This week, I had the honor and delight to be a Visiting Professor at Cornell. Specifically, I met with members of the Department of Anesthesiology of Weill Cornell Medical College at New York-Presbyterian Hospital on the Upper East Side of Manhattan (although the undergrad campus of Cornell is in Ithaca).

I was invited to speak about high-stakes decision making and the intersection with medical errors.

high stakes medical decisions fast thinking

In a nutshell, this is an exploration of:

  • the benefits of “fast” thinking in medical emergencies as and a marker of expertise (the very ability to use heuristics and intuitive processes effectively requires extensive knowledge and experience),
  • the associated pitfalls when the expected or obvious answer turns out to be wrong (which is a minority of decisions overall, but highly represented when decisions contain errors), and
  • ideas about how we can employ “systems” fixes – also known as human factors engineering – to prevent errors from slipping through, and how we might use the concept of the nudge to guide behaviors in a way that makes the desirable, safest behavior also an easy, attractive, default option

operating room data exceeds human cognition capacity and working memory

Part of the Visiting Professor experience is a little like speed dating – brief meetings with many members of the department, usually faculty who have overlapping interests. Ideally, there is a great exchange of ideas and opportunities to collaborate emerge. This trip was excellent in that regard. Cornell (not surprisingly) is packed with very smart people doing very innovative things. Their simulation lab is even named to reflect that.

I came away with lots of food for thought, great new relationships, and possible new projects –a big success for me and for the UNC Department of Anesthesiology. While I could list all of those moments, there is one question that I was asked by just about everyone with whom I met that really has me thinking. It is a question I’ve been asked many times before, and it usually surprises me despite the frequency, because it is a huge compliment and isn’t really consistent with my own self-view. People asked how I was able to achieve such a high degree of academic success in such a short time. Did I have some magic mentorship? Who helped me and guided me and told me what to do?

path to success in academic medicine and faculty development

First, let me say that “a short time” is really 13 years, and that it isn’t really such a short time. Second, sure – I trained at MGH, which is a top Harvard hospital, and I did indeed have a really wonderful program director and other faculty to teach me. But the specific question of how I found my academic niche, and managed to get myself published and invited to speak at major venues early on without a senior mentor in my specific area of cognitive errors is largely due to…well, I have no idea.

So this leads me to wonder, are we (the establishment of academic medicine) doing a good job of providing mentorship to the next generation? What is the “path” or “formula” – is there one? If you are an academic, I hope you’ll leave me a comment or shoot me an email with your ideas on this. If you aren’t an academic, but you have had some kind of career catalyst in your domain, please do the same.

Together, perhaps we can improve the process of faculty development and professional success for those who will make the next big leaps and discoveries in healthcare – and possibly, get them there faster, which benefits everyone.

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