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After the Match: The Myth of Natural-Born Leaders

Cook, Thomas MD

doi: 10.1097/01.EEM.0000524794.67056.cd
After the Match

Dr. Cookis the program director of the emergency medicine residency at Palmetto Health Richland in Columbia, SC. He is also the founder of 3rd Rock Ultrasound (http://emergencyultrasound.com). Friend him atwww.facebook.com/3rdRockUltrasound, follow him on Twitter @3rdRockUS, and read his past columns athttp://bit.ly/EMN-Match.

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I've watched many residents ascend to the position of chief resident over the years, and I have heard on more occasions than I can count an attending, nurse, or resident say, “I knew on the first day I met her that she would be chief resident.” These statements are even made when interviewing medical students. It is common for someone to write “future chief” in his synopsis of an applicant.

History is replete with stories about natural-born leaders. It's as if DNA roulette created people with the necessary skills to lead sports teams, armies, Fortune 500 companies, nations, or other residents. But is it true? Are some people really destined to lead? Are people like Abraham Lincoln, Winston Churchill, Angela Merkel, Martin Luther King Jr., Dwight D. Eisenhower, and Margaret Thatcher put on this earth to take care of us? Were they all natural-born leaders?

The reality is great leaders are usually like the rest of us. President Lincoln did not grow up being thought of as exceptional. Born into desperate poverty, he lost everything on several occasions, including money, his mother, a sister, a child, and the first love of his life. (Mary Todd was his second choice.) He was even routinely likened to an ape during his presidential campaign. Yet he held the country together through hell, only to be assassinated.

Dr. King had rocks thrown at his head, received bomb threats and countless insults, was incarcerated, and suffered the same fate as Lincoln. German Chancellor Merkel was raised in relative deprivation in East Germany, only to emerge as the most consistent current leader of an embattled continent. In truth, no one looked at these individuals as natural-born leaders for most of their lives. They were viewed as the wrong color, the wrong gender, or as uneducated and awkward in appearance. Yet, history will never forget them.

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Exposed to Criticism

It is my experience that most physicians pursue medical careers because they are intelligent and want to serve people, but most also want their professional relationships to be one-on-one. They may seek out leadership opportunities before medical school or residency, but most of their career aspirations are related to helping individuals as opposed to organizations. For them, leadership is either not appealing, or they feel self-conscious about exposing themselves to the criticism that is invariably slung at anyone with authority. It's enough trouble to put up with insults from patients and consultants; why open up your flanks to attacks from anyone else, especially your peers? Why not just work your shift and go home? It's easier and much less stressful.

I am one of these people, to be honest. I have always been naturally leery of getting involved in organizations where I have to make decisions about what other people will do and then hold them accountable for their actions. It took me years as a program director to learn to delegate tasks and not pester colleagues about how they should do things. I was clearly not a natural-born leader. I had terrible communication skills with peers and subordinates, and I routinely stuck my foot in my mouth. I still cringe at some of the things I did in the past. But in the midst of all those mistakes, something happened: I got better at it.

How do natural-born leaders do it? How do they become great? The answer is simple. They learn how to do it. Leadership is a skill like any other. People are not born with it. No amount of reading will take the place of throwing yourself into a position of leadership and failing, usually multiple times. Elon Musk, Warren Buffet, and Steve Jobs did not attend leadership school. They founded organizations that forced them to learn how to do it. Each of them had countless failures, but each also learned from his failures and pressed on.

That brings me back to the average emergency medicine resident. What if you want to be a leader but are not chosen to be a chief resident? Trust me, leadership opportunities abound in residency and after graduation. Whether it is EMRA, your local medical society, the resident council, an NGO for global health, or your own business, many, many leadership opportunities are available for doctors. Do not be afraid to try something to see if it works. And do not be afraid of failure on your part or on the part of the organization not fulfilling your desire to lead. In the end, it will prepare you for all the other opportunities that will inevitably come your way in the future.

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