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I Have Been Changed for Good

2012; Accreditation Council for Graduate Medical Education; Volume: 4; Issue: 1 Linguagem: Inglês

10.4300/jgme-d-11-00168.1

1949-8349

Daniel J. Schumacher,

Child and Adolescent Health

The musical Wicked opens with the birth of a green baby, which is greeted with shock and disgust by the townspeople. The love child of a woman and a mysterious man with a green elixir, Elphaba—the future Wicked Witch of the West of The Wizard of Oz—grows up as a green girl in a nongreen world. At Shiz University, Elphaba is assigned to room with Galinda (the future good witch, Glinda), and the two react with “loathing, unadulterated loathing” toward one another. However, it is not long before Galinda decides to make Elphaba popular, and their relationship, while not always smooth, changes them. As the musical closes, they reflect upon the impact they have had in each other's lives. Their answer comes in song lyrics that warm the heart: “because I knew you, I have been changed for good.” I feel the same way about my closest mentors.There we were, the 10 members of the Pediatrics Milestone Project Working Group, sitting in a boardroom at the Accreditation Council for Graduate Medical Education (ACGME) in downtown Chicago. Having grown up in Wisconsin, I had been to Chicago many times before; however, this time the skyline view seemed different. I am convinced that time stood still as I gazed out the window—even the clouds and thick smoke from the rooftops seemed motionless. I wanted this day to last. The other Working Group members sitting in the room were plucked from a veritable “who's who” of graduate medical education in pediatrics. As a young and enthusiastic chief resident, I, like Elphaba, was the green kid in the room. However, I did come with a budding passion for medical education that I yearned to develop.Although I was definitely a master at being a resident, I was an advanced beginner in graduate medical education. Was I included in this illustrious group for my expertise in being a resident? Perhaps, but that answer was only partially correct.As our work progressed in the ensuing months, my colleagues rattled off authors' and researchers' names with ease. They pulled articles from what I believe to this day to be a PubMed library in their minds. I was fortunate to recognize one-quarter of the names cited. Then the time came to begin writing our Milestones. Oh, how I hoped that I would be included in the writing assignments despite my relative inexperience.At the start of our writing phase, the chair of our project asked, “Dan, which subcompetencies are you most interested in writing?” I could hardly believe how much trust the senior educators were placing in me. Why was I being included in the primary writing assignments in our sine qua non? The answer is simple, but it still escapes many senior clinicians: my colleagues knew I needed to do the work to allow me to learn. It was really the only way to keep me intimately involved and help me grow the most.Throughout the next year, I spent weeks researching each Milestone. We edited our work with writing partners before taking it to the full group. My partner thoughtfully edited my work, and her experiences as a senior clinician and educator were reflected in her nuanced comments. I read her work as well, and she embraced my thoughts and edits. We sometimes talked for an hour on a single aspect of one Milestone. The work of authors I did not know mere months before were being woven into a rich understanding of physician development. Soon I was learning about my writing partner's personal and professional life outside of the Milestone Project as well. In a single conversation, I learned more about all aspects of leading graduate medical education than I could have from months of individual study.In our large-group work, discussions about the Milestones we were developing and how this work fit into our personal lives and the groups' collective academic world challenged and transformed me. These discussions altered how I see myself, how I view others, how I think, and what I think.I am convinced that the transformational learning I experienced would not have been possible without the friendships I formed with these mentors. We learn the most when we feel safe, and we feel safest when we are close to someone. This leadership group welcomed me, then a “green” chief resident. They shared their personal lives and were honest when they did not know something; they trusted me and cared about me. We became friends—safe and honest with each other. We became what mentors and mentees are meant to be.I have been fortunate that the Pediatrics Milestone Project has not been my only source of mentors who have invested in, trusted, and befriended me. Much of my identity as a physician and as a person truly has developed out of what I learned from them. They have altered the trajectory of my professional development forever. Indeed, because I knew them, I have been changed for good.