In its relatively short history, Duke University School of Medicine has earned a reputation for its ability to prepare leaders in all areas of medical practice, education, and research. Yet, pinpointing exactly when and how that leadership training occurs over the course of a student's studies at Duke could be difficult. That is, until now.
As of this fall, the school has officially incorporated leadership training into its curriculum with the new Duke Leadership, Education, and Development (LEAD) Program. Created by medical students, the program focuses on developing students' leadership skills throughout their years at Duke, whether they dream of one day reaching department chair or CEO status, flying solo as a practitioner, or landing somewhere in between.
The LEAD Program is one of the country's first formal medical student leadership curricula. Earlier this year, Alpha Omega Alpha recognized the group of Duke medical students responsible for creating the innovative program with its annual Service Leadership Project Award. One of only three recipients of the award nationwide, Duke will receive $9,000 over three years to support the new LEAD curriculum.
The group was led by medical student Kyle Gibler, MSIV, and over the past two years has included team members Marisa Dowling, MSIII; Parastou Fatemi, MSIII; Nimit Lad, T'10, MSIII; Nicole Zelenski, MSIV; Peter Wei, MSIV; Mitchell Bassett, MD'13; and Grant Sutter, MD'13, HS-current.
Piloted in the 2012-2013 academic year, the LEAD Program was fully rolled out to first-year students during the 2013-2014 academic year. Unlike other programs geared toward residents or medical students seeking special qualifications or an additional degree focused on management or leadership, the LEAD Program is not a separate track and will benefit all Duke medical students regardless of their interest or future goals.
On the surface, the LEAD Program may not look much different than what students over the past few decades have experienced. Students will continue to take courses such as the
Practice course during the first year and the Capstone course during the fourth year. However, what's special about LEAD is that leadership components are more explicitly woven into the existing curriculum's basic courses, clinical rotations, and during the scholarly research year. Special workshops, small group activities, and lectures led by faculty outside of the School of Medicine are highlights of LEAD as well.
Colleen O'Connor Grochowski, associate dean for curricular affairs, says leadership has been a fundamental yet implicit part of medical school training at Duke for years.
"Students glean leadership-type experiences through the educational program, particularly as it relates to the third year," she says. "They have to be self-motivated, create a proposal, and integrate themselves into a working team to do research. It's sort of implied that those experiences will result in leadership skills or leadership qualities within our graduates, but I always thought we had an opportunity to do a little more."
Aware of this gap in leadership training at the medical-student level, along with the health care industry's growing need for more physician leaders, in 2011 Dean Taylor, MD'85, HS'87-'91, challenged a group of students to come up with a way to change the direction of leadership education.
"We've never really had an identifiable program where we've taken on that responsibility," Taylor says. "Every business school has leadership development as part of its curriculum, but it's rare in medical schools."
As chairman of the Feagin Leadership Program at Duke, Taylor assigned the task as part of the already-established, yearlong Feagin Scholars Program named in honor of emeritus faculty member John A. Feagin Jr., MD'61. Gibler and the student group worked closely with Taylor and other faculty mentors, Saumil Chudgar, MD'05, HS'05-'08; and Devdutta Sangvai, MD, B'03, to find ways to incorporate leadership training models from the business world and the military into the world of medical education. They also collaborated with faculty and administrators in the Duke Fuqua School of Business and Duke Corporate Education to come up with the LEAD Program. "Medical students' schedules are already so packed," Gibler says. "This curriculum wasn't about adding on more classes but repurposing them."
The group worked to make sure the leadership components fit well into both the lecture-based and experiential portions of the curriculum and would naturally build on one another as students progressed through medical school. The topics covered include team-building, communication, self-reflection, and leadership theory for first-year and second-year students. Third- and fourth-year students will have a chance to officially put their new skills in practice during a community service project and while serving as leadership mentors to first-year students.
Taylor was pleasantly surprised at how well the group's proposal turned out and was eagerly accepted by several faculty members, including Grochowski.
"I was very excited," Grochowski says of first hearing the group's proposal for LEAD. "We've had this opportunity in our curriculum, and this was a way we could address that."
It did not take long for other faculty and the advisory deans to buy into the idea of the new curriculum as well, particularly considering the monumental changes currently facing the health care industry.
"Health care is going to be delivered more and more in teams with health professionals working together," Grochowski says. "Certainly teamwork is a critical cornerstone of leadership, as is knowing when to lead and when to follow and how to interact with others. We have placed an increasing emphasis on creating opportunities for our students to learn with their health professions peers here at Duke. Incorporating teamwork into a leadership curriculum will help enhance our medical students' participation in these types of inter-professional activities both as students and then as professionals."
"I think we've fallen behind in our profession," Taylor adds. "We need to take active leadership roles at all levels."
While Gibler himself is earning an MBA degree in addition to his medical degree, he realizes business or management degrees aren't for every student, but that doesn't mean they aren't cut out for leadership roles.
"An MBA is clearly a good idea for a certain subset of students," he says. "But every student needs to understand the skills to be an effective leader. The hope is that students will think of themselves as leaders because eventually we'll all have the opportunity to lead on a daily basis. Traditionally leadership within medicine has been seen as a physician leading a hospital. We believe all physicians are leaders."
Although the LEAD curriculum is now formally part of the school's curriculum, the student leaders had the foresight to include a way to measure the effectiveness of the program and make improvements along the way.
Lad headed up that portion of the curriculum development project. He and other students also collaborated with colleagues across campus, including researchers in statistics, to create a 25-question assessment survey that will be given to students periodically over their four years at Duke. The questions focus on six core values: self-management, teamwork, communication, improvement in innovation, mentorship, and health care acumen.