To me, five years ago:

Right now you are 28, seated at the top of everything: chief resident of the entire pediatric department. You are in charge of 19 other interns and residents. You are resilient, kind, funny and determined. You seem to have the solution for everything, yet you don’t actually have the answer to anything. At least that’s how you’ll feel on most days in your new leadership role. As chief resident, you will repeatedly fail at your job in helping to train and educate medical students and interns/residents. In fact, you will also fail as a teacher and as a leader every month when you first become an attending physician. However, I am here to remind you of a great quote by Henry Ford, “Failure is only the opportunity to begin again, only this time more wisely.”

In writing this, it’s obviously going to take you a few years to realize that you have failed. But when you finally do, you’ll be so proud of yourself. Those who are involved in academic medicine (like your current and future self) are responsible for molding student doctors and teaching them the art and science of taking care of “human” patients. This grueling process (known as “graduate medical education”) typically occurs through many years of supervised clinical practice, with gradually increasing responsibility. When a student finishes medical school, he/she has been exposed to tons of random medical data and has learned some fundamental facts about how to be a physician. But as you know, none of them have really learned how to work independently in any particular field of medicine. Thus, it will take anywhere from three to six additional years in residency/fellowship to acquire the ability to make a decision independently (without having to ask someone else if it’s the right decision). You might ask yourself, “I’ve had some excellent teachers and mentors in my career, how did I manage to fail?”

Spoiler alert: As a busy chief resident and attending physician, you will fail at your job in three different ways:

When you neglect to give your students/interns the autonomy to practice being independent physicians. When you don’t provide constructive feedback on their mistakes or missteps. And when you simply “just do it yourself” to get the job done faster.

Collectively, these three simple failures will affect your leadership abilities and you will eventually become a disservice to your followers. Wow OK, so that was the “how” part. “Why” did you fail in this story? Right now, you’re probably too young to grasp the idea that a true leader is someone who takes the time to create a culture with such clarity and focus that their followers not only understand how to act but why they should act in those certain manners. Knowing what you might be thinking, “It’s probably easier if I just did it so that I’ll know the job was done correctly. Right?” You might even go on to say that only people like Tom Atchison (who writes leadership books for a living) will recite grandiose statements such as, “Leaders give work meaning — a context. It is this dynamic that inspires others to follow them”. Surely, nobody can apply these leadership qualities to real life scenarios.

To that end, you still don’t realize that even though your medical students and residents have acquired lots of book knowledge, they will lack the “non-data skills” to become a good physician, partly because you didn’t communicate clear expectations and you didn’t frame context into their work (so to speak). As a result, you are not helping to prepare them for the rigors and stresses of being an independent physician. And that is how and why you fail.

At this point, I commend you for wanting to finish reading this uplifting letter. What are the long-term consequences of your failures? First and foremost, GME residency programs were originally designed to mold newly minted student doctors into competent physicians equipped with the knowledge and skills to start running a practice. But without the proper feedback and constructive criticisms, some graduates may experience difficulty with the transition from being a doctor to becoming a physician. You can try to blame it on the less stringent and less harsh rules of modern residency programs, with the new imposed work hour/work load restrictions.

But at the end of the day,you are the one who has the distinct privilege to train future doctors, as a chief resident and as an attending physician. You are responsible for producing “less-than” physicians when you fail to perform those three tasks that I mentioned above. And ultimately, this will translate into a bigger disservice to your patients and the community that you serve. What will happen to you personally as a result of these failures? Well, I don’t know yet, but maybe that will be the topic for a new introspective “letter to self” in the coming years.

I also don’t know of any infamous tales of failed health care executives that I can share with you, because five years later I am still doing my best to avoid the corporate health care like it was Ebola. More spoiler alert: Ebola was a trending topic in 2014. But I digress. One day, you’ll find yourself reading Followership, written by the insightful Tom Atchison, who argued that perhaps the “blame for most of the health care problems today lies with the nation’s health care executives who have failed to create organizational cultures that reward compassion and understand the differences between employees.”

Then, you’ll begin to ponder and look no further than within yourself and ask, “What have I done to help solve some of the complex problems in health care?”

One of the core personality traits of physicians is that we care. In a way, all of the stress about not doing well enough happens only because we possess empathy and compassion for others. So, you’ll eventually learn that certain “failure” in your career will become your most valuable lessons. If you’re too afraid to fail again, then you won’t make any progress. There’s a well-known quote about how “there is only progress or regress, but there’s no standing still.” You’re either moving forward or you’re moving backward. And the good news — a few years from now, you will learn from your mistakes, and you will not sit back anymore. You will begin to lead the way and move forward. Because after all, failure is your opportunity to begin again.

#lifegoals

Binh Phung is a pediatrician.

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