2) Leverage the Knowledge & Skills of Your Faculty
Most of you are in your final stretch as a trainee. This may be the last time there are easy opportunities to observe other physicians caring for patients, to regularly discuss patient care, to have potential mentors at your side and to find new perspectives or areas of expertise you may not have considered. Even though you probably have a well-honed set of clinical skills at this point in your career, a good physician will recognize opportunities for learning even in common situations.
These opportunities can be missed if the fellow views their interaction with faculty as a performance to demonstrate knowledge and skills, rather than an opportunity to grow in these areas.
Your faculty and colleagues likely have specific attributes that contribute to their success. Some have tricks for getting to important and sensitive bits of history; others may have excellent exam skills, practical tricks for efficiency or simply behave in a professional way that you admire. Faculty often enjoy sharing their pearls of wisdom and experience, so don’t be afraid to ask.
Most fellows recognize the importance of seeking guidance when facing complex, difficult or unfamiliar situations, but it can also be helpful to learn diverse approaches to routine situations. For example, watch what your faculty choose to focus on when they do an exam, see if your joint counts match theirs, ask how they chose to code an encounter and understand their thought process when they make clinical recommendations.
No individual faculty member will be a perfect model, but by intentionally recognizing attributes you admire, you can more readily emulate the best aspects of each of your mentors and colleagues to put together an individual clinical style.
3) Develop Skill Sets Beyond Medical Knowledge
In addition to building your specialty-specific knowledge base, it’s important to consider ways to build your skills in other ways. You will be a more effective rheumatologist if you commit to not only recognizing and filling your knowledge gaps, but also those areas in which you could develop specific practice skills, business skills or academic skills.
Clinical practice skills may be the easiest to identify. Develop scripts that will ensure you can be clear and complete when describing common diagnoses or treatment options. Learn what the pills look like and which ones taste bad or are hard to swallow. Develop strategies for managing side effects. Learn your electronic medical record in detail, including shortcuts and efficiencies. Understand the expertise of the other professionals in your office to help facilitate patient education, scheduling, medication authorization and delivery, and other care tasks. Understand your local referral options when patients need additional consultation.
It’s also helpful to understand the business environment in which you practice. Learn how to code and bill, understand how staff are hired and supervised, and ask about investments your practice has made. This is especially important if you plan to join or start a private practice, or if you are interested in leadership roles in an academic career.
Fellowship is also an excellent time to think about your career niche and consider what skills you need to advance in this area. This could be in clinical or translational research, a focused clinical interest, such as pregnancy or musculoskeletal ultrasound, or it could be in advocacy, community engagement, quality of care or medical education. Choosing a specific area of focus early in training may allow you to identify mentors and develop skills in this area while still in the training environment.
