That sounds pretty easy, but in practice, it is considerably difficult. It requires constant discipline in upholding values and principles that are shared between subordinate and supervisor. Even a single misstep can undo weeks, months, even years, of hard work. With some, more prickly supervisors, establishing trust may require a lot of effort and planning.
Here is where sucking up is likely going to backfire, because after some time, the inauthenticity of constant flattery will become obvious.
6 Develop a repertoire of skills through practice and reflection: One curious aspect of upward management is that it has great applicability but not a lot of theoretic underpinnings. That means that it is basically up to the fellow to continue honing their skills by reflecting periodically on what works and what doesn’t. As noted before, what works for one relationship may spell disaster for another. Therefore, the art of upward management requires development of a repertoire of different skills for use with different people and environments. Complicating matters is that our environment will continue to be in flux as we grow. No matter how far it seems, it won’t be long until graduation. And at that point, the direction of your management may not be so upward anymore.
7 Upward management is an extension of self-management: As mentioned earlier, upward management requires discipline and focus. It means that you are in a position of control even if you aren’t in a position of power. That demands a lot of hard work and breaking maladaptive habits, such as procrastination and impulsiveness. That’s not easy to do, by any stretch of the imagination. Moreover, it is never fair to expect anything more out of anyone else than what you can expect from yourself. Therefore, you have got to commit to self-management as much as managing upward.
Conclusion
It’s unrealistic to expect fellowship programs to suddenly start teaching about leadership and management styles, but whether subtly or more overtly, fellows learn a lot about management throughout their years in training. Fellows would be well advised to take these lessons and reflect on upward management. It is guaranteed that these skills will come in handy long after graduation. After all, if you ever hope to move upward, you’ll also have to manage upward.
Bharat Kumar, MD, MME, FACP, RhMSUS, is a clinical assistant professor of internal medicine at the University of Iowa. He completed a dual fellowship in rheumatology and allergy/immunology, as well as a Master’s in Medical Education in 2017. He has a special interest in journalism, healthcare policy and ethics. Follow him on Twitter @BharatKumarMD.
