In the Netherlands around 1890s, prospects for farmers were very poor. As a result, my grandfather’s uncles, Cees and Leen Schelling left their family farm in Goudswaard and immigrated to Sioux Center, Iowa, in 1893 and 1895, to start their futures as farmers in the United States. My great-great-grandfather gave Leen the advice to learn how to make cheese as preparation for working in the USA. They left without courses to help them prepare for a new future. Although they had a good network of family and friends at home, it was hard to contact them since there were no phones and mail was delivered by boat. What a different experience I had…

In June 2014, I took my first Harvard-Macy Institute (HMI) course Leading Innovations in Health Care and Education. At that time, I worked as a senior advisor for Under Graduate Medical Education, Graduate Medical Education and Continuing Medical Education at a large hospital (3800 employees, 800 beds) in the Netherlands. This hospital belonged to the Association of Tertiary Medical Teaching Hospitals (STZ). To be part of this network of 26 STZ-hospitals, these hospitals had to excel in patient care, research, and education. Part of my job was to guarantee the excellence in education related to the medical field.

Working as an educational scientist in hospitals is a challenge, because patient care is top priority and I had to find a way to fit in the educational and scientific needs. Although my medical colleagues were very supportive, I was the only educational scientist and it was sometimes a lonely position. To reach the educational research goals, informal leadership was required, such as presenting ideas to the right people, creating buy-in for changes, lobbying- and informing the leaders at the right time so they were included in the planning.

After a large amount of initial success, the amount of progress somewhat declined andI even doubted my skills. I realized I could use some external input to grow even further. Taking the Leading Innovations in Health Care and Education course could help me see the current situation from a different perspective, I reasoned. But I was worried beforehand this course was not suitable for me because as an educational scientist, I was not in a formal leadership position. Could I relate enough to the topics presented? Harvard has a big name; do I belong in the community?

Luckily, my hospital was supportive and let me apply, and HMI accepted me.

This course helped me to further discover how important it is to work at a place where you are able to grow. A regular theme in the course was the importance for people to work at the top-end of their ability. We discussed disruptive innovations and the prerequisites which are necessary to facilitate changes; I wondered which of the prerequisites were present and which were not at my own institution, and how this affected my job and my future. During breaks, lunches and dinners we often - unintentionally - reflected with faculty and participants on each other’s and our own goals, and how we wanted to reach them.

I slowly began to realize there are contexts which are better suitable for ‘working on the top-end of one’s ability’ for realizing the activities I enjoy, such as feedback and medical education research, working on faculty development and teaching. When I noticed the job advertisement in July 2014 of the Michigan State University College of Human Medicine on the Dr-Ed listserv I applied and happily was accepted.

Since December 1, 2015, I have been employed at the Michigan State University Office of Medical Education and Research (OMERAD) and Faculty Affairs and Development (FAD). Often, I think how much I profited from the knowledge gained at HMI. It helps me to place discussions in a context. Although I had previously attended international medical education conferences, such as Ottawa and AMEE, at HMI cultural contexts were discussed in greater length during the small group work with a variety of people - some more administrative, some health care oriented and others education oriented. Because participants came from a variety of countries with different health care systems, we also discussed differences in organizational structures, differences in hierarchy within organizations, differences in promotion expectations and how this affects decisions. It exposed me to jargon I was not used to; Medicaid, Medicare, the Affordable Care Act, Minute Clinic, Osteopathic Medicine, and American tenure systems.

As part of the course I was also part of an international network. I know I can ask people questions: what are the differences between private and state universities, what we in the Netherlands call a community hospital, does it have the same meaning in the USA? This is helpful in understanding the system which, in turn, helps in feeling comfortable in a new environment.

In hindsight, I can see HMI indirectly opened my eyes for moving. The exchange both in the small and in the large group sessions helped me to reflect upon my goals, passion, and motives to make the decision to move as did my ancestors. It gave me the knowledge and background information which I use so well in my current position, and it gave me a valuable international network. This network of global professionals, along with nice and helpful colleagues at work, a caring church community, and living in the largest Dutch community within the USA, helps me to feel at ease as I settle down in Grand Rapids, Michigan.

The history of my ancestors Cees and Leen Schelling did not speak much to me until my first week in Grand Rapids. A lady from my church – I never met her before - gave me a ride home. We talked about our backgrounds and it turns out Leen Schelling was her grandfather! She gave me a pair of small, nicely knitted baby booties my great-grandmother had sent to her when she was born, 85 years ago. She never wore the socks because when they arrived they were already too small. These special baby booties now hold an honored place in my home. My great-grandmother sewed a tag on them. With beautiful handwriting she wrote “For Alyda from aunty Betje”. Having relatives in Grand Rapids and possessing something of my great-grandmother at home, brings the two worlds together and makes full circle.



J.M. Monica van de Ridder, PhD

Monica van de Ridder, PhD, is Assistant Professor at the College of Human Medicine, Michigan State University. After teacher training college, she received a Masters’ degree in Educational Sciences and a PhD in Medical Education both from Utrecht University, the Netherlands. Her research interest is focused on giving and receiving feedback in clinical education. Faculty development is another area of her attention. Besides that, she loves to read, embroider and hike.