Transitioning into Practice: A Letter from Someone Still on the Other Side

By Clauden Louis, MD

November 1, 2019

Congratulations on becoming a credentialed cardiothoracic surgeon. I hope that you continue to find meaning in your work. You have and will continue to serve not only as an inspiration, but also as a bridge for trainees (like me) to the world of cardiothoracic surgery. As a previous associate of yours who continues in the trenches of residency, I will hold your transition dearly, observe closely, and live vicariously. Now that you are on the other side, working through the difficult balance between new autonomy, resident education, and public reporting—I humbly ask that you consider the following:

  1. Lead by Example — In an essay written in 1970, Robert K. Greenleaf coined the term: The Servant as Leader. Servant leadership is a timeless concept. The intrinsic benefits of servitude are likely where many who serve tirelessly, derive gratification. Serving others provides a context for drive, purpose, and motivation. As a junior attending, you can teach much more by empowering your residents to make decisions, giving autonomy to manage aspects of a case, and above all grounding us in the importance of serving others.

  2. Remember that Motivation is Contagious — When motivated, one can be fulfilled by performing duties congruent to end goals. Our shared goal of improving patient care can be realized at the highest levels when all remain motivated as you set the tone. Even though Wood Allen famously stated that 80% of success is showing up, the mantra of the junior attending must be much more. World class leaders are innovative, desire to contribute, attain the highest levels of education, and volunteer their time and resources. My fellow residents and I will be motivated when we see that you not only show up, but also are prepared and eager to engage respectfully with staff and patients.

  3. Understand the Difference Between Engagement and Burnout — Burnout has three dimensions: emotional exhaustion, depersonalization, and feelings of inefficacy. The antithesis of burnout, however, is engagement, as it is characterized by vigor, dedication, and absorption in work. The work you do matters and the time you sacrifice engaging with patients, colleagues, residents, and students adds meaning to your work. Continue to speak publicly of your passions regarding this great field, push the boundaries, advance scholarship, be passionate, and above all remain engaged.

  4. Stay Relevant — It is up to all members of the team to keep our field positioned at great heights with surgical and technological advances. It is you, the junior attending, who remains at the precipice of perspective. This also applies to advocating in the name of our specialty, as policies applied too broadly lead to inefficacy.

Please continue to educate, inspire, and stand resolute in the promotion of our great field. I ask that you be both my mentor and coach. Always teach, lead, and obsess over the care of our patients. I’ll follow your lead closely so that together we can work toward achieving the Society’s vision of improving the lives of patients with cardiothoracic diseases.

The opinions expressed in this article are those of the author and do not necessarily reflect the views of The Society of Thoracic Surgeons.


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