PEDIATRICS Vol. 116 No. 2 August 2005, pp. 518-519 (doi:10.1542/peds.2005-1050)
Training Young Pediatricians as Leaders: In Reply
Laurel K. Leslie, MDChild and Adolescent Services Research Center
Children’s Hospital
San Diego, CA 92123-0282
Gilbert C. Liu, MD
Department of Pediatrics
Indiana University School of Medicine
Indianapolis, IN 46202
Mary Beth Miotto, MD
Private Practice
Suburban ADHD Clinic
Marlborough, MA 01532
Kenneth Slaw, PhD
Membership
American Academy of Pediatrics
Elk Grove Village, IL 60007-1098
In Reply.—
We were delighted to receive the response to our article1 from Drs Boulanger, Buencamino, and Dovichi. These 3 chief residents describe a unique opportunity, fully supported and embraced by their department chair, Dr Elizabeth McAnarney, to conduct interviews with influential leaders in their institution about their experiences as leaders. In addition, these residents had the opportunity to act as "Chair for the day." We applaud this innovative educational approach that allowed these 3 chief residents to witness, analyze, and learn from more seasoned leaders during the course of their chief residency.
As these 3 chief residents state, this type of training is essential for young pediatricians in training. As pediatricians, we often find ourselves functioning as leaders in our environments (eg, hospital, health plan, office, community, medical school). Effective leadership in these settings is even more critical today and will continue to be so, given the pressures to rapidly transform medical training and practice in response to new technologies, reimbursement mechanisms, an aging population, and growing socioeconomic and racial/ethnic disparities. In addition, no matter how much those of us on intern-selection committees joke about it, many medical students choose to go into pediatrics because they intend to make a difference by being "leaders of change" for children and families.
The decision to be a leader can create vulnerability and risk, as Heifetz and Linsky state in Leadership on the Line: Staying Alive Through the Dangers of Leading. Many changes that accompany leadership roles require that people make difficult adjustments in their attitudes, practice, and lives. Heifetz and Linksy describe how initiating these types of changes often engender resistance from others, resulting in a leader being "pushed aside, undermined, or eliminated."2 To survive and successfully guide the change process, leaders need to be able to analyze situations, understand the issues and stakes of different parties, and propose a vision of change. In addition, as these 3 chief residents found, leaders need to know their own goals, priorities, and motivators and have at least 1 mentor to provide support, guidance, and modeling.
Much in the same way we train medical students and residents to think methodically about history taking and the physical examination, individuals can learn a systematic approach to the process of envisioning and implementing change. Indeed, authors such as Heifetz and Linksy would argue that this type of training is not only possible but necessary, arguing that much of the stress and burnout associated with leading could be prevented or at least lessened by educating individuals in leadership skills. The Pediatric Leadership Alliance is predicated on this concept: that leadership can be imparted through training and such training will not only allow leaders to survive but also to thrive as agents of change.
Many medical institutions are developing programs that provide this type of training for physicians. Among them are the American Academy of Pediatrics leadership training program, Robert Doughty’s ongoing leadership training program for chief residents and program directors, seminars available through the Association of American Medical Colleges and the American College of Physician Executives, the US Department of Health and Human Services National Centers of Leadership in Academic Medicine programs, and opportunities such as that experienced by these chief residents in Rochester, New York. Some of these programs are available through fellowship and scholarship programs (ie, the Robert Wood Johnson Scholarship programs) and are aimed at current leaders, and some are available to any physician who recognizes the need for this skill-set development, such as those developed by the American Association of Medical Society Executives and individual state medical societies such as those in Massachusetts, North Carolina, and Pennsylvania.
We hope that our article and the letter from Drs Boulanger, Buencamino, and Dovichi catalyze increasing discussion between existing programs and allow for expansion of these types of programs, further advancing these young doctors’ call to propel "residents to pursue more active leadership roles during their career and to ultimately succeed at them."2
REFERENCES
- Leslie LK, Miotto MB, Liu GC, et al. Training young pediatricians as leaders for the 21st century.
Pediatrics. 2005;115
:765
–773
[Abstract/Free Full Text] - Heifetz RA, Linksy M. Leadership on the Line: Staying Alive Through the Dangers of Leading. Boston, MA: Harvard Business School Press; 2002:2
PEDIATRICS (ISSN 1098-4275). ©2005 by the American Academy of Pediatrics
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