Tomorrow’s Psychiatrists, Tomorrow’s Leaders

It was Match Day, 1977. I had just earned a spot in a psychiatry residency and could not have been happier. So when a distinguished professor (from another specialty) approached me, I smiled and prepared to receive his congratulations. Instead, he frowned and told me “what a waste” it was for me to pursue psychiatry.

But despite that memorable exchange, I forged ahead with my career plans-and every day, I am glad I did. My experience in the years since has shown me what a wonderful foundation a career in psychiatry provides for leadership opportunities.

I am privileged to travel the country and speak with medical students, residents, and faculty members in my current role as president and CEO of the Association of American Medical Colleges (AAMC). When I am introduced at events, the host usually reads through a summary of my biography and, on more than one occasion, he or she has joked that my former work as a psychiatrist is the perfect training for the roles I have held. Although this quip never fails to get a laugh, it actually is not far from the truth!

In psychiatry, we embrace complexity. We encourage bilateral communication and have fine-tuned our observation and listening skills. We think analytically and draw connections between multiple sources of information. Perhaps most important, we are comfortable with ambiguity and are not afraid to confront and manage conflict. Each of these skills has helped me immeasurably in the roles I have been privileged to hold, whether as medical school dean, health system leader, or now at the AAMC.

Having a unique insight into the inner workings of the brain, which is far and away the most complex organ in the human body, will serve you well on any path you may take. During my time at the National Institute of Mental Health, my research interests were in the most extreme psychiatric dysfunctions-the psychotic disorders. By becoming acquainted with the full range of the mental health spectrum, I have learned how to navigate even the most challenging interpersonal exchanges outside of the clinic.

My psychiatry background also has allowed me to see that, like human beings, organizations can exhibit a wide spectrum of dysfunction. It is not such a large leap to move from diagnosing dysfunctions in human behavior to identifying dysfunctions in entire systems. This is a lesson I have learned repeatedly over the years, and one I hope helps you as you consider your future.

As a psychiatry resident, I do not need to tell you how rewarding a career in our field can be. But what you may not have considered are the many roads down which psychiatry can take you. As such, my best advice to you is to broaden your focus.

This may be surprising advice given the expert-centric nature of medicine. After all, our current health system tends to focus rewards on the work of specialists and sub-specialists who perform tests and procedures. But remember when you learned about pluripotent cells, which are unique because of their ability to develop into many different cell types? Today’s researchers value stem cells so much, precisely because they are pluripotent. This is why, when I am asked for career advice by medical students and residents, I always tell them to take a lesson from basic human biology and never lose sight of their own pluripotency.

There is great benefit in not allowing yourself to be pigeonholed or to feel that your career options are limited. I was not encouraged enough as a resident to think at the “30,000-foot level.” I invite you to recognize what broad applications your training can have.

Although academic medicine’s culture traditionally has been marked by hierarchy, expert-centrism, and individualism, important shifts are under way. The AAMC and I are working with residents and faculty at our member institutions to help foster a culture of collaboration, patient-centrism, and mutual accountability. I would argue that in this emerging culture of medicine, psychiatrists are well positioned to lead for all of the reasons I outlined above.

To those current, future, and aspiring leaders reading this, I would like to congratulate you for choosing psychiatry. With your skills and training, you can help lead our nation, whether in the classroom, laboratory, clinic, hospital, health system, or policy arena. And to that well-meaning professor from my Match Day, what you should have said is, “What a fantastic specialty psychiatry is for future leaders.”