New York American College of Emergency Physicians

Arlene S. Chung, MD MACM FACEP

Arlene S. Chung, MD MACM FACEP

Professor of Clinical Emergency Medicine Vice Chair of Education & Residency Director Emeritus Department of Emergency Medicine Maimonides Medical Center

Julie Cueva, DO MSEd FACEP

Julie Cueva, DO MSEd FACEP

Clinical Assistant Professor of Emergency Medicine Residency Director Department of Emergency Medicine Maimonides Medical Center

Passing the Baton: Leadership Transitions & Lessons Learned

Change is an inevitable part of every career in emergency medicine. In a specialty exemplified by the mission of anyone, anywhere, anytime, adaptability to change can be seen as both a core skill and a desired personality trait. At the same time, transitions into new roles can also be one of the most challenging times in our professional lives. Emergency physicians who regularly encounter medical students, residents and fellows recognize the rights of passage associated with graduation from medical school, progression through residency training and setting forth as an attending emergency physician. Many resources have been dedicated to these early professional transitions. However, our careers continue to evolve and change throughout our lives and successfully navigating that path remains important as we progress in responsibility and leadership roles over time. Here we share lessons learned from our recent leadership transition of Program Director in our department with the hope our experiences may help you make the next leap in your own career.

Lesson Learned #1: Have a plan

There are many reasons why leadership changes occur but it is important to recognize they will inevitably happen. Proper succession planning will minimize distraction and should be done well in advance. Even if there is no clear internal candidate, steps can be taken to ensure thorough documentation of processes and decision-making transparency to avoid information-hoarding and allow for others to more easily assume the role. External searches should be strategic and inclusive. It is important to describe the role, maximize the reach of the search and ensure the candidate evaluation process is fair and unbiased.

In our case example, I (ASC) had accepted a new position as the Vice Chair of Academic Affairs for a different institution and so our department had the need for a new Program Director. Throughout my years as the Program Director, I had taken the time to create a large electronic repository of policies, meeting notes and other documents that was contemporaneously shared among the other members of the residency leadership team. Importantly, we engaged in discussions about potential succession planning well in advance of my decision to leave. This included the two of us (ASC, JC), other members of the residency leadership team and our department Chair. We ultimately decided that Dr. Cueva was the best candidate for the position and did not pursue an external search.

Lesson Learned #2: Announce with intention

Many people are affected by any leadership transition. Identification of key stakeholders and the determination of the order in which they will be notified is important. Announcements should also be tailored to each constituency group. Multiple staggered messages on different platforms may need to be released at different times. Although many times the timing of a transition is not entirely flexible, when possible it should be done at a time that will be the least disruptive.

The two of us (ASC, JC) and our department Chair met regularly to strategically determine the best course of action with regards to the announcement of the Program Director transition. The most important group that needed to be notified were the current residents and pains were taken to ensure they did not find out prior to being told personally by us (ASC, JC). We informed them during a live Wednesday resident conference. A follow-up email was sent later that afternoon to the remaining faculty and staff in the department. Importantly, we timed the transition such that it occurred prior to recruitment season for the residency program, so as to avoid a perceived ‘bait and switch.’

Lesson Learned #3: Continue support and then let go

The transition process itself does not happen overnight. Ideally allow for several weeks to months for time for the identified successor to offload prior responsibilities and take on new ones. Remember that the successor should also be given the freedom to leverage their new responsibilities and influence in their role.

We (ASC, JC) allowed for a three-month transition period from the time of announcement to the official transition date. Immediately after the announcement, I (JC) functionally took over many of the daily responsibilities of running the residency program. I was able to make definitive decisions that would impact the program in the future, even though the timing of those decisions were prior to the official start date of my new role. The two of us (ASC, JC) set up regular meetings to transfer any remaining documents or information and to touch base regarding issues as they arose.

In closing, change is common, inevitable and can be a challenging time for both the individuals involved and those around them who may be affected. Proper planning, clear communication and ongoing support during the transition process can help to minimize disruptions and allow for future success.

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