The Importance of Self-Motivation in a Non-Clinical Mini-Fellowshipself motivation

One morning during my fourth-year mini-fellowship in quality and patient safety, I walked into work and ran into one of the radiology fellows, who was surprised to find that I had arrived on time. “My mini-fellowship involved watching ESPN in my underwear,” he quipped.

In December’s Journal of the American College of Radiology, I outlined 6 steps that any radiology resident can take to ensure a successful mini-fellowship. While the steps are necessary for having a rewarding experience during your mini-fellowship, there is one factor that will ultimately dictate your success: self-motivation.

One of the greatest impediments to successfully completing a non-clinical mini-fellowship is a lack of motivation. Unlike a clinical mini-fellowship, where there are diagnostic studies that need interpreting and there is an attending who expects to see you to read out cases, a non-clinical mini-fellowship requires you to perform most of the work on your own.

Whether you are tasked with a long-term project or small assignment, no one is going to be checking in on you at each step. I could have easily spent my mornings at home without anyone knowing, only coming in to work for any face-to-face meetings that I had. However, my motivation to learn about quality and patient safety, to continue to expand my network of colleagues, and — most importantly — to have a positive effect on patient care at the hospital kept me actively engaged.

During parts of my mini-fellowship, I found that the work I was given was not nearly enough to fill my days. I therefore sought ways to become more involved outside of the scope of my initial quality improvement project. I enrolled in all courses offered through the Division of Quality and Patient Safety, and volunteered myself for tasks that were well outside the scope of my assigned work. For instance, I went to the hospital on weekends at midnight to survey nurses about the challenges they face to successfully complete their work.

I also came in on weekdays at 5:00 AM to educate nurses about the importance of giving chlorhexidine baths to patients with central venous catheters to help prevent central line associate blood stream infections (CLABSIs). I travelled to Westchester on a moment’s notice to take part in a Joint Commission survey. I even became a certified C. difficile prevention coach. I did not have to do any of these things as part of my mini-fellowship, but I was so excited about learning all aspects of quality and patient safety, that I was happy to do all of them. Moreover, these experiences allowed me to network with colleagues and to increase my visibility among the hospital staff.

As stated in my article, the fourth year of radiology residency is now a unique time for radiology residents to explore their interests. While non-clinical mini-fellowships are not for everyone, this may be the last chance you have in your career to gain real-world experience outside of imaging interpretation. But before you decide that a non-clinical mini-fellowship is right for you, examine your own motivations and ensure that you will not end up at home watching ESPN.

By Ian R. Drexler, MD, MBA, Cardiothoracic Imaging Fellow at Weill Cornell Medicine

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