FEATURE
Features: For Fellows & Trainees
The American Society of Hematology (ASH) created the ASH Trainee Council to
advocate for the issues and concerns of hematology/oncology trainees, including
mentorship, publishing, and funding. ASH Clinical News spoke with the current and
immediate-past Trainee Council chairs about the issues facing hematology trainees.
Choosing Your Own Training
Adventure: Where Do You Start?
Leidy Isenalumhe, MD, MS, chair of the Trainee Council for 2017-2018, speaks
about the wonderful – but overwhelming – array of careers open to trainees, and
the difficulties of transitioning from trainee to attending.
Dr. Isenalumhe is a clinical hematology/oncology fellow at H. Lee Moffitt Cancer
Center and Research Institute in Tampa, Florida.
What are the biggest
challenges faced by today’s
trainees?
The variety of career options
available to hematology/
oncology trainees is a blessing
and a curse. We only have three
years to forge our career path,
learn everything we can about
hematology or oncology, and
essentially lay out the rest of
our lives. It can be a confusing,
stressful, and overwhelming
endeavor, and determining where
to start is difficult.
Do you have any advice
about navigating those
decisions?
Be completely honest with
yourself. Ask, “What do I really
want to do?” Or, ask yourself
the cliché interview question,
“Where do you see yourself in 10
years?” Then, document those
answers; write down how you
want your weeks to look when
you’re an attending. Would it
make you happy to see patients
five days a week? Or do you want
to train fellows or work in the lab
most of the time?
When you start answering
those questions, you can work
backwards and break your
training into yearly, monthly,
and even weekly timelines. Then,
pick a focus for each timepoint
and determine what you need to
do to achieve those goals.
Doing this helped me
realize that academic medicine
and patient care are equally
important to me. I know that I
want an even balance between
the two. When I start my job
ASHClinicalNews.org
search later this year, I know
what to petition for during an
interview.
It’s so important to know and
trust yourself, as well. We have
been in the mindset of a trainee
since college – always following
a specific protocol laid out by
someone else. Transitioning
into someone who doesn’t
need to check with a superior
before making a decision can be
difficult.
A couple of years ago,
someone gave me advice that
I took to heart: “Think like
an attending.” In other words,
think ahead to cover all your
bases before an issue develops.
If you’re seeing a patient with
Philadelphia-positive acute
lymphocytic leukemia for the
first time, rather than waiting for
someone to walk you through
the treatment scenarios, come
up with your own list: How do I
diagnose the disease? What do I
do if the diagnosis is ambiguous?
How will I treat the patient
initially? What if the disease is
refractory to treatment? What’s
the next treatment option?
Try to engage in active
learning. There will be a point
when we aren’t in training; the
patient is in front of you and you
have to make a clinical judgment.
Don’t be afraid to speak up; no
one will say you’re overstepping
your boundaries if you present a
thoughtful, researched opinion.
Fortunately, my training
experiences have been structured
to facilitate the transition
from trainee to attending.
For instance, at my second
fellowship, we had “attending
week,” during which we acted
as the attending on service.
Trainees conducted rounds and
decided the clinical therapy
for 30 to 40 patients, then we
convened with the attending at
the end of service.
How have other mentors
helped you along your
career path?
It takes a village to raise a
hematologist; there isn’t one
individual who will guide you
to success. Different types of
people can guide you through
your training – even those who
don’t fit the typical mentor mold.
Multiple junior attendings have
helped me, and it’s a different
mentoring relationship than one
with a more senior colleague.
Junior attendings are closer
to your “training age” and
it can be easier to approach
them with questions about the
everyday details of training, even
something as simple as how to
format an email to the head of
your division.
What qualities should
trainees look for in a
mentor?
Essentially, you want to find
someone with whom you feel
comfortable. Look at how your
mentor works with other fellows:
Does he or she listen to ideas
or offer constructive criticism?
Look at their track record: Have
past mentees had successful
careers? What is your mentor’s
availability like? You want to be
able to have at least biweekly
meetings with your mentor, and
you don’t want to have to fight
for them.
I’ve realized during training
that finding the right mentor can
mean changing mentors. It’s your
career, not his or hers, so don’t be
afraid to look for someone with
whom you work better.
“Different
types of
people can
guide you
through your
training –
even those
who don’t fit
the typical
mentor
mold.”
Compassion is also important.
Life happens – will your mentor
be flexible? Work/life balance
is something I think should be
emphasized more during train-
ing because, unfortunately, some
people think that choosing a ca-
reer in medicine means choosing
constant sacrifice. I’m not arguing
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