Teacher of the Year award for Thomas Billings, D.O. – leaves a lasting impression with fish-hook demonstration

Thomas Billings, D.O. (FM ’99), is a consultant in the Department of Family Medicine at Mayo Clinic in Rochester. He’s a Mayo Fellows’ Association Teacher of the Year Hall of Famer, with recognition four times since 2005 from the since he began teaching residents including 2018. He’s also an assistant professor of family medicine in the Mayo Clinic College of Medicine and Science.

He is perhaps distinguished for his fish-hook demonstration. Once every 18 months or so, he numbs his left arm and embeds a fish hook in it. After teaching about different techniques of removing a fish hook, he has a resident demonstrate the removal of the hook.

The outpatient clinic for Mayo family medicine residency training is in Kasson, Minnesota, a rural community. “We see things in our setting that would usually not be seen in the clinic setting in Rochester,” says Dr. Billings. “This makes for great education.  Research shows that residents and students learn better with action and doing. The fish hook demonstration seems to leave a lasting impression so we continue to use it.”

Dr. Billings has taught approximately 150 residents over the last 14 years but remains focused on continually improving his own learning to be as good a teacher as he can be. “We’ve moved away from lecturing and PowerPoint presentations in a traditional classroom and toward role playing, direct observation and discussion,” he says. “People learn better this way, and I want to make sure my teaching skills are cutting edge.”

How do you know when you’ve done a good job teaching?

I’ve done a good job teaching when I can just sit and listen while the resident provides the patient with good care. My mind races, thinking of all the potential pitfalls, but none of them happen. The resident hits all the marks, and I don’t have to say a word. That’s success.

What’s your teaching style?

I try to be as hands-off as I can be. It’s difficult. The easy thing is to tell the resident the right way to do things. The more difficult thing is to remain quiet and let the student figure things out.

I was a hands-on learner myself, and I teach that way.

How have students changed through the years?

They haven’t really other than more technology-related skills.

What’s rewarding about teaching?

I like to see the transition from paper and classroom memorization to students developing their own rhythm. When they start to fly, it’s a nice feeling.

Teaching keeps you fresh and abreast of changes in the field. I feel worthwhile helping the up-and-comers. Our residency is set up to make residents into super-physicians. From desk staff to nurses and everyone else involved, we share that mission.

Who were your teaching role models?

My colleague in the Department of Family Medicine Margaret Gill, M.D. (MED ’93, FM ’96), has always been my hero. She taught me.

Dr. Gill is a great teacher — brilliant, enthusiastic and easy to listen to. I emulate her enthusiasm and how she cares for patients and residents.

What does the Teacher of the Year award mean to you?

It means I’m doing my job well and that residents still feel I’m valuable. Times change and teachers change, and perhaps there’s a defined lifespan to teaching. New, energetic teachers will come along to take our place.

I’m happy for my colleagues when they receive the award, too. My joy and happiness come from residents having the aha moments and I know they’ll be super-physicians when they leave here.

Student comments:

“Compared to teaching, it is clear that everything else is of secondary importance to Dr. Billings.”

“He meets residents where they are in their knowledge and knows how and when to appropriately balance supportive encouragement with investigative probing and challenge to promote our growth.”

“Dr. Billings is a fantastic teacher who puts tremendous effort into teaching residents on a daily basis.”

“He is always in clinic before anybody else, reviewing notes and preparing for teaching. He breaks down difficult concepts into analogies that are more easily understood and demonstrates how to approach complex problems in the clinic.”

“In a moment of self-sacrifice, he put a fish hook in his own arm (with lidocaine and up-to-date tetanus, of course) to demonstrate how to remove a hook.”