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Last Friday - Match Day - was an exciting time for medical school seniors who found out where theyíll spend the next three plus years of their trainee lives. For me and my intern colleagues, it was exciting in another way: we now have a list of people contractually obligated to take over our jobs in four months.
For us, the excitement came hand in hand with trepidation over the responsibility of supervising our replacements. Though interns do work one on one with medical students, managing teams is the purview of upperclassmen. On MGHís Bigelow service, for example, a second year resident leads a team of four interns and a few medical students to care for 20-odd patients.
At this point in the year, internshipís daily grind of writing patient notes and ordering chest x-rays feels almost automated. Our next challenge is one for which we get little formal training. But we think about all the time.
Inter-intern conversation inevitably drifts to the topic that makes or breaks our every day: team dynamics, and in particular, the junior or senior resident who sets the tempo of morning rounds and sets an example for the Way We Do Things.
Our teams reshuffle every two weeks, so we have plenty of data points to draw upon. We admire the resident who made sure interns were free to attend morning conference, the one who corrected us with gentle humor, the one who made a point of communicating with patientsí family members, the one who brought us morale-boosting cookies on a particularly horrible day. And we vow never to repeat the mistakes of the resident who let morning rounds drift into the afternoon or the one who informed us that our patient had passed away without skipping a beat.
It is the poor manís version of a business school case discussion. Best and worst practices emerge out of these collected experiences. But itís also clear from these conversations that being a good manager, as for so many other roles, means something different for every person. You have to know your personality, and your doctoring style, in order to be effective. Most of us canít pull off impersonations and semi-adorable blunders as a management approach.
This concept has been put into action at hospitals like Brigham and Womenís, where a handful of internal medicine residents work with a management psychologist who observes them during rounds and gives them feedback on their leadership style.
Iíve started to gather some data of my own. When I give medical students feedback on their work, Iíve made a habit of soliciting it as well. Constructive criticism has been hard to come by, not because I donít deserve it but because itís hard to tell the intern writing your evaluation that she stinks to her face (thatís what your peers are for). On the flip side, a few have told me they appreciate that I supervise at a distance and let them take ownership of their patients.
Itís something to keep in mind come July.
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About the authorIshani Ganguli, MD, is a journalist and a second-year resident physician in internal medicine/primary care at Massachusetts General Hospital. She studied biochemistry and Spanish at Harvard College and received her More »
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