Wind of Change or Siren Song?
Although we agree with Luedi et al regarding the difficulty of assessing EI, we would have liked a more detailed discussion regarding the authors’ view of the possible pathways to improve EI amidst the constraints of a residency program. How should EI be nourished and thrived in current settings? Twenty percent of physicians are “burned out,” meaning they cannot achieve their emotional balance.2 Would programs that strengthen EI lessen this burnout? Alternatively, are the current circumstances creating an environment that even the person with the highest, most developed EI could not survive unscathed? Another important question to consider is how many medical school graduates are emotionally mature and to what extent. Is it ethical to assess the candidates applying for an anesthesiology residency for their EI level, knowing that the current residency programs rarely if ever offer EI improvement programs? Furthermore, improper attempts to support EI development could trigger a coping process that may be dysfunctional on multiple levels (clinical, personal, and emotional). Perhaps we should start first considering what we can offer to our trainees so they can grow and be nourished into professional and emotional maturity. If 20% of us cannot help themselves, then the selection of the potential mentors is critical. And they will need space, time, training, and money for adequate mentoring. Anesthesia residents face competing interests and demands from residency training, hospital administration, and their personal lives. We must admit that, without changing our mindset, attitudes, and support toward proper emotional and professional development of our trainees, the article by Luedi et al is just a siren song, an alluring goal but impossible to reach.
The message by Luedi et al should be carried further and emphasized. The medical field has taken a significant turn in the level of the skills required. Physicians are becoming managers, and their skillset expands beyond the traditional art of healing. The American Society of Anesthesiologists states the task of the anesthesiologist in multiple ways, but the overarching idea is to become “glue” for the surgical home. Significant managerial skills and EI on top of clinical skills are required. Kwon et al3 are pushing the envelope even further by suggesting anesthesiologists become medical entrepreneurs. It is not evident that organization, goals, and direction of most current residency programs will fill these needs. Are the demands evolving faster than residency programs can adapt? These are significant questions to ask, and they need to be answered if we want our anesthesiologist graduates to be strong and inspiring leaders. How to achieve such goals should be the focus of article like the one prepared by Luedi et al.