geiger, now a fourth-year general surgery resident. “Most of us receive limited, if any, formal palliative care training in residency.”
— Misty Humphries, assistant professor of surgery
Patients will benefit from the new curriculum
The curriculum will benefit residents and in turn, their patients and families, said UC Davis Health Associate Professor of Surgery Misty Humphries, who is Geiger’s mentor and director of the Research Experience in Surgery (RESURG) Program.
“As surgeons who do a lot of emergency-based work, such as trauma or vascular, we see patients frequently at the end of their life,” Humphries said. “We have very quick discussions about what the patient wants when they present with catastrophic illnesses that could potentially lead to imminent death or a prolonged hospitalization.”
In many cases, Humphries said, a surgeon readying for an emergency procedure has less than 30 minutes to get to know a patient, gain insight into their values, and learn their desires for end-of-life care.
Geiger’s curriculum will teach residents how to engage in palliative care conversations, such as making sure patients and their family members understand how to file an advanced directive, the legal document that spells out how someone wants to live the rest of their life if they can no longer make decisions on their own.
“She’s looking to train people about having these difficult conversations,” Humphries said. “She’s tackling a really difficult problem that a lot of people don’t want to address. That’s what’s unique about her work.”
Geiger, who earned her medical degree from the University of Michigan and a master’s in public health from Harvard University, aspires to become an academic surgeon with a focus on patient-centered outcomes and health services research.
Upon completion of her year-long curriculum project, Geiger will present a summary of her research at the 2023 Academic Surgical Congress meeting.
She’s already looking forward to the presentation.
“It’s an incredible opportunity to access the mentorship of surgical leaders in the association – an invaluable resource in pursing an academic surgical career,” Geiger said.
She hopes to share the curriculum with surgical training programs beyond UC Davis, so that residents across the country “are better equipped to meet the needs of our patients and provide value-concordant care.”