The recent International Conference of Residency Education (ICRE) ran virtually last October, bringing together close to 1,200 clinical educators, surgeons, physicians, residents and medical students worldwide to share ideas, challenges, innovations, and advanced training.
The conference opening plenary “A Catalyst for Change: Leading by Example” addressed the inequities in access to medical care and medical education, as well as physician burnout and barriers to advancement. After the session opened with Dr. Patrice Harris, immediate past president of the AMA, reflecting on her experiences as a leader, a provocative interview session followed, featuring Dr. Harris and Dr. Susan Moffatt-Bruce, CEO of the Royal College of Physicians and Surgeons of Canada. They discussed the role of leaders in exacting change — for the patient, the physician, and those coming up through the medical education system.
Following are eight calls to action for medical leaders that surfaced from the discussion:
1. Move the burden of navigating care away from the individual
Dr. Harris advocated strongly for meeting people where they are and training the next generation of physicians to recognize and address obstacles to care.
“Are we sending our trainees into the community? Are we sending them to non-traditional opportunities so we centre care around the patient and their families?” she asked. “I think there is an opportunity for us to hold ourselves to account.”
Dr. Harris added how it’s imperative to train physicians to be engaged in the system as well as to explore different ways of practicing to make it easier for patients to access care. Dr. Moffatt-Bruce agreed, adding that leaders have a responsibility to train practitioners about systems and play a part in removing the burden of navigation away from the patient to the medical professional.
2. Improve access to medical education
Dr. Moffatt-Bruce feels it is incumbent for leaders to listen and figure out where problems exist in accessing medical education. “Where are the points that make education and specialization inaccessible for prospective medical students and residents?” she asked. “We need to do a root cause analysis so we can understand and come up with solutions.”
Dr. Harris provided insight into pipeline programs in the U.S. as an area worth exploring further in Canada. “The Morehouse School of Medicine, a historically Black medical school, has multiple pipeline programs. They admit those students who score lower on the MCAT and work with them to fill any gaps.”
3. Leave space for advocacy
Addressing the issue of medical misinformation, both Drs. Harris and Moffatt-Bruce believe advocacy must play a critical role in both self-preservation and public health. “Advocacy should be as important a part of your professional life as getting your continuing education credit,” said Dr. Harris. “It can be something as simple as writing an email or a note to your elected official.”
Dr. Moffatt-Bruce added that the role of the advocate ought to be embedded throughout the continuum of learning and be part of a physician’s responsibility. Empowering people to be health advocates may be difficult when there is a fear of repercussions. Both doctors believe there is a need for a circle of support, including mentors who can help address and navigate potential implications and enable a safe space to speak up. “You need to lead from behind in these instances and be ready and willing to be an ally,” added Dr. Moffatt-Bruce.
4. Understand how failure may lead to growth
Both Dr. Harris and Dr. Moffatt-Bruce feel learning from failure makes a good leader — having a vision, stumbling from time to time and learning from mistakes can give a leader perspective and more effectiveness. “Failure is part of opportunity,” said Dr. Moffatt-Bruce, who said she has normalized failure in her role.
5. Learn to lead with humility
“If this pandemic has taught us anything, it should be humility,” said Dr. Harris. “Because just when we thought we made a little bit of progress, the virus outsmarted us. Just when we think it’s safe to get out of the water, we should maintain a level of humility,” she added.
Dr. Moffatt-Bruce added that while she was coming into a new position of leadership, humility enabled her to listen more than speak, manage self-doubt and make sure she is travelling forward toward her vision.
6. Make room for self-care
Both doctors believe a conscious focus on self-care is essential to being a good leader. “If we’re not healthy, the system can’t be healthy,” said Dr. Harris.
“As leaders, we have an ability and responsibility to enable healthcare providers to do their job and for patients to get the care they deserve,” added Dr. Moffatt-Bruce, addressing the need to understand professional burnout and reward performance in a new and different way.
7. Provide opportunities for individuals to change
Dr. Harris spoke about microaggressions in the workplace, which she’s encountered as a Black female physician. She urged listeners to have conversations about racism and social justice and to have tough conversations when in a position of leadership.
And while she has “called people out” for saying something inappropriate, she has also started “calling people in,” which gives people an opportunity to change. “I try to call people in and say ‘there are some gaps in your knowledge — here are some books you can read.'” By calling people in, you can address issues head-on while growing your circle of support.
8. Be willing to share power
Being able to lead with others who have different lived experiences, education and opinions is essential to being an effective and fair leader. “Be willing to share power, be willing to listen and recognize the community has the answer,” said Dr. Harris.
Dr. Moffatt-Bruce added that she and her team of leaders have spent a great deal of time understanding the coin model of privilege and critical allyship and where they could sit in order to lead in solidarity with others. “Asking the question am I helpful, should I stand back, or just be humbled to help share power, champion others and be an authentic ally.”
As Dr. Harris mentioned at the top of her talk, being a good leader is not about the title, it’s about the work. Being authentic, humble, curious and healthy are critical elements to leadership. And as Dr. Moffatt-Bruce added, leading by example, demonstrating allyship and recognizing disparities and differences also contribute to an equitable and inclusive system of medical care and education.
Diane Amato is a Toronto-based freelance writer who loves to talk about finances, healthcare, travel and technology.
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