Residency Spotlight

An Interview with Carl Bonnett, MD

Tell us about your career path since graduating from Denver Health.

I began the emergency medical services (EMS) fellowship immediately after graduating and am currently still in the fellowship.

What are your goals after finishing your fellowship?

I would like to work in an academic setting conducting research and educational activities relating to emergency management and disaster response. On the military side of my life I am working within the Colorado National Guard to improve its disaster response capabilities and to turn it into a high-speed homeland security/disaster response organization.

What are goals to achieve during your fellowship?

First, I want to learn as much as I can about the management and administration of prehospital systems.  Second, I want to hone my skills in the areas of emergency management and disaster response.  I'm attempting to develop an understanding and knowledge of the various agencies and organizations from the national down to the local level which prepare for and respond to disasters. Finally, I want to develop an understanding of and conduct research in the area of EMS/disaster communication.

How did you decide to come to Denver Health for residency training?

I initially was drawn to Denver because my wife's sister and her husband moved out here first. After I rotated here as a fourth year medical student I was sold on the program.

Did you rotate at Denver Health as a fourth year student?

Yes. Here and Hennepin County Medical Center in Minneapolis, MN.

Many alumni talk about the "DG way" or the "Denver way".  How do you describe that phenomenon?

The residency has been around for a long time and has played an important role in the development of the specialty of emergency medicine. Additionally many Denver Health physicians have made important contributions to our specialty's collective knowledge base and the practice of emergency medicine. In so doing, I think you can't help but create an institution with its own culture and traditions. The "DG way" does NOT mean a failure to practice evidence-based medicine however. There is a certain order to how we do things and a certain way in which the department is structured. This is the same reason that people are attracted to some of the older well-established Ivy League universities. We have a unique culture and I see this as a positive. There are plenty of emergency departments in town where nurses and techs could work. Most of them want to work here because of the team atmosphere and the environment that Denver Health has created.

Applicants are often focused on choosing between a three year and four year program.  What are your thoughts on that?

I think that emergency medicine residencies should be four years long. There wasn't a single shift in my fourth year where I didn't learn something new. When you are in residency, you are actively interacting with attendings and other residents and learning new things every day. I guess it depends on your personality. Are you the type of person who wants to be prepared with a capital "P" or do you want to be in an emergency department by yourself swallowing hard and hoping that nobody really sick comes in? If you think about it, psychiatry and neurology are both four year residencies. Do they have more to know than we do?

Are there any particular moments or patients that you still remember from residency?

Part of the training process is making mistakes and getting that queasy feeling in your stomach when you realize you may have done something wrong. Luckily that's why we have higher level residents and attendings to catch us before we do something really stupid. No particular patients are coming to mind but there were plenty which humbled me and gave me an understanding for just how bad things can get if you get overconfident and let your guard down.

What advice would you offer to residents at each level of their training?

Don't get cocky. If you haven't dropped a lung yet then you haven't done enough central lines. If you haven't missed an intubation yet you haven't done enough tubes.

Did you feel like the senior position prepared you well for your role as an attending?

Residency prepares you to manage patients safely and tell the difference between "sick" and "not sick." To any readers who think that this is easy I would refer you to my previous answer. What I have found is that residency is just the beginning. I still have a lot to learn. This is especially true with regards to really understanding the evidence behind the things I do in my practice.

Where do you see yourself in five years?

I see myself as an attending in an academic emergency department. I would also like to be actively involved in emergency management and disaster medicine on the local and national level.

How has your military experience benefited you as a clinician?

Joining the Army National Guard was a life-changing experience and one of the most important decisions I have made. One can laugh about various bureaucratic aspects of the military but the mindset that one develops as a result of the training is invaluable. Military people don't deal with problems; they attack them.

On a purely personal level, serving in the military and especially getting the chance to serve in Operation Iraqi Freedom has given me a whole new perspective on what it means to be a citizen of the United States. It is like being given a color TV after watching black & white for your whole life.

Do you feel your training at Denver Health has prepared you for the unique and important challenges you will face as a military practitioner?

It is almost cliché to say, but I feel prepared to practice in any medical environment. Denver Health is a challenging residency. You are going to see a lot of patients and you are going to work hard. When you are done though you're not going to be swallowing hard hoping that no one sick comes through your door.