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Being a Memorable Leader

By Krystle R. Tuaño, MD

“The three most important ways to lead people are: by example… by example… by example… ”
– Albert Schweitzer

Obviously, right?

It’s year eight in your continuum of post-doctorate training and you’re juggling an eighty-hour work week, the consults are piling up at three different campuses, your floor patients are all simultaneously becoming unstable, and you just spilled your coffee all over your white coat as you were getting out of the car.

Attempting to slow your heart rate, you settle into a computer chair to start processing your in-basket notifications, and sift through the seventy plus charts you pended to sort them into chronological order…when your bright-eyed medical student turns to you and says, “Can I ask you a question?”

These are the moments that you really channel your ability to lead. The fleeting moments that seem inconsequential, yet make you feel like they’re simultaneously about to throw you over the edge, into the abyss of burnout, while somehow reminding you exactly why you are doing this in the first place. To teach. To be taught. To give back.

Just yesterday you were thinking about what it might be like to be a resident, and before you know it, you’re the final word in the room, aching for the safety of someone to “kick it up the chain” to.

What makes a “good leader?” Often that means someone is memorable.

We used to have a checkbox on our monthly rotation surveys in general surgery that said something like, “Excited or relieved to see that I am working with this person.” I could think of a handful of individuals that embodied that checkbox. As I moved on in my training, I hoped to convey the same.

I lead remembering that everyone learns differently. Finding a way to connect, making something personal, making it individual, is the most meaningful way for me to both learn and teach. The interconnection we share with our colleagues and patients allows us to remain compassionate.

It is equally important to remember, in kind, our different stages in training. This allows us to empathize and impart advice that we wish we had been given. So, I try to keep it simple, but meaningful. At the beginning of the rotation, I ask that all members of the team set three goals. They can be broad or specific, but they must be something that can reasonably be achieved during the rotation. I also send out in-service questions that are rotation-specific, or might serve as a specialty-specific pick-me-up, if the rotation that we’re on isn’t the learner’s favorite.

Small acts of kindness go a long way. That includes making sure that people don’t feel invisible. We have all been in the situation of “trying to not be in the way.” Medicine is a team sport, and unfortunately, it isn’t learned via osmosis. Active learning and participation leads to fewer near misses, actual misses, and errors.

Similarly, communication is invaluable, and everyone should feel like they are part of the team. If a person is treated as a nuisance, their involvement as a team member will likely reflect this. Likewise, you can’t be upset with someone about something you haven’t yet showed them how to do. Investing time and patience to teach someone how something works, rather than just barking orders, generally improves retention, patient care, and allows the knowledge to be passed along.

I ask others to work only as hard as I do. The standard of care that you demand from your colleagues should match the quality of care that you are giving. This brings me to my next point, which is, “Treat everyone like family.” This thought has gotten me through many rough call nights and moments of the dreaded “pager rage.”

We often gravitate towards specialties and interests that we share with our mentors whom we seek to emulate. Thus, it is important to remember that each day is an opportunity to leave a lasting impression. Training during a pandemic has incorporated a whole new set of challenges that we are still yet to see the full effects of. It has also provided a plethora of opportunities to learn how to lead. As we navigate the world of “Zoom fatigue,” it is not only essential to adjust our leadership style to captivate the attention of learners, but also the attention of ourselves, as leaders.

The culture that we establish in our work-environment begins with ourselves. Leading in a way that encourages others to be resourceful, resilient, and confident will similarly allow for utilization of support systems, ability to seek help when it is needed, and establishment of a nurturing educational setting. Part of feeling “relieved” when I would work with certain people included never feeling afraid or ashamed to call them. I lead such that maintaining a professional environment doesn’t mean an unapproachable environment. Don’t underestimate the impact of the “small stuff”—like sharing a bag of peanut M&M’s with your residents on a bad call night.

Personally, the most rewarding part of leading has been watching my colleagues transition into leadership roles, themselves. Seeing the change in confidence, the refinement of skillsets, and the look of satisfaction as the juniors admire their work and glance at you grinning with a silent, “Look, I did that.”

I’m sure all of us have heard some version of, “Eat when you can, sleep when you can, shower when you can (this one is optional), and don’t mess with the pancreas.” These days I’m more focused on replacing those thoughts with, “Give what I can, ask for help when I need it, learn something new, have fun, and… don’t mess with the pancreas.”

Krystle R. Tuaño, M.D., PGY-8
University of Colorado Independent Plastic and Reconstructive Surgery Fellow
Incoming Massachusetts General Hospital Hand Surgery Fellow, 2022

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