By Luis Guilherme Rosifini Alves Rezende, MD

Leading is a very challenging task in the current scenario. As the youngest and youngest member of our team, Leadership becomes an arduous daily journey. Several factors can become essential obstacles, such as the age difference between me (Staff) and Fellow, where the hierarchical sequence and respect can be confused by the “age” variance.

In addition, the COVID pandemic presented a peculiar difference in the context of Leadership and teaching: social distancing and the reduction in the number of consultations and surgeries. In this way, our fellows started to be connected remotely for meetings and discussions of cases that have already taken place, and the form of assistance was no longer the same. Furthermore, the possibility of having the surgery (or the main bonus of a Fellow) has become a distant dream, generating frustration, discontent, and worry. The main concerns were: (1) “Will I be able to come out well-formed?”, (2) “Will I be able to perform surgeries?, and (3) “I did not operate anything during my fellowship year.”

Indeed, it was a troubled year, with an abrupt reduction in the surgical volume, and promises of opportunities to perform surgeries could not be made, as the scenario was uncertain. We chose to restructure the program and carry out a continuous training process under the coordination of Prof. Dr. Nilton Mazzer (my Mentor and friend for many years), where we structured the Fellowship of the Hand Surgery Program at our Hospital (which lasts for two years in Brazil). We restructured the program into three theoretical, practical, and academic parts.

The theoretical programming was done through selected classes for each year’s fellows as they progressed with the subjects selected for the study. We created laboratories for microsurgery, arthroscopy, and osteosynthesis. The academic part was structured through training for presentations and scientific papers. These programs involved the structuring and subdivision of the team by hierarchical scale, and staff members and Fellows were involved in carrying out the tasks to produce good results in this context. It was a productive period, where we managed to obtain an increase in the production of scientific papers and participation in events via videoconference. In addition, we restructured, and standardized team conducted, writing manuals for internal use, and increased the number of meetings between Fellows and Staff.

Another essential feature is the change in the profile of younger generations, who live in a more dynamic world with easy access to information and search for answers. The most crucial aspect for success in Leadership was the proximity between Fellows, Staff, and whole Team, either through weekly videoconferences or communication groups (WhatsApp) to exchange information daily.

Leadership is a dynamic quality, which must accompany the Fellows’ profile, and involves global, local, generational, and technological issues, among other aspects. Furthermore, Leadership is cyclical, and the Leader must have focus, routine, and discipline, where a more open way of thinking can facilitate understanding and peer acceptance. And most importantly, no one leads alone. Achieve Leadership, there must be a team, and for there, we must treat each other with respect, loyalty, and honesty, giving them opportunities for personal and professional growth.

Luis Guilherme Rosifini Alves Rezende, MD
Associated Hand Surgeon at the Hospital of Clinics of the Ribeirao Preto Medical School of the University of Sao Paulo. Ribeirão Preto, São Paulo, Brazil.