Susan E. Wiegers, MD, FASE, FACC

Many of us have so many demands on our time and attention that we don’t often take time to map out our direction. In fact, many of us feel that we have no control over the direction of our career and are swept along by a tidal wave of competing tasks that have to be completed. I think this is the wrong way to look at it. The mindset that one doesn’t have control can be very debilitating but also secretly comforting: It isn’t your fault that you got into the mess you are in now. And by mess I mean agreeing (or being assigned) to so many activities a superhero couldn’t finish them all. I call this the “good scout” syndrome. This is the idea that if you do everything that is asked of you, the powers-that-be will notice, and you will be rewarded with promotions, raises, and acclaim. This of course is exactly what doesn’t happen—instead you are vaguely appreciated as a good soldier and whatever necessary but uninspiring task that comes up your superiors think (to paraphrase that old commercial) “Let Mikey do it, Mikey will do anything.”

This is honestly where I was in my career about 20 years ago. Then the new division chief in cardiology asked me why I had agreed to yet another hospital role when I was so frustrated with several others that I already had. It frankly hadn’t occurred to me to say “NO thank you.” The idea that it was important to be strategic was new to me and at first seemed egotistical or conniving. That was then, and I have come a long way. It is actually important and appropriate to be strategic in your career decisions. I know that many of us dislike the occasional colleague who will not agree to anything “if there is nothing in it for them” but that is not what I am suggesting. Being a team player could (and in my mind should) be part of your strategic plan.

First of all, figure out what you want to accomplish in your career. Think beyond “Survival” to what your vision of the future would be. When I mentor medical students, I do recommend a reality check with someone else on your vision. The example I always give, if you want to be Chief of Cardiology by 35, publish an acclaimed textbook, be a revered clinician who rushes to the bedside of your critically ill patients day or night, and with your partner, the neurosurgeon of your dreams, have 5 children, even the most strategic of planning is going to make at least that timeline difficult. But once you have an idea of where you would like to go, figure out what you need to get there. Do you want to be the technical director of a lab? Great! What credentials and skills does being a technical director require, and what do you need? Will the Advanced Cardiac Sonographer (ACS) credential be of benefit? What are the requirements, and how do you go about fulfilling them? It is comfortable to stick with what we are good at and uncomfortable to learn and practice things we are bad at. Research has shown that many physicians and sonographers in academic medicine feel limited by their discomfort with public speaking. Here again, the idea that you are born with this skill and if you don’t have it, you are never going to get it will hold you back. I am living proof of that. I am very comfortable with public speaking now, but when I first did it (in the debating club in high school in a room with 7 people in it), I stopped in the middle of my prepared speech and cried. For a while, the debating coach would say after a competition “And Susan didn’t cry this time. That was great.” Eventually I got the hang of it. Public speaking and understanding the way finances work and are presented are the two missing skills that hold some people back from their goals. Both of those are learned talents rather than innate ones.

Once you have identified some goals and the skills you need, get help. An important skill in this regard is practicing “report talk.” This is not boasting but rather letting the person you are speaking to know who you are and what you can do. This is the difference between saying “I would like a chance to speak at the Scientific Sessions,” and “I would like the chance to speak at the Scientific Sessions on RV function assessment—I gave that talk at the local level and it was well received.” Colleagues can be excellent mentors and coaches. The great thing about collaborating with colleagues is that you can be helpful to them just as they are to you. I have found many of those colleagues in my “medical home,” ASE. In our organization I have found role models, colleagues, collaborators, coaches, and friends. ASE fosters this type of networking by providing a matchmaking service to mentors for Scientific Sessions abstract presenters and by helping early career members get volunteer roles to help them achieve the organization’s FASE designation. I invite you to get involved by volunteering and connecting with the members and staff at meetings and online. Remember the old proverb: “If the wind will not serve, take the oars!”

Susan E. Wiegers, MD, FASE, FACC is a Senior Associate Dean of Faculty Affairs and a Professor of Medicine at Lewis Katz School of Medicine at Temple University.