When I began telling people I was considering becoming the Founding Program Director of a new family medicine residency in rural Eastern Washington, the responses were not exactly subtle. “Are you nuts?” “Do you need me to say WTF, Tonya?!” And, perhaps most thoughtfully: “This doesn’t seem align...

A webinar this week about the evolution of a rural residency program inspired this week's reflections. In addition to the successes and growing pains, the thing that caught my attention was the sheer number of changes they had both created and endured. In just 11 years, the program had 4 Chief Me...

In medicine and academic leadership, change is constant. But the kind we choose feels different than the kind we don’t. Lately, I’ve found myself thinking about what lies beneath the surface when frustration rises. Sometimes what looks like resistance or blame turns out to be something else entir...

Last June, the Titan submersive caught the attention of the world. When he described the Naval Submarine Priorities in all situations, Rear Admiral John Mauger caught my attention when he said: "Number 1 is Safety, Number 2 is maybe something along the lines of avoiding counter detection, Number ...