The Future of Medicine: Are We Training the Right Kind of Leaders?

If we expect there to be more clinician leaders innovating and advancing care delivery, we need to better equip physicians with skillsets beyond clinical care.

TL;DR…

Medical education is a long journey, lasting anywhere from 7-16+ years post-college. While we do a great job at training competent and skilled physicians over the course of these decades, we are shortchanging our future doctors by not including more content around the hard and soft skills that are necessary to not just become great clinicians, but also great leaders to innovate and advance the way care is delivered in this country. As much as we shout for there to be more clinician leaders in America, we first need more clinicians who have the skills and perspective necessary to be great leaders themselves.

Intro…

Hey there, folks 👋! We're going to dive into a topic that's been on our minds lately: the state of medical education today. Is it really setting up the future generation of clinician leaders we need to care for the next generation of Americans? We're not so sure 🤔.

We graduated from medical school in 2013 and 2016, respectively, and from residency/fellowship in 2017 and 2021, respectively. We've been incredibly lucky to, through a combination of serendipity, a dash of luck, and some intentional maneuvering, evolve from purely patient-facing physicians to holding leadership positions in care delivery organizations.

As we've written about before, we're firm believers that there need to be more physician (and clinician, generally) leaders starting, building, and investing in healthcare delivery businesses. But here's the kicker: this is a tall order when the vast majority of clinicians are unprepared to embark on this journey. So, it's not surprising (though it's still a bit sad 😔) that in many situations, physicians are cast aside as ‘token’ members of senior / executive leadership teams.

Shaky foundations…

Why? Well, physicians are generally woefully underprepared to hold these roles, both from a soft skills perspective (like how to build and lead teams) and from a hard skills perspective (like understanding the healthcare system-at-large, or being able to understand a high-level financial model).

Throughout our collective decades in medical school, residency, and fellowship, the number of opportunities we had to understand how the healthcare system operates, and from there understand the opportunities to fundamentally change it for the better, could be counted on one hand (and realistically, was actually zero). There was zero-to-no focus on the incredible opportunity that we could have in the private sector building care delivery models or organizations, which in hindsight was such a disservice to our entire class of fellow graduates (sorry, Ohio State, we still love you, but you were not perfect).

Beyond the hard skills, there was also a lack of teaching of the soft skills necessary to be an effective leader. Now, you might argue that the point of going to medical school and completing residency is not to be a great leader, but instead to be a competent doctor. But we'd counter that being a great leader actually makes one a much more effective and competent doctor. In many ways, the delivery of healthcare is the epitome of multidisciplinary collaboration. The doctor plays point guard in running highly coordinated plays, except in this case the end goal is not scoring a bucket 🏀 but saving a life, and the downside case is not losing a game but the loss of a life 💔.

A few exceptions

Of course, our experiences may not have been totally representative. You wouldn’t have to convince us that our peers who completed medical school at Ivy League institutions with top-tier on-campus business schools and tight integrations between the clinical and non-clinical healthcare faculties, or those who graduated from residency training programs with department chairs who prioritized bringing in faculty members with non-traditional clinical experiences got some dose of both the soft and hard skills. However, we would submit that those students and trainees make up a small, very lucky minority, and the vast majority of medical students and trainees don’t receive that type of exposure or access over the course of their educational careers (before doctors become doctors, we truly are professional students for the better part of a decade) 🎓.

Prioritizing the right type of learning

Don’t get us wrong; there is plenty to learn in gross anatomy about the insertion and innervation of every muscle in the human body, or in biochemistry having to memorize every step in the Krebs cycle approximately 5 separate times over the duration of medical school, or even in residency having to study esoteric medication side-effects so we can answer that one question that always gets asked on boards. However, we don’t buy that over the course of 4 years of medical school and 3 to 7 years of residency, plus another 1-3 years of fellowship, there isn’t time and space (and more importantly, a critical need) to create curriculum around the hard skills and soft skills that just a small minority of doctors today have been lucky enough to formally learn, and that an equally small minority of doctors never formally learned but were lucky enough to gather up over the course of their careers📚.

So, what's the solution? We believe it's time for a shift in the medical education paradigm. We need to introduce curricula that arm our students and trainees with the hard and soft skills they need to be the next generation of physician leaders our healthcare system needs. This could include courses on healthcare systems, leadership and team-building, and even entrepreneurship. And it's not just about adding new courses - we also need to integrate these skills throughout the existing curriculum, so that our future physicians are learning to think like leaders 🚀 from day one.

What can we do about it?

So, to all the Deans of Medical Schools, and Residency Program Directors, and Department Chairs who read this Substack (which is likely zero in total), we challenge you. Find the time and space to introduce these curricula. We know there are a few of you out there, as we see some examples of these curricula starting to spread beyond the rarified air of that handful of programs we mentioned above. And we’ve even been invited to start some of these curricula at Medical Schools and residency training programs in the communities we are a part of. But moving the needle here will require more than one-off thinking. The number of times our not recalling the enzyme that catalyzes the 4th step of the Krebs cycle has in any way shape or form impacted the care I’ve delivered to a patient: zero. The number of patient lives we’ve touched because of our luck in gathering some of the hard knowledge and soft skills we did not learn in medical school or training thereafter: countless, and increasing 📈.

So, what do you think? Are we on the right track? Let's continue the conversation. Drop us a line, share your thoughts, and let's work together to shape the future of medical education to foster the type of physician leaders our country and our system so dramatically needs 🙌👩‍⚕️👨‍⚕️🎓.

Two Questions:

1. If you are a medical school dean, residency program director, or department chair, what are you doing to incorporate non-clinical content into your curricula?

2. If you’re a clinician, what are some of the best resources you’ve found to build and hone your non-clinical skill-set (outside of taking the plunge to go back to earn a graduate degree such as an MBA or MPH)?

✌🏽 A + A

To read more about our vision for the Stack, check out our intro post here.

Feedback? Find us on Twitter: Amit & Arpan