Dr. James Wyant, Program Director of Sentara and Eastern Virginia Medical School's newly established neurology residency program

Summary

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Becker’s Healthcare Podcast Episode Summary

Guest: Dr. James Wyant, Program Director, Sentara and Eastern Virginia Medical School Neurology Residency
Date: November 9, 2025
Host: Becker's Healthcare Podcast
Topic: Launching and Sustaining a New Neurology Residency Program

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Overview

This episode features Dr. James Wyant, program director of the newly established neurology residency at Sentara and Eastern Virginia Medical School (EVMS). The conversation centers on the complexities of starting a new physician training program, overcoming obstacles, the importance of collaboration, and strategies to build a sustainable workforce for neurology in a region facing provider shortages. Dr. Wyant also shares insights around retention, resident wellness, and provides advice for other leaders considering similar initiatives.

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Key Discussion Points and Insights

1. Challenges Launching a New Residency Program

• Complexity & Scale: Dr. Wyant emphasizes the monumental nature of starting a program from scratch and the sheer number of administrative and curriculum-development tasks involved.
  • “There are so many small pieces to starting a program like this. There’s a lot of paperwork…it’s a monumental project.” (01:13)
• Collaborative Environment: Success has come through robust collaboration between Sentara, EVMS, and various stakeholders.
  • “That collaboration...helped overcome the biggest challenge, which is getting a handle on the many moving parts and assembling that into one cohesive program.” (01:53)

2. Securing Faculty and Institutional Buy-In

• Anticipated Hesitancy—But Found Enthusiasm: Despite concerns about faculty bandwidth, Dr. Wyant found great support within the local medical community.
  • “I haven’t seen that [hesitancy]. Every person that I’ve talked to...it has been nothing but positive feedback.” (03:19)
• Advice to Others: Leading with a “top-down” approach helps secure leadership buy-in and demonstrates how residents add value.
  • “Convincing leadership...that the residents can add value, can assist with workflow rather than slow it down, is essential to fighting that hesitancy.” (04:08)

3. Impact on Local Neurology Access and Care

• Filling Regional and National Gaps: There’s an acute shortage of neurology providers, not just physicians but the entire neurology care team.
• Pipeline Solution: Residency programs are critical for safeguarding and expanding the clinical workforce, ensuring patients’ access to specialized care.
  • “Starting this residency is going to help expand and safeguard the clinical workforce years down the line by establishing a pipeline of training.” (07:19)
• Business Case: The need for neurologists was self-evident to administrators, making approval and investment straightforward.
  • “It took very little convincing to get our administrators to recognize the value of starting this program.” (08:13)

4. Retention and Resident Wellbeing

• Building for the Long-Term: Strong departmental culture and communication are foundational.
  • “It comes down to fostering good teamwork…and my leadership already does that.” (10:16)
• Wellness and Professional Growth: Resident wellbeing is embedded in the curriculum, focusing on burnout prevention and leadership.
  • “EVMS cares about resident wellbeing…Residence is very difficult…we’re not just going to be supervising them, we’re also going to be teaching them how to safeguard their own mental wellbeing.” (11:12)
• Community Connection: The structure encourages residents to remain local after graduation, supported by an environment that prizes fulfillment and teamwork.

5. Advice for Other Programs

• Culture is Critical: Launching a residency is not a solo effort—broad engagement and celebration of milestones are essential.
  • “Don’t try to do this alone. Engage with faculty members, leadership, communicate constantly, and try to celebrate your progress.” (13:22)
• Patience Required: The process is slow, but worthwhile.
  • “Be patient, and gather as many people around you as you can that are willing to help in any kind of way. Because I definitely could not have done it without a whole lot of support.” (14:56)
• It’s a Team Effort: Dr. Wyant stresses gratitude for collaborators, making clear this is a collective achievement.

6. Program Growth & Future Plans

• Initial and Projected Size:
  • “Our first class is three residents. Going forward, we're going to have four residents per year...Ultimately, there’ll be 16 neurology residents here at any one time.” (16:04)
• Outlook: Potential for future fellowships to expand opportunities further.

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Notable Quotes & Memorable Moments

• On the magnitude of the challenge:
  • “The biggest challenge for me has been getting a handle on the many moving parts and assembling that into one cohesive program.” — Dr. Wyant (01:53)
• On faculty and staff engagement:
  • “I haven’t really faced [hesitancy to engage] yet…that’s been to my benefit.” — Dr. Wyant (03:19)
• On workforce development:
  • “Establishing a pipeline of training…hopefully [residents] realize that Sentara and EVMS and ODU, it’s a good place to work and hopefully stay local.” — Dr. Wyant (07:38)
• On wellness and retention:
  • “Residency is very difficult. You gotta work hard…and also safeguard your own wellbeing.” — Dr. Wyant (11:09)
• On leadership advice:
  • “Don’t try to do this alone…celebrate your progress. It’s a huge undertaking.” — Dr. Wyant (13:23)
  • “This is not a solo project…there are so many people that deserve my thanks and admiration.” — Dr. Wyant (15:33)
• On growth and future outlook:
  • “Our first class is three residents…once we fully matriculate, there’ll be a total of sixteen neurology residents here at any one time.” — Dr. Wyant (16:04)

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Timestamps for Important Segments

• 00:49 — Dr. Wyant on the biggest challenges of starting a residency
• 03:03 — Faculty engagement and securing buy-in
• 06:27 — Impact on regional neurology care and program’s business case
• 09:57 — Retention strategies and resident wellbeing
• 13:11 — Dr. Wyant’s advice to other program leaders
• 16:02 — Program’s initial class size and growth plans

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Tone & Language

Dr. Wyant’s tone is candid, collaborative, and encouraging. He frequently acknowledges the collective nature of the effort (“This is not a solo project”), expresses gratitude, and conveys both the challenge and the profound fulfillment found in the work.

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Transcript

[A]

Hi, everyone. You are listening to the Becker's Healthcare Podcast. Thank you so much for tuning into this episode where we are joined by Dr. James Wyant, program director of a new neurology residency program supported by Sentara in Eastern Virginia Medical School. We're going to be discussing today what it takes to get a new physician training program up and running, as well as the retention piece and challenges within this process as well. Dr. Wyatt, thank you so much for joining us today. Excited to have you.

[B]

Thank you for inviting me on.

[A]

Yeah. Well, do you want to start off. Let's start off with challenges. Can you share what you have found to be a big challenge in launching and growing the neurology residency program and how has you and other leaders worked through it, Worked through that.

[B]

There have been so very many challenges. The biggest overarching challenge is that this is a monumental project. It's totally new to me. Never been a program director before. I work at Centera, which is a regional medical provider group in Southeastern Virginia, and the program is a Eastern Virginia medical school program. So there's a lot of collaboration between organizations. And that that collaboration and the collaboration between all the very many stakeholders in this program have really helped overcome the biggest challenge, which is that there are so many small pieces to starting a program like this. There's a lot of paperwork that needs to be completed. You got to develop a curriculum for training the residents that are coming on board. You got to make sure that the faculty knows what they're doing, they're well qualified, they're invested in developing as mentors and teachers and cultivating just a culture where it's a good learning environment, invest in research. So your question was, what is the biggest challenge? The biggest challenge for me has been getting a handle on the many moving parts and assembling that into one cohesive program.

[A]

Yeah, thanks, Dr. Wyatt. Yeah, definitely. So many moving parts there. And I imagine that in and of itself just makes it so critical to have, you know, a great partner that you are working with to stand this up? A sentiment that I do hear often from other leaders when talking about residency programs and fellowships is securing buy in from local hospital teams on the ground, particularly when you're know those facilities might be hosting residents for the first time. And then how that can be a real challenge at times. Have you encountered that dynamic and if so, what lessons have you learned in navigating it or a piece of advice you'd share?

[B]

Thank you for asking that question. I very much fear that hesitancy to engage because I know that all the faculty members, all the team members that are helping make this program exist are already working hard at patient care. So their limited bandwidth to help start a program was something that I was worried that I wasn't going to get buy in. But I haven't seen that. In fact, every person that I've talked to to say, hey, would you help us with interviewing candidates or who hosting residents, it has been nothing but positive feedback. So I think I happen to land in a community, a culture that was already fertile ground to start a neurology program. So I haven't really faced that yet. That's been to my benefit. You asked for advice that I would give to other people facing that, trusting the process, convincing leadership. I think it would need to come in a top down approach. But convincing leadership and then potential faculty members that the residents can add value, can assist with workflow rather than slow it down is going to be essential to fighting that hesitancy to buy into the program. Of course there's going to be a learning curve. Many of the faculty of my brand new program have not recently spent a lot of time engaged in teaching residents. And that's a tough thing to do because medical students are still learning a lot of the basics of medical care, whereas residents, they're kind of past that and they're learning at a higher level. And so that means that the teaching needs to occur at a higher level and that's tough. That can slow down clinical workflow until you're certain that the residents have at least some experience and then they still require supervision. But they can really add value. They can help see patients while they're learning. So both the patients benefit from that, the faculty members benefit from that, and the residents learn from that. So you asked the question about whether or not I've had trouble securing buy in. I have not, thank goodness.

[A]

Yeah, no, that's great to hear. And I think it's an interesting point just around where residents can add value. And one of the things I've heard too from leaders in academic medicine and teaching hospitals is just seeing evidence too that having residents on site can improve quality. So it's interesting point. Dr. Wyant, can you share a little bit about how the new residency program is expected to improve access to neurological care in the region? Obviously, you know, with the physician shortage, neurology is a big part of that specialties and what outcomes you're hoping to see.

[B]

Yeah. Regionally and nationwide, probably globally, there's an insufficient amount of neurologic care providers. And that's not just Physicians, there's not enough medical assistance and advanced practitioners and nursing staff, physical therapists, occupational therapists, etc, that is required for the collaborative team based approach that is required for many neurologic conditions. The need for residency training programs is one component of what I have seen Sentara engaging in, which seems like a, a concerted effort to safeguard the infrastructure for patients access to care. So I think starting this residency is going to help expand and safeguard the clinical workforce years down the line by establishing a pipeline of training. And then if we've got a culture that, that is supportive of the residents well being, they will realize that Sentara and EVMs and ODU, it's a good place to work and hopefully stay local and continue to provide care for patients in this region. My direct administrators have done a great job of shielding me from major financial considerations here because I know it's a major investment by Sentara and EVMs to start up a new program like this. The, the business argument that we made to get approval to start this residency was that our patients need more local access to neurology and it took very little convincing to get our administrators to recognize the value of starting this program. The Sentara credo is we improve health every day and we're a medical care providing institution so we're focused on how to best serve our community. And my hope is that this residency accomplishes that. Improving healthcare every day for our local community by having enthusiastic, compassionate care providers trained right here and staying right here.

[A]

Yeah, absolutely. Dr. Wyatt, I think interesting to hear too like a little bit of what you shared there on the business case side and really just sounds like it comes down to, you know, there's a regional need there for access and this is a sustainable way to, to build that and provide that for patients. Filling a gap, so to speak. You started to talk a little bit as well about retention and well being and how, you know, as residents go through an experience they'll see that this is a good place to work and this is where we want to stay. And obviously, you know, we see a lot of national data that speaks to where you train is where you end up practicing for a while. So how is the program? Can you talk a little bit more about how the program is structured or how you anticipate Sentara will aim to support long term retention of trainees in the region.

[B]

The two parts of your question are closely tied. How we crafted this program and how we intend to keep our trainees, encourage them to remain local and care for patients locally. Although I'm sure that some are going to decide that they want to pursue careers elsewhere. My hope is that a whole lot of them are going to want to stay stay here and find this to be a good place to work. I think it comes down to fostering good teamwork and my leadership already does that within the department. When I joined this department a few years ago, because I haven't been here that long at this particular location, I discovered that all of my colleagues liked working with each other and communicated very well. And so it's going to be easy to duplicate that model in our residency. EVMS cares about resident well being. There's no two ways about it. Residency is very difficult. You got to work hard. You're expected to do a lot for a lot of people and also safeguard your own well being. And EVMS and the overarching graduate Medical education department is insists that we build that into our didactic curriculum. So residents are, we're not just going to be supervising them, we're also going to be teaching them. Hey, how do you become a good neurologist and also safeguard your own mental well being so that you don't get burned out so that you can continue caring for patients in your community for a really long time and have a satisfying and fulfilling career. So that's a wellness and professional growth and teaching leadership skills from an early phase of the residency, not just the clinical nuts and bolts competency of how do you understand neurologic disease and come up with a game plan for treating a patient afflicted by a neurologic disease?

[A]

Yeah, thanks Dr. Wyatt. I think interesting to hear on the well being piece too. It's like sounds like it's owned by both you stakeholders in terms of there's a role that the university plays and then there the medical school and then there's also a role that Sentara plays. And it really needs to be something that's routine and something that is built into the learnings that they're, that they're going through.

[B]

Yeah, absolutely.

[A]

Well, to close us out, Dr. Wyatt, what advice would you give to leaders at other hospitals or health systems that are planning to either debut a residency for the first time or expand their existing offerings?

[B]

Advice, good luck. It's a lot of fun, but it's a lot of hard work. The emphasizing the importance of culture is key. Don't try to do this alone. So engage with faculty members, future faculty members, leadership, communicate constantly and try to celebrate your progress. It's a huge undertaking. So it's going to be a whole bunch of small victories that keep you going? Yes, I crafted a curriculum. Yes, I got the leadership to say that we've got the financials in place to pursue this project and being patient, because we have just started this residency program. So we're just barely getting the, the project off the ground. And we've got a whole lot left to go to maintain it and to start producing some outstanding neurology graduates. We've just got our first class. They're all interns, first year neurology residents. And we are extremely fortunate that they're all compassionate and enthusiastic and great people. And so I know that they're going to make great neurologists. We have started searching out and interviewing candidates for our second class. And we're incredibly fortunate that the pool of talent is enormous. We've had a lot of interest in our program, even though it's a new program. So for those out there that are considering starting a program, it is worth it. And be patient and gather as many people around you as you can that are willing to help in any kind of way. Because I definitely could not have done it without a whole lot of support. This is, in fact, I shouldn't even be using I. Because this is not a solo project. There are so many people that deserve my thanks and admiration because I could not have gotten to where we are yet without an enormous amount of assistance. So those are, those are my bits of advice is you need a lot of people to help you is the main piece of advice.

[A]

Yeah, absolutely. I imagine. Before we go, do you mind just sharing to the number of residents you have in this first class and how you anticipate that number growing next year?

[B]

Our first class is three residents. Going forward, we're going to have four residents per year. So once we fully matriculated residents to fill every class and graduated this first class, there'll be a total of 16 neurology residents here at any one time. And looking forward into the future, we might develop some fellowship programs. I hope that I get to be a part of that and that might expand the number of local trainees. And it's a four year residency. Neurology residency is a four year undertaking. So 16 total once we're fully up and running, but three right now.

[A]

Well, Dr. Wyant, thank you so much for your time today. Appreciate you being on the podcast for such an important topic.

[B]

Well, thank you for letting me talk about it. I love talking about it. It's a whole lot of fun and it's something I'm pretty passionate about. So I appreciate you asking me questions about it. Let me spout off about it.

[A]

Yeah, absolutely. I look forward to connecting again.

[B]

Yeah.