S3E7: Building the Foundations of Leadership in Medical School (feat. Alexa Lisevick MD, Samuel Oduwole MD, & Salvatore Falisi MD)
Brooke
Welcome to Learning to Lead, a podcast about leadership, teamwork, and reimagining healthcare. This podcast is for learners, educators, and healthcare professionals interested in building leadership skills in a supportive community.
We are your hosts Rahul Anand, Maya Doyle, Peter Longley, and Brooklynn Weber.
Together we bring you conversations with emerging and established leaders, deep dives and hacks to help you become the best leader you can be.
Rahul
Welcome to this episode of Learning to Lead. I'm your host, Rahul, and with me, our co-host, Amber and Pete.
Pete
Hello.
Amber
Hello. Happy to be here.
Rahul
Today's show is a special one. We're reconnecting with three Quinnipiac alumni who sat in the same leadership class as medical students just a few years ago now, seven years later, they're in their third year of residency out in the field, living and leading at the front lines of healthcare. We are here to reflect on their journeys, what's shaped them, what's challenged them, and how they've become the leaders and team members they are today. Alexa, Sam and Sal, welcome to the show.
Alexa
This is Alexa. Thank you so much for having me. I am initially from Avon, Connecticut, and now I am in my third year of general surgery residency at the Medical College of Wisconsin.
Sam
Hey everyone, I'm Sam Oduwole. I am from Philadelphia, originally from Liberia in West Africa. I'm currently at the University of Pennsylvania as a resident. I've made a short career path change. I'm now in physical medicine and rehabilitation residency, third year residency, but first year of this residency. So thanks for having me all. It's great to be here.
Sal
Hi everybody. I'm Sal Falisi. Graduated with these two guys from Netter in 2022. I'm originally from Long Island and I am currently an active duty army officer and anesthesia resident at Walter Reed Military Medical Center in Bethesda outside DC.
Rahul
Alexa, Sam and Sal, we're delighted to have you on. So let's go back to the beginning of your journey. What brought you into healthcare? Alexa, you want to get us started?
Alexa
Sure. So I think what initially brought me into healthcare was a desire that a lot of healthcare professionals share, which is a want to help others and care for other people. But I think very closely adjacent to that, I really wanted to be a problem solver. And so healthcare providers every single day are problem solving and being able to relieve the burden of disease from someone is something that is outstanding and tremendously satisfying.
Rahul
Sam, what about you?
Sam
Yeah, I went to college and I was a biology major and I knew I liked science and interpersonal, I love people and I love being with people and taking care of people. But I decided to go to medical school while working in clinical research with patients and suddenly realizing that my love for science and my love for exploring, understanding complex things match well with medicine where I can really apply my love for science and biology to the human body and make people better. And so during that time, I decided to apply to medical school and knowing my media family had to go into medical school. My mother actually was in medical school in our country before the Civil War, but that ended her time in medical school. And so I knew that I liked medicine, but no one that I knew closely was in medicine at that time. And so it was a dream. I figured I could give it a try and to get that email that I was accepted was a pretty surreal experience for me.
Sal
Wow, this is Sal. So yeah, similar themes for my colleagues here. So what brought me to medicine initially was just a love of, I mean broadly science, but just the human body is just incredible and just wanting to know more and more about how it works from an anatomical level to a physiologic level all the way down the individual little proteins that we learned about in biochemistry classes in M1. That stuff is just always amazing. And I still have days at work where I'm amazed by some function of the human body, some medicine I give or something. So yeah, medicine was a career. I'm a fundamentally lazy and easily bored person, so I didn't want to do something that would feel like work. And don't get me wrong, it's still work and it's still a job, but it's rewarding enough that I think I will do it for a long time.
Rahul
Wonderful. So tell us what motivated you to take up leadership training in medical school. I'm sure you had many choices, so there was something motivating you.
Sal
This is Sal. I'll take a stab at this question first. So honestly, if I remember looking through the course catalog for the electives, we all had to take certain number of the electives. I was mostly drawn by the instructors. So I remember seeing your name, Dr. Anand and Dr. Drying who co-taught that first cohort. And I had separate experiences with both of you. I knew you were both coming from very different places from a leadership perspective, you more of the business entrepreneurial medical education side, and then from her prior naval military experience, which was relevant to me as a military scholarship student. So I was really just intrigued by kind of the blending of those two different perspectives. And also just the idea of being a Guinea pig for a new course was not a bad thing. I was kind of excited. Netter itself a very new school at the time, I think we were the third or fourth graduating class, so taking that plunge wasn't such a leap from going to netter in the first place. So getting in on the ground floor was kind of an exciting prospect in that way.
Alexa
This is Alexa. I would echo what Sal said, and I would also add that I think that it is well recognized that all doctors are leaders. And I think a lot of medical students, myself included, come into medical school with some sort of leadership experience and the recognition that leadership can be very rewarding, but there can also be a lot of bumps along the way and there can be uncomfortable moments as well. And no one necessarily teaches you how to be a leader. And so having formal education of any sort and dedicated time to work on that is I think a super unique opportunity.
Sam
Yeah, this is Sam. I'd also like to echo what my colleagues spoke about. I agree with the themes mentioned already. For me, setting up for this course in medical school, I'm a bit of an adventurous person. So I saw a course and I thought, this is a really cool course and it's applicable as Alexis said, to being a physician. You are a leader in your team. The big reason for me choosing leadership was that I want to make an impact on the people around me, the teams that I'm with and the systems that I encounter or interact with. I believe that I do things based on values. And so whatever I'm doing, I try to do the right thing and I believe that things should be done the right way. Kindness, love, love effort. And so I think this class for me was an opportunity to learn the foundations of leadership.
I know that being a doctor is being a leader, which you forget in medical school because you are the bottom of the totem pole. But I recognize that I would be a leader in the future and I want to have an impact, influence on those around me for the better. And so having a structured course where I can learn the foundations and really foster the tools to be a effective leader was something that stood out to me. And so I decided to take the course to get those means, and I found within the course a great core of people and it was really fun and such an amazing experience.
Rahul
So what I'm hearing is that you see being a leader as part of being a physician, it was part of the identity of a physician, which was one of the motivations. And you also see these skills and tools helping you be more effective as a physician, which was another motivation. And a third one was wanting to do it in a space with peers and faculty that you trust. So that was part of the package that helped you take that leap?
Alexa
Yes, absolutely.
Rahul
Sam, you talked about it being a great experience. So what stands out to you now as you think back to that experience? Were there any key moments or stories or lessons that stayed with you?
Sam
I think a big part of the group that made it so successful was the safety in the group. We all felt that we could be vulnerable and share and give real life experience and our vulnerabilities, our successes in order to become better leaders. Thinking to the Everest simulation, I thought that was a really incredible experience that we all did together. And now as a resident physician and looking back, seeing the significance of that Everest experience, seeing in healthcare is a pretty complex multifaceted system with multiple stakeholders and people with various interests and navigating those interests for the good of the patient, the good of the health system is something that you really truly face when you are a resident. I think that seeing the patients who liked this evidence-based medicine says this, the hospital needs to have these many discharges to have open beds and families want to do this, but patients themselves want something else. So navigating all those different stakeholders interests and desires and ultimately doing the best thing for the patients and society is something that I thought was very well illustrated by the Everest simulation.
Rahul
So just for context for listeners, the Everest simulation is a team simulation played in groups of five or six where everyone has different roles and they're climbing up the Everest Mountain over six days and the simulation creates scenarios and conflicts that pull out rich lessons in leadership. And it's from Harvard Business School publishing. Sam, you talked about safety. Let's explore that thread a little bit with the group. So what is it that created safety in this group for you?
Sam
I felt safe because as Sal mentioned, Dr. Anand and Dr. Drying both fostered an environment of safety. They're both vulnerable and shared anything that they would ask us to share. So I felt very genuine connection with the instructors and they created a culture of that where we could all share if we wanted to or not. And the more we each shared, the more others around us would follow suit. And we also put each other through all that sharing and vulnerabilities. And we were motivated to be better in whatever we were trying to accomplish. So I think it starts in the top down and the professors and the instructors did a really good job of creating that environment which allowed the rest of us to open up. I'm an extrovert, so I share regardless, but I think watching other members of the cohort who are not as extroverted, open up and feel safe was pretty incredible.
Rahul
Alexa, Sal, your thoughts to build on that?
Sal
Yeah, I will agree with what Sam said. I think just the concept of safety in general is so important to an educational environment. People should be able to share their thoughts and challenge others' thoughts without fear of reprisal or judgment. And I think from day one, it was very apparent that we could be vulnerable, we could ask questions of each other. There was that environment, there was no judgment, there was no reprisal or negative repercussions. And it's the kind of thing that I had not intellectually learned about as a concept, like psychological safety. And now that I've went through the course, you see it and you see it's absence real quickly thinking of some clinical scenarios I've been in. But it's so fundamentally important to create effectively leading a team and creating a cohesive environment and educational environment. So yeah, just agree wholeheartedly that it was there from day one for our course.
Alexa
Yeah, I would agree with that. I think in particular, the fact that there was gratitude expressed to people for sharing and being open, I think provided positive reinforcement to continue to create that environment. And I think that is one thing that I have tried to take forward with me because as a resident or just in general, you're not always the leader or the boss, but you can always try to build in psychological safety with small techniques such as being respectful and being grateful for people who do speak up. For instance.
Rahul
Sal, Alexa, your thoughts on experiences or moments or lessons that stayed with you?
Alexa
I think one of the things that really stood out to me in this course was actually early on when we discussed situational leadership and the application of different leadership styles in different environments. And this was the first time that I really learned that to be an effective leader, you need to be able to bounce between each leadership style to be efficient and effective. And I think internally I began to recognize that the leadership style that I was using most often was probably what came most comfortably to me, but also maybe was a bit socially constructed, meaning I thought that that is what the world wanted from me and unlearning that and recognizing that you need to be able to use different leadership styles and then being able to externally see that in people around me in various different situations. That was wildly mind opening for me.
Sal
Something that has definitely stuck with me, and I don't know if it was a, I don't remember the specific lesson, but I definitely remember that it being a big kind of core of the Everest simulation that we've talked about already is alignment of goals for effectively leading a team. If you have five people on a team, one of them's goal is just to get home as soon as possible. One of them is to do as many cases as possible. One of them is to do a lot of teaching, finding a way to meet those different purposes and aligning all those different things so that everyone is getting their desired outcome is half the battle in healthcare. I feel like very, very often, and I think Alexa mentioned as a resident, you're not always the leader. You typically have at least an attending over you or a fellow or something. But as you go through the years and you're a junior resident and then a senior resident, you have a little bit of influence. And so just getting people on the same page is sometimes the best thing that you can do to move a team forward,
Sam
The different desires of people on a team, because healthcare I believe is a big team and sometimes it can be us versus them mentality, and that's just kind of human nature sometimes. But an example of this as an intern, I was sort of the leader and sometimes in social work rounds. And so we get rounds together where I represent the clinical team and then you have the switch workers talk about this physician. The therapist will be there talking about PTOT, case management, talking about their needs, medical devices, and sometimes the nurses about who's being discharged, like other things. And so a big part of, I think for me leading is just listening. I'm a big talker, so I do try to listen. I think listening is something that I work on to just sit there and just be with the silence and listen. And you can glean a lot of these motivations just by listening.
In the Everest simulation, some of the motivations are hidden, but in healthcare, at least within the clinical team, onsite team, you can really, if you listen, you can hear from the motivation. So for example, I would be motivated to discharge a clinically stable patient. This patient is done, they no longer need to be in the hospital, we can get a bed for someone else. I wouldn't discharge this patient. So we say, oh, the family would like to be home for discharge. Can we delay the discharge till tomorrow? And so now I have opposing things like my desire and the social worker desire, but I realized that it's all for the good of the patient and their wellbeing, their family. And so for me, while this patient's clinically stable, tomorrow could be a bit of discharge for them because they have the support system with their family there to receive them and family's happy, patient's happy, and it creates a better situation. So that's just one example of how listening and seeing and meeting each other where we are and seeing that in the end we all have the same shared goal and compromise can be done, but that's an example. I'm sure you all have examples of being in these multidisciplinary rounds and seeing the misaligned or being in the operating room and the different goals people may share.
Rahul
I love how what you're saying builds up on each other. How did this experience of leadership training change you and what impact did that have on the rest of your medical school journey?
Alexa
This is Alexa speaking. One of the quotes that I think I like is the eyes cannot see what the mind doesn't know. And I think that the way in which this leadership training changed me as a student and as a learner was that I began to have a critical eye for watching the behaviors of people around me who were leading and trying to orient myself and decide is that helpful in this situation? Is that efficient in this situation? What worked really well, what could have been better? And then sort of putting that into my own toolbox so that when I am in that situation, these are things that I can consider or I should do something like that, or I should attempt to be mimic or model similar behavior that seemed to work really well. And so I think having more things in your toolbox, it just helps to make your learning overall more efficient, more effective.
Sam
Yeah. Thanks Alexa, this is Sam here from the class. I noticed that Alexa brought up earlier the different types of leadership styles and being effective means utilizing all of them. And I very quickly learned that I have a preference. For one, it was a more passive style and for me, recognizing that I did need to incorporate the others was very helpful. This class really allowed me to contemplate on myself and what I bring to the table and how I can be more effective by utilizing goals that are realistic. And so I think that was the biggest thing for me in this class, just being able to be self-reflective and then set out tasks that allow me to change and grow.
Rahul
Yeah. Sam, what you're talking about, so for listeners, Sam's talking about the four leader behaviors in path goal theory, which are directive, supportive, participative and achievement oriented.
Sal
I think something that I took from the course pretty early on was kind of growth mindset. So I think something that I've seen as you kind of progress through the years of medicine from a student to a junior resident, senior resident, as you kind of move up, you get more and more comfortable saying like, oh, I'm not sure about that. Let me look it up. Or at least the people that I strive to emulate are very much like that. And I think seeing things you don't know as an opportunity to learn or you're asked a question on rounds as a med student or an intern and you almost don't want to say, I don't know because you feel like you're being evaluated and that's going to negatively reflect, then I should know that. But you can't know everything. You can't see everything. And just seeing moments like that, not as a sign of failure or shortcoming, but more optimistically as an opportunity to learn something that day has I think continually served me pretty well.
Rahul
Yeah, that's such a huge lesson. I remember from one of our times at a community health center I was working at, we had a large audit coming up of our HIV program, and so everybody had this very natural tendency to be defensive and hope that nothing is found. And I remember our program manager, she was having a real growth mindset because she said, Hey, look, this is a great opportunity. We have some experts in the field coming and looking at our small program and whatever they're going to find is going to help us grow and become so much stronger. I thought it was a beautiful example of how that growth mindset, if nurtured, can take you really far even at the toughest moments in the future.
Alexa
Yeah, that's amazing. I can imagine that must have reduced so much stress of the moment when she said that.
Rahul
It completely changed my mindset. Now I was looking forward to what they're going to find.
Sam
That's awesome. I'm going to piggyback off the groove mindset here a little bit. In some of this clinical application. As I mentioned earlier, I've made a career path change in my residency. And so for me, doing two years of one residency and going to another year and starting over, essentially being an intern is a job, a task that you learn how to do. And so for me, having the growth mindset was really acutely applicable year in that learning how to doing the intern role in a different specialty. There's some things that are the same. So how to write notes, I write notes, use templates, smart phrases, putting in orders, those things are unchanged, but how you do med reconciliation was slightly different. How you phrase something in your notes slightly different, how you rounded was different. So for me, even though I had done the interim role before, being humble and understanding there was a lot to learn in a different way people do things was actually very helpful for me because I learned even during intern year for the second time, a lot more at this time. So it was really helpful to be humble and being open to learn and do things a different way. And I found a lot more efficiencies in the way that I review the chart and things that are applicable with the patient care. So it is cool. Having a growth mindset really does help you learn and give better care to patients.
Rahul
What a beautiful example, Sam. Well, Alexa, Sam Sal, thank you so much for being here. It's been a privilege and a joy. And listeners, if you're thinking about your own leadership journey, we'd love to hear from you too. Thanks for tuning in. Until next time, take care and keep leading and learning.
Brooke
Thank you for listening to our show. Learning to Lead is a production of the Quinnipiac University podcast studio, in partnership with the Schools of Medicine, Nursing and Health Sciences.
Creators of this show are Rahul Anand, Maya Doyle, Peter Longley, and Brooklynn Weber.
The student producer is Brooklynn Weber, and the executive producer is David DesRoches.
Connect with us on social media @LearningToLeadPod or email us at LearningToLeadPod@quinnipiac.edu.