Making Yourself Indispensable
Ben Bryner -- Recently I heard a talk by a physician from New Zealand who does a lot of health work throughout the Pacific islands. He was talking about the keys to success of health programs, specifically advice to those trying to set up programs in other countries. He made several comments on various ways to establish and maintain these programs, and he placed special emphasis on "investing" in those whom the program was designed to serve. In other words, no matter where you're trying to set up a health program, at home or abroad, the key to making it sustainable is to avoid making it dependent on you personally. Instead it should be dependent on the people who work there and who it's designed to serve. His advice was "make yourself redundant." Sound advice, similar to what I'd heard other people experienced in the field say before; but I liked the way he summarized it with that phrase.
This is in contrast to the advice I'd give to someone trying to do well on a sub-internship, which is, "Make yourself indispensable." This is some pretty common advice for people in the workplace, where the idea is that if your boss doesn't know how he or she would be able to function without you, you're unlikely to get fired. As a sub-intern, often your roles aren't fully defined and you have some latitude. You can often choose what you want to do with your time and what you want to learn. On the other hand, there are lots of things you can't actually do because you're only a medical student. So you will never be literally indispensable, but I think the best strategy for a good evaluation is to try to make yourself as close to indispensable as possible to your team members.
Sometimes this means taking on a complex job, sometimes it means taking on scut work. The point is that you have to try to enthusiastically make yourself a key part of the team, regularly taking on a recurring task that you get, and by remaining flexible. I think that last point is one of the most important ones; often the sub-intern is the person on the team with the least amount of fixed responsibilities, so you can often be the one able to take on a job that may take a lot of time or take you away from the floor. It's often less than exciting in the beginning, but the more you take on and handle competently, the more likely you are to be assigned more interesting tasks.
So the focus in the global health situation that the speaker was describing is on the well-being of the institution, while the latter advice focuses on the well-being of the individual. It may sound selfish on the surface, but it isn't really. Of course, the needs of patients always come first in the hospital; but the sub-internship is the last real time that education is your primary goal rather than patient care. It's also the last time you're paying to be there and be educated instead of being paid to work, so you should try to get the most learning out of it as you can as well as trying to get a good evaluation that will allow you to go on and learn how to truly care for patients.
And of course, every team, every service, every department, and every school is different, so always try to figure out specific expectations. But it should hold true that if you become a reliable and capable part of the team you'll get a better learning experience; and if the team wishes you were still around after you rotate to the next service they'll be likely to give you a good evaluation.
Evaluations are important, obviously, but they aren't the only thing either. I've tried to take advantage of the flexibility of my sub-internships to spend time getting to know patients, who you can nearly always learn something from. Most of this advice is probably obvious, and hopefully it is applicable to your sub-internship experience, but if you have something to add or disagree with, please feel free to comment. I'm trying to figure out how to be useful and flexible one day at a time as well.
This is an excellent thought provoking post.
Posted by: mba | Oct 24, 2010 9:35:14 PM
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