How do you become a leader early in your career? Basically, stay in one position long enough, don’t screw up too many times, and one day, you might be a leader. That’s how it works sometimes. If you are like me, and shine over time, this is a decent strategy. Unfortunately, many change jobs after their first year as an attending. But moving from job to job can thwart your leadership prospects. In this post, I talk about some leadership lessons for your first attending gig. 

Daily challenges as a leader in training

Practicing as a physician, dealing with varied personalities and high stakes situations daily, is incredible work. Take pride in what you do. It’s a challenge to maintain a high standard every day, in order to build and maintain a reputation. There is nowhere to hide once you are out of training. Over time, everyone will end up knowing you where you practice. I’ve made mistakes, but thankfully, leaders don’t have to be perfect.

Consistency as a leadership superpower

You don’t have to be as amazing as the giants of your field to stand out at your local institution. Reputation is built by committing to doing what is best for the patient consistently over time. People in every department in the hospital will come to know they can count on you.

Becoming an expert in your environment

A benefit of sticking around in one job for a while is the ability to learn the processes and people involved, so over time, you can identify areas for improvement. When you are new, it is harder to leverage raw enthusiasm and new ideas, before you have had a chance to really understand the environment. It’s hard to grasp the strengths or constraints of a particular place until you have some experience there. Providing solutions to problems you see on your arrival can insult colleagues who have been there for some time. Observe for a few months before attempting to make changes.

Opportunities to ascend to leadership in your first gig

A few years into my attending gig, a leadership void developed. I had been the most visible interventionalist in the department for over a year, when my group promoted me to section Chief. This coincided with the end of my maternity leave. The promotion could have appeared incredibly progressive, or overdue, depending on the lens applied. In the end, it was perfect. I had some time to grow into my attending shoes before taking the helm as Chief.

Claim the label of leader  

I scurry back and forth from one part of radiology to the other, from biliary drain to lumbar puncture and back. Lead hooks are mounted outside the interventional suite, and a few of them were labeled “Doc,” right in the middle. The velcro of my lead stuck to others’ hanging nearby, and I came to covet an unlabeled hook at the end of the rack. I jokingly told one of the techs, “Put ‘Chief’ right over this hook,” indicating my favorite spot. Later that day, she fired up the label maker, and soon after uttering my wish, I had my very own hook. I could be bashful about this ostentatious little label, but I like it, and I’ve earned it. Claiming my leadership position has been an important leadership lesson for my first gig. 

Put yourself forth: “Put me on a billboard!”

One year post fellowship, I was working at a medical center with a dedicated cancer center but no percutaneous ablation program, so I decided to start one. I took the practice-building advice I’d heard at various lectures and meetings, and put together a presentation for tumor board, to showcase what IR could offer in locoregional therapies. The cancer center has billboards advertising their doctors and services along the desert highways, and so as a joke, in the middle of my presentation, I entitled one of my slides, “Put me on a billboard!” My intent was to convey, “I’m part of the team caring for cancer patients too.”

The room buzzed with laughter at my young enthusiasm. The Director of the cancer center promptly emailed me to inquire when I would be available for a photoshoot. It turns out, they could Photoshop me into one of the existing billboards. Since I am not located in the cancer center with the oncologists, they weren’t likely to think of putting an interventional radiologist up there on their own. So I suggested it.  I’m still part of that advertising campaign as it moves around the valley. Part of becoming a leader is putting yourself out there. 

Share your own leadership lessons in the comments, and get ready to lead, even if it’s your first attending gig!