Friday, September 11, 2020


I recently listened to a talk by Dana A. Telem, MD, MPH* titled FAILING FORWARD.
In her talk, Dr. Telem discussed several aspects of failure during her career that resonated with me including:
·         Over confidence compounded by internal focus (a “I can do everything” without help), and a fixed mindset.
She moved on to state that she learned some valuable lessons thru her failures including:
·         Failures will happen to everyone and these failures make you better.
·         Leave your insecurities at the door and have trust in a mentorship and be a mentor. Her mentorship with Justin Dimick (see prior interview below), was invaluable, as he  fostered her harvesting her potential, created a culture of radical candor and always “had her back”.
Her fondness for her mentor raised some questions from me. It is known that “effective mentoring is critical to the success of early-stage investigators at academic health centers (AHCs). Strong mentorship has been linked to enhanced mentee productivity, self-efficacy, and career satisfaction.” I was curious how she has grown thru a successful mentorship relationship.
Dr. Telem:
1.      You indicated that your strong personality tended to hamper your development along the way. Most of us never understand that a strong independent personality can be counterproductive, until late in life. This is a valuable lesson. When did you first realize this about yourself? How did you gain the emotional intelligence to realize that? How do you teach that to junior faculty or trainees?
I am solution oriented and felt I did not need to bother others. That may help in a crisis but it did not work when trying to work with others. Asking for help does not make you weak- it is good to acknowledge you need help. It is hard for surgeons. It may be a fear that we will look weak if we are vulnerable, its uncomfortable. You feel you need to prove yourself before you can be vulnerable.”
2.      Technical skills tend to be the main focus of young trainees and attendings. I have discussed the importance of non-technical skills several times in the past with Steve Yule and Rhona Flin. Given the clinical work (and research work) they are responsible for,  it seems like a considerable challenge to engage trainees and junior faculty who feel that their focus should be on clinical medicine. How do you engage residents / trainees / young faculty on non-technical skills?
Our newer trainees feel charged to seek help, call out, unlike those that came before. Millennials are good at this.
It’s the culture that sets up this path. A culture of psychological safety builds this ability to learn Non-technical skills and to change. It has to start at the top leadership. I took over as the General Surgery Chief, but I have a Department chair that supports people no matter what the need. That tone and culture fosters this. Then it is not difficult to solicit that skillset. It is supportive and not punitive.
Trust is the key to this foundation. If you have trust it is not difficult.”

3.      Those of us who have a “I can do it on my own” mentality do not take to mentorship too easily.  how did that relationship develop? Was this arranged or fortuitous?  How did you ease into that relationship?
in residency I felt I had to do everything on my own. As a junior faculty, for clinical help it was a standard practice. But for administrative needs I just did not know what I needed and sought further training instead of a mentor. I earned multiple degrees trying to better myself. Coming to U. Michigan revealed the obvious- that you DO need help. Research was very intimidating for me when I came to U. Michigan. I was so worried about my interpretation of my research but Justin allowed me to realize that a mistake is fine and not a big thing. His blunt critique to make you better instills trust. This was the first time I really got that.”
4.      I recently picked up on this article in non-medical literature: “A mentor isn't always someone who has been there, done that before, who draws on his or her own experience to guide the younger less experienced person, but in some cases, a professional trained in coaching, who is guiding and advising people who are pursuing a wide range of goals and careers. In recent years, especially in the management and human resources literature, there are consultants whose job is to advise members of the business community on the mysteries of mentoring.” **
a.       What is your focus when it comes to trainees or junior faculty regarding mentorship? Is waiting for the trainee to request a mentorship or is there a process to proactively establishing that relationship?
If this is a scheduled process how is that conducted?
“Michigan promise- promise that we will develop all new faculty. Each new faculty joins a LAUNCH TEAM. There is a team of mentors for all research. These include sounding boards. There are advisors to support those who feel they may be in a rut. They are now tracking people in their internship and identifying those with promise.
Forced mentorship does not work. This system allows for pairing until a successful relationship has started. This just started so data is coming in for analysis. This will help with the different types of residents but mostly those that are just not sure where they want to go or to be- help them identify where they want to be.”
b.      What is the secret of a successful mentorship?
“Mentorship and sponsorship are different things. Mentorship can be impactful and change the course of your career and others who mentor from afar. Success comes when the mentor allows you to build yourself but not recreate them. Trust is key. Success comes from who are there whether you are successful or not. The mentor should let you be who you were meant to be.”
Listen to Julie Ann Sosa, M.D., M.A., FACS  UCSF Department of Surgery- transformational growth.
c.       Have you equated successful mentorship with increased productivity? Reduced burnout/ less stress? Do the residents who have successful mentorships have a more successful process in finding an ideal job or fellowship?
“Yes and yes! I had a lack of focus on priorities. If you don’t have focus, you don’t know what you want. Hard to be intentional. Hard for you to know what to look for. I decided I needed more training, more fellowships. I wrote a lot of papers and felt satisfied. But in retrospect I was not satisfied that these had any impact. It was not until I had a mentor that I trusted that if felt I could write and make an impact. I learned that the best writers were mentored by the best writers!”.
d.      Can you teach this old dog new tricks? Is it too late (at 58 years old) for me to find a mentor?
“Its never too late! learn from your peers!! Peer mentors are the best! The young trainees are so smart and can teach. .
**Mentoring: What Is It? How Do We Do It and How Do We Get More Of It?[8/3/2020 9:14:53 AM]
Kenneth A. Lipshy
Dana A Telem MD, MPH, Department of Surgery University of Michigan, Vice Chair Quality and patient safety, division chief minimally invasive surgery.
INTERVIEW: INNOVATIVE STRATEGIES FOR IMPROVING SURGICAL PERFORMANCE Justin Dimick, MD, FACS; Chief of the Division of Minimally Invasive Surgery, and Director of the Center for Healthcare Outcomes & Policy at the University of Michigan.
Winston Churchill: “Definition of Success is the ability to move from failure to failure without losing enthusiasm”
“Relationships are as important as the task.” ANON
“in Failure cones strength and a new direction” ANON
“there’s almost nothing to learn from success. Failure’s the best teacher you will ever have” Blue Bloods.
“when something blows up in your face try again, try again, try again and eventually you will be on top” Wernher von Braun. V2 Rocket creator. NASA rocket engineer.
And the contradiction in philosophy, “The human condition actually prevents us from adopting lessons learned” Dr. Emily Mayhew, PhD, London. WWI 100th anniversary recognition Excelsior lecture 2018.