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Previous feature articles:
September 2020
October 2020
​November 2020

Physician Coaching Articles of Interest

January 2021


The articles featured this month discuss the high prevalence of imposter syndrome in physicians from medical student years on and describes a leadership journey that managed to move past it.

Should Medical Educators Help Learners Reframe
Imposterism?

  • Authors:  Bruce Z. Morgenstern & Gary Beck Dallaghan
Reference: ​https://doi.org/10.1080/10401334.2020.1856112
Summary: This opinion piece opens with an excellent succinct review of the issue of imposter syndrome in the medical profession, with a particular focus on medical students.  The authors note the that the elements of the competitive journey into medicine create pressures around perfectionism and fear of failure, important but not sole drivers of the phenomenon.  They cite studies that have attempted to estimate prevalence which, while the studies face methodological challenges, is high with estimates ranging from 60 to 90%.  The consequences are serious, whether they are personal in terms of anxiety, or depression, or at a system level where qualified individuals may feel inhibited from working to their full potential for fear that they are not as competent or capable as they feel they project.  The mutually enabling relationship of imposter syndrome with burnout, with its deleterious effect on perception of effectiveness, is underscored.
 
The point of this article is its call to action; a call to recognize the issue, surface it, and support its management with culture change, curriculum, coaching, counselling and ongoing research and measurement.
Comment:  Imposter syndrome in varying degrees is common thread in coaching conversations, particularly in the leadership context.  This review underscores that physician coaches are likely seeing not leaders with imposter syndrome, but physicians with imposter syndrome who have become leaders.  If the prevalence is as high as it seems, this is a theme that warrants some air time in any context of physician coaching.

SBM Mid-Career Leadership Institute: replacing “fake it till
you make it” with authentic leadership

  • Authors:  Sandra J. Winter
Reference: https://doi.org/10.1093/tbm/ibaa046
Summary: This commentary by a senior leader describes her journey through the Society for Behavioural Management (SBM) Mid Career Leadership Institute.  The program aims to support leaders working in VUCA (Volatile, Uncertain, Complex, Ambiguous) environments blends formal workshops, the creation of small peer communities, access to formal mentors and regular follow up interaction with executive coaches.  The program emphasizes assessment and reflection on leadership style and choices, and the author contrasted this approach with approaches providing instruction in specific leadership competencies.  The author’s thesis, supported by past literature, was that focusing only on competencies can undermine leadership by fueling a sense of being incomplete in some way, driving the “imposter” perception.  Dr Winter reports that the program has been a potent enabler of her ability to manage significant career changes and accept additional challenges with confidence.
​Comment:  While not a scientific study, this is an interesting personal experience, not in the least because it is about someone moving past imposter syndrome, rather than just sharing that they suffer from it! The multifaceted approach and use of coaching in a longitudinal fashion to support the application of reflections about leadership style and self learnings are a model that is of interest to anyone designing leadership programs.

Executive Leadership and Physician Well-being:
Nine Organizational Strategies to Promote
Engagement and Reduce Burnout

  • Authors:  Tait D. Shanafelt, and John H. Noseworthy
Reference: ​http://dx.doi.org/10.1016/j.mayocp.2016.10.004
Summary: This opinion piece co-authored by the Director of the Program on Physician Well being and the President and CEO of the Mayo Clinic in Rochester, MN works from the assumption that burnout arises from a combination of personal and systemic factors and has personal and systemic costs that cannot be artificially separated from each other. In some ways complementary to the aforementioned paper, they generate a table identifying personal and multiple levels of system factors that come into play for all the commonly accepted drivers of burnout. Their strategies are:
1. Acknowledge and Assess the problem
2. Harness the Power of Leadership
3. Develop and implement targeted interventions
4. Cultivate community at work
5. Use rewards and incentive wisely
6. Align Values and Strengthen Culture
7. Promote Flexibility and Work Life Integration
8. Provide Resources to Promote Resilience and Self Care
9. Facilitate and Find Organizational Science>
 
While numbers 7 and 8 would be strongly in the wheel house of focused life and wellness coaches, the rest of the recommendations and daily grist to any organizational or leadership coach.
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