Leadership in Medical Education: Learning to be a Better Leader

By Michael Gisondi(@MikeGisondi

I recently completed the Stanford Medicine Leadership Academy (SMLA), an 18-month, intensive, leadership training program for medical school faculty members.

This post shares my reflections as a ‘mid-career student’ after participating in a formal leadership development program.

Why learn about leadership?

I’ve been lucky to serve in several administrative roles in medical education throughout my career. Each new role demanded that I lean into different professional strengths, while discovering my blind spots and addressing gaps in my leadership skills. Through previous experiences as a manager and leader, I came to appreciate that leadership – like any domain — must be learned and practiced. There are clear ‘leadership competencies’ to master.

When I assumed the role of vice chair of education in my department, I wanted to ensure that I was fully prepared to produce in yet another new and challenging leadership opportunity. What additional blind spots would reveal themselves? How might I be most effective?

My vice chair position is as new to me as it is to the members of the department that I lead – I’m the inaugural vice chair of education. The vice chair of education role is a relatively new one across the medical specialties, evolving out of a need for content expertise in medical education to meet the complexity and demands of our modern health care system. New roles inherently come with shifting responsibilities and uncertain metrics of success. When I interviewed at Stanford, I asked everyone I met, “How do you define success?”

Leadership training had a clear and positive impact on these first few years as a vice chair. The program served as the classroom in which I learned the requisite leadership competencies for my new role. Class sessions provided the framework for assessing my performance as a leader and guiding how I might deliver better results for my department.

Which instructional techniques worked for me?

Several features of the leadership program proved especially useful.

Professional Coaching. This was my first experience with a professional coach and I took full advantage of her wisdom and experience. The coaching framework is one of the most underappreciated in medical education; we historically focus on mentorship or assign participation to formal advising programs. In my opinion, learning coaches offer students far more efficient skill development and achievement of outcomes than traditional mentoring programs. My experience with my coach proved just as valuable. She refined my communication skills and encouraged me to apply what I learned to real-time challenges in my department. She helped to clarify my observations of the contemporary problems in medical education that I am trying to tackle. She defined success for me in several areas of my work and curated appropriate learning resources for me. I attribute specific achievements in my leadership role this year to my professional coach.

Multi-rater Leadership Assessments. I found the formal 360° assessment of my leadership skills highly valuable. Like many adult learners, I struggle to incorporate formative feedback because I personalize the negative aspects of external assessments. The executive coach who directs our program recognizes this challenge for physicians and navigates the use of 360° assessments exceptionally well. Participants attend an off-site, weekend retreat at the mid-point of the program in which the results of our 360°s are reviewed. You can imagine how terrifying it might be for a room of highly-accomplished physicians to enter the abyss of potentially difficult feedback. Instead, our cohort returned to campus finding new power in our strengths and better able to address our leadership gaps.

Executive Interviews. My perspectives on leadership further evolved by participating in executive interviews. I am grateful for the time and thoughtfulness of those I interviewed: Dean Lloyd Minor, Dr. Charles Prober, Dr. Robert Jackler, Dr. Victoria Brazil, and Dr. Jonathan Sherbino. I took copious notes in these interviews and will share my favorite quote (among many favorites), though I will keep the source anonymous: “Leadership roles are a privilege, not a right. You have to be successful.”

Project-based Leadership Training. Our executive coach challenged us to choose strategic initiatives that moved us out of our comfort zone and were high risk, high reward. I took several lessons away from the design and execution of my project:

  1. Don’t fear the unknown, embrace it. The greatest successes come from taking risks.
  2. Use the sponsors afforded to you. This was especially important to me as a new Stanford faculty member who didn’t know where to seek guidance at the start of my project.
  3. Listen to those you lead and be ready to pivot your vision: do what is best for them. This seems simple, but physician educators are historically poor at creating truly learner-centered educational experiences. This principle extends to leadership domains, as well.
  4. Call on your peers to find your blind spots. Peer consults with my classmates shaped the evolution of my strategic initiative each month. I am so grateful for the wisdom of my colleagues.
  5. Leadership is not a spectator sport. Use your passion to address ‘wicked problems’. Be motivated to hop out of bed every day and put in the hard work.

What was the impact of leadership training for me?

SMLA is directed by an outstanding executive coach with years of experience teaching leaders in health care. The program features monthly classes with guest faculty from business and leadership domains, performance coaching, multi-rater leadership assessments, executive interviews, peer consults, and a strategic initiative mentored by established leaders in Stanford Medicine.

The foundational content covered in the SMLA program, the interactive instructional techniques, and the influence of my peers in the program all led to important changes in my leadership style. In the past, I viewed myself as a servant leader – one whose main leadership goal is simply the act of service itself. While I haven’t abandoned the best parts of servant leadership, I better capitalize on my strengths now: taking initiative, strategizing, and diversifying teams. I try to ‘challenge directly’ and ‘care personally’, as Lisa Scott describes in her book, Radical Candor. I set goals for my team and strive to help them achieve results, much like the fictional character, Katherine, in Patrick Lencioni’s The Five Dysfunctions of Team.

The stated purposes of SMLA are, “to strengthen the capacity of faculty to shape the future of Stanford Medicine,” and, “to expand the range of talent and champions who can initiate and sustain effective change projects and processes.”

Most importantly, SMLA accelerated my professional identity formation as a leader. I view my identity, influence, responsibilities, and successes through a far more nuanced lens of leadership.

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About the author: Michael A. Gisondi, MD is an emergency physician, medical educator, and education researcher who lives in Palo Alto, California. Michael currently holds a position as Associate Professor and Vice Chair of Education in the Department of Emergency Medicine at Stanford University.