Leadership development: Why is it important for radiation oncology residents?

Medicine is a unique career in which, regardless of formal titles, all physicians will be considered leaders. After more than a decade of higher education one may presume that physicians entering independent practice have received formal instruction on effective leadership, but too often that is not the case. Leadership development was traditionally an investment in those who demonstrated characteristics of “natural born leaders” chosen for positions of authority. However, as our expectation of leadership has evolved, so should our approach to training and development. The authoritative leadership model has been replaced by a collaborative vision of leading through influence.¹

Despite growing awareness of the importance of leadership development, it remains sparsely integrated into graduate medical education, and is infrequently included in radiation oncology residency specifically. Leadership development should be regarded as a part of lifelong learning, recognizing its ability to positively impact physician development. Radiation oncology training affords four years for developing leadership skills at a critical point of a young physician’s career.

Professionalism, interpersonal skills, and communication are core competencies of resident education and important components of leadership, but there is more. Suppose there is a skill that correlates with resident wellness, performance, and decreased burnout. Should we be teaching that? What if that skill is also associated with quality improvement and patient outcomes? Emotional intelligence is an integral part of leadership development that can be taught, measured, and positively impacts all of the above.^2-4 Implementing a leadership development program takes considerable investment, but the results can be influential in the short and long term.

The Cleveland Clinic residency program has been innovative in its creation of a leadership curriculum within the formal curricular structure. Leadership training takes place during semi-annual group retreats scheduled during regular clinical hours. The focus of retreats includes self-awareness, team-building, principles of effective communication, cultural development, and operational leadership.⁵ As residents, we participate in both individual and group activities that facilitate strength finding, the understanding of leadership styles, and the learning of effective communication skills to enable conflict management. These daylong retreats are well received by residents and often followed by an enjoyable group bonding activity such as axe throwing, doing an escape room challenge, and volunteering with local organizations.

Failing to incorporate formal leadership development into residency training is a missed opportunity. Every physician is a leader and providing basic training during residency prepares new graduates to be effective leaders. We need to remove the notion that leadership training is for those interested in heading a committee or department and instead provide the stable framework upon which new graduates can more effectively manage their clinical practice. The future of medicine will be value-based, patient-centered care, and the new generation of radiation oncologists will need the leadership skills to guide our field through this transition.

References

1. Collins-Nakai R. Leadership in medicine. McGill J Med. 2006;9(1):68-73.
2. Talarico JF, Varon AJ, Banks SE, et al. Emotional intelligence and the relationship to resident performance: a multi-institutional study. J Clin Anesth. 2013;25(3):181-187.
3. Ishak WW, Lederer S, Mandili C, et al. Burnout during residency training: a literature review. J Grad Med Educ. 2009;1(2):236-242.
4. Lin DT, Liebert CA, Tran J, Lau JN, Salles A. Emotional intelligence as a predictor of resident well-being. J Am Coll Surg. 2016;223(2):352-358.
5. Berriochoa C, Amarnath S, Berry D, Koyfman SA, Suh JH, Tendulkar RD. Physician leadership development: a pilot program for radiation oncology residents. Int J Radiat Oncol Biol Phys. 2018;102(2):254-256.