Doug Rice, MD (right), his fellow ACP Doctor's Dilemma®
teammates and 2023 champions from Oregon Health & Science
University.
Gabriel Monti, MD
Chief Resident in Quality and Safety
Portland VA Healthcare System, OR
Which residency or fellowship program are you currently in?
Chief Resident in Quality and Safety at Portland VA Healthcare System
Why did you choose internal medicine? If you’re in fellowship, why did you choose that subspecialty?
I have a deep passion for internal medicine, particularly in evaluating patients thoroughly and taking ownership of their care. I enjoy staying updated on advancements in the field to enhance patient care. My chief year in quality improvement and patient safety at the VA was driven by my commitment to improving patient access to care. While I admire my colleagues' work on new therapies, we must ensure patients can access existing treatments. This year, I will begin a fellowship in gastroenterology, motivated by my interest in performing procedures and treating patients with varying levels of acuity.
What lesson(s) did you learn in residency or fellowship that will help you for the rest of your career?
Ultimately, it is essential to meet patients where they are. Many may not be ready to follow recommendations, whether it involves taking medication, changing behaviors, seeing a specialist, or undergoing a procedure. This does not diminish our commitment to their care, but I have observed early learners struggle with this aspect, often leading to burnout. I have dedicated myself to understanding the reasons behind patients' decisions and addressing any barriers that prevent them from receiving the care they deserve, knowing I have done what I can.
What are your plans for after residency or fellowship? What factors or advice from mentors contributed to your decision?
I will be starting a gastroenterology fellowship at Oregon Health and Science University (OHSU) this year. Beyond that, I intend to remain in academics due to my strong interest in medical education. A mentor helped me realize that we must practice the type of medicine that excites and interests us; otherwise, the field will consume us. Personally, I can work for a week straight and then do a full day of teaching, feeling more invigorated than if I had worked less.
How has being a member of ACP helped you in your professional life? What resources have been most helpful to you?
I have been fortunate enough to be involved in ACP throughout my residency and chief year in various settings. Most critically, attending local and national conferences has enabled me to meet new colleagues and learn more about our profession than I ever could just at my home institution.