Cultivating Creativity in Medical Training FedEx Style

14 01 2013

Over the holidays, I took full advantage of this opportunity to read a book from start to finish.  I chose Daniel Pink’s Drive.  It was actually recommended by @Medrants and I read it partly to understand why pay-for-performance often fails to accomplish its goals for complex tasks, such as patient care.  However, the thing I found most interesting about this book was the way in which creativity is deliberately inspired and cultivated by industry.

I could not help but think about why we don’t deliberately nurture creativity in medical trainees.  Why am I so interested in creativity?  Perhaps it is the countless trainees I have come across who are recruited to medical school and residency because of their commitment to service who also happen to have an exceptionally creative spirit.  Unfortunately, I worry too many of them have their spirit squashed during traditional medical training.   I am not alone.  I have seen experts argue the need to go from the traditional medical education that is fundamentally oppressive, inhibits critical thinking, and rewards conformity.   Apart from the criticism, it is of course understandable why medical training does not cultivate creativity.  Traditional medical practice does not value creativity.  Patients don’t equate ‘creative doctors’ as the ‘best doctors’.  In fact, doctors who may be overly creative are accused of quackery.

So, why bother with cultivating creativity in medical training? Well, for one thing, creativity is tightly linked to innovation, something we can all benefit from in medical education and healthcare delivery.   While patients may not want a ‘creative approach’ to their medical care, creativity is the key spice in generating groundbreaking medical research, developing a new community or global health outreach program, or testing an innovative approach to improving the system of care that we work in.  Lastly, one key reason to cultivate creativity in medical trainees is to keep all those hopeful and motivated trainees engaged so that they can find joy in work and realize their value and potential as future physicians.  In short, the healthcare system stands to benefit from the changes that are likely to emanate from creative inspired practicing physicians.

So what can we do to cultivate and promote creativity among medical trainees? While there are many possibilities including the trend to implement scholarly concentrations programs like the one I direct, one idea I was intrigued by was the use of a “FedEx Day”.  FedEx Days originated in an Australian software company, but became popularized by Daniel Pink and others in industry.  For a 24 hour period, employees are instructed to work on anything they want, provided it is not part of their regular job.  The name “FedEx” stuck because of the ‘overnight delivery’ of the exceptionally creative idea to the team, although there are efforts being undertaken to provide this idea with a new name. Some of the best ideas have come from FedEx Days or similar approaches, like 3M’s post-its or Google’s gmail.  I haven’t fully figured out how duty hours plays into this yet… so before you report me or ride this off, consider the following.  Borrowing on the theories of Daniel Pink, we would conclude that trainees would gladly volunteer their time to do this because of intrinsic motivation to work on something that they could control and create.  And to all the medical educators who can’t possibly imagine how would we do this during a jam packed training program, lets brainstorm a creative solution together!

Vineet Arora MD





Mentoring in Medical Education: Modeling from the Movies

23 04 2012

A big part of medical education is mentoring.  The term ‘mentor’ originates from Homer’s the Odyssey and refers to an advisor.   The role of mentors vary, but generally serve to guide mentees through work, support them during the process, keep them grounded and focused on the task at hand, and provide general moral support.

Over the weekend, at the Pritzker Revisit session on Scholarship and Discovery, our own students stated the number one thing to consider when finding a project was finding a great mentor.  How does one find a great mentor?  Well, our students are encouraged to seek “CAPE” mentors- think Superhero mentors.  The mentor should be Capable, Available, have a Project that is of interest to the student, and Easy to get along with.   Capable means that the mentor has the skills to not only be a good mentor, but also to carry out the task or project at hand.  This may sound like odd, but sometimes faculty are so excited to have a medical student work for them, they may make the false assumption that the medical student will help them with tasks (i.e. statistics) that they themselves don’t know.  Availability is especially important as it is the number one reason our students state they had a less than optimal experience in the summer doing scholarly work is that their mentor was not available.  While availability of all doctors is an issue, the question is often whether faculty make themselves available when they can (i.e. answer student email, take phone calls, meetings).  Setting expectations for when and how to meet can be very important.  Ideally, the mentor has a project that is interesting to the student since if the work is not interesting, it will be even harder to make progress.  Last but not least, the mentor has to be easy to get along with – meaning that their style meshes well with their mentees.  Some people simply do not work well together do to different personality types.  So, I often tell our students to consider that when meeting potential mentors or deciding between two mentors.

As I was thinking about ways to highlight effective mentors, I recalled some classic movies with mentoring relationship.  In relooking at these scenes this weekend, it struck me that there are some interesting reasons why they are good mentors that correlate with our model (well some of them are a stretch but they are still fun to watch!).

  • Yoda in Empire Strike Back encourages Luke Skywalker to not just try, but do.  When Luke fails to resurrect the wing fighter, he does not allow Luke to make excuses but instead demonstrates that he can do it showing that he is CAPABLE.  
  • Mr Miyagi with the Karate Kid mentors through teaching small movements related to everyday house chores “wax on, wax off.”  While he is certainly gruff and challenges Daniel, Mr Miyagi also makes himself AVAILABLE to Daniel at that moment and in the future by saying at the end “Come back tomorrow” to continue the training.  
  • Remus Lupin goes so far to use a “simulated” Death Eater to challenge Harry Potter to learn the Patronus charm (and making all standardized patient experiences seem like a cake walk!).  When Harry fails at first, he is patient and nurturing, stating that he did not expect Harry to get it on the first try.  He also makes suggestions to the technique which turn out to be the key.   Since Harry really needs this charm, this is a PROJECT THAT IS OF INTEREST and Harry ultimately succeeds in casting the spell.  
  • Gandelf in Lord of the Rings provides consolation to Frotto during a moment of despair by highlighting that it his job and also showing that Gandelf is sensitive to Frotto’s needs and EASY TO GET ALONG WITH.   

In addition to these highly acclaimed superhero and superstar CAPE mentors, let me know if you know of other model mentors from the movies.

Vineet Arora MD






The Last Summer for Medical Students

12 01 2012

The summer between first year and second year of medical school is sometimes referred to as the “last summer” since it is the last time students can travel or take off before they start the journey towards USMLE Step 1 and then their third year clerkships.  With the angst building, first year medical students are actively deciding in the dead of winter what they will do over the summer.  One popular decision is to do research – this is not uncommon since residency programs are increasingly competitive and look for students who have a commitment to scholarly work.  However, there are a plethora of other things students could do as well.    As tonight is our “Intro to our Summer Research Program” for Pritzker medical students, I thought I would share some of the most common questions I get about the “Last Summer”:

  • Should I do research in a competitive field?   The answer here is to do substantive research that you are interested in with a “CAPE” mentor (Capable, Available, Project interests you, Easy to get along with).   As my premed advisor once told me, “Mickey Mouse” research is not going to look good to anyone (no offense Mickey).   The key is to find something you are passionate about – after all you have to tell this story on your interview trail of why you choose to do this and the answer “because I wanted to go into ortho” is not really that captivating to anyone (even to an orthopedic surgeon).   Instead, if you do something you are passionate about, like community health work, you can always tie it back to your chosen field.  Most residency program directors don’t expect you arrived in medical school with laser like focus towards their field anyway and expect to hear some type of journey or a-ha moment that drew you to their field.  Because competitive specialties are often reimbursed for clinical work and tend to be smaller departments, they depth of research opportunities may be more limited.  But, don’t forget that neuroscience research is relevant to neurosurgery – and oncology research on head and neck cancer is still relevant for ENT and so forth.  The best research is often interdisciplinary and crosses department boundaries so you should not be afraid to either.  It’s also important to remember that as a first year student, it’s hard to even know if you will be competitive for radiation oncology or associated competitive specialties.  You will need killer board scores, and great clinical grades.  So, while you may think securing the research with the Dept Chair will give you an extra ‘edge’, nothing and no one can make up for a poor performance on high stakes exams or clinical rotations.  So, don’t forget to study!
  • I want to go to country X?  How can I get a global health rotation there?  Well, certainly the urge to travel is strong in anyone (including me).  But, you need to separate your travel bug from a genuine interest in global health.  Most global health rotations are not a vacation – and may not be what you think of as “tourist” destination (despite the short-lived popularity of Off the Map).   Maybe your stars are aligned and your school or a nearby affiliate you know has a program near your hot spot of interest.  Usually, however, it is not that easy and you should consider how strong your affinity is for a specific country or location versus your interest in getting the best global health experience possible.  Global health programs that fund medical students are not easy to come by.  So, if you are genuinely interested in global health, it is always better to go with an established program and mentor to get the most substantive experience even if it’s not in the exact country you are interested in.  The other thing to remember is while this may be your last summer for a while; it is not your last vacation!  You will have time to plan a vacation to your designated hot spot if you can’t work it in this summer.
  • Do I have to do anything?  The answer here is easy – no, you don’t have to do anything per se with your ‘time off’.  Many students find themselves on the hamster wheel of endless extracurricular activities.  The real question is what is your goal? If it is to go home and see family and friends, there is nothing wrong with that!  The key is to ensure that you are doing something with your time off that will make you feel ready to face the second year of medical school.   It is easy to forget that there is a lot of time to participate in extracurricular activities at various other points in your medical school career.   The key is that if you will regret not spending time with your friends or family this summer, then you need to make time to do that.
  • What if I want to do everything because I don’t want to close any doors?  This is not an uncommon feeling for medical students. However, its important to remember that your summer work is not choosing a specialty! There is essentially nothing you can do over the summer that will ‘close a door’ – there may be some things that allow you to put your foot further into the doorway but that does not mean another door will close.   The only doors you close are the ones in your mind.   Most students decide on their specialty after their third year rotations and will often fine-tune their experiences in research in that area in the fourth year.   Another thing to consider is to do research in a cross-cutting area like ethics that could apply to everything.  Sometimes the angst you may be feeling is about making a choice that is wrong for you.  However, the truth is that as long as you are genuinely interested in the opportunity, you cannot make a wrong choice since it will be an easy story to tell no matter what you do.  Since everyone is different, it is always good to get individualized advice from a faculty advisor at your school who can comment on your specific career and research goals.

Finally, no matter what you do with your last summer, don’t forget to make sure you enjoy it!

Vineet Arora MD








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