Rheumatology Fellowship Programs Could Benefit from Leadership Training

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The beep of the cellphone text got me off the armchair. I had been feeling cozy and comfortable. Outside the window, it was a blissful winter wonderland—the one, I believe, Nat King Cole intended when recording “The Christmas Song.” But at the same time, I was anxious to hear whether my clinic would be canceled due to the Monday morning blizzard raging outside. I was looking at yet either another snow/vacation day, or worse, the prospect of driving to work in my aging SUV with all-weather tires that I don’t believe adequately live up to their optimistic name.

With one eye on the TV meteorologist’s excitement over yet another New England snowstorm—in its full glory—a quick look at the incoming text prompted me to nearly faint. Despite heavy snowfall, my resident had made her way to the clinic this very morning. She was asking what time we were starting because it was already close to 9 a.m. and someone had told her that we might delay opening. I froze. I was physically comfortable and out of the elements in my warm home because, the previous evening, I had been advised that the clinic would not open until 10 a.m. The brave and devoted resident had just started her rotation with us, and the prior Friday, we had exchanged phone numbers just in case we needed to communicate about the anticipated Monday storm.

As I read her text, I panicked. At this moment, our lackluster communication plan was beside the point. What mattered was the powerful storm outside and news that close to a foot of snow had already fallen, making roads treacherous, and this young woman was stuck alone in an empty clinic. Because it was close to 9 a.m., the time we were supposed to get another update on clinic delays, I suggested she call the designated number about the storm update and stay put for now, adding that if she felt the roads were getting worse to leave right away. I hoped that she lived around the corner from the clinic. Of course, such was not the case. She lived at least 15 slippery miles distant. I envisioned her sliding from snowbank to snowbank as she traversed icy streets, justifiably cursing me for not notifying her of the clinic’s opening status in a timely manner.

My Fellowship Experience

This experience was a hard lesson learned for me, a recent fellowship graduate and new associate program director. During fellowship, our mentality was that we were to complete assigned tasks and follow defined schedules and rules. We were to be obedient followers, and those who performed well in that role probably were considered nicer, maybe better and easier to get along with. We showed up when told to, did our job and soon graduated. Fellows seldom are assigned tasks that test our sense of responsibility or exercise leadership/management skills.