Strategy

Leadership is crucial in medicine, yet it often takes a backseat to technical and academic training. For underrepresented groups in medicine, additional challenges including historical discrimination and stereotypes hinder leadership development even further. Asian Americans in medical leadership are impacted by the phenomenon called the “bamboo ceiling,” which refers to the multifaceted challenges (ranging from cultural differences, systemic bias, ingrained stereotypes, and lack of role models) that prevent Asian Americans from achieving leadership positions. More specifically, Asian American women in particular are challenged by a double ceiling effect by having to overcome both the bamboo ceiling and the glass ceiling (social barrier that prevents women from workforce advancement). 

Initially, we wrote these five tips to help Asian American women at any stage of their career to navigate the challenges in developing leadership skills and promoting inclusivity in medical leadership. However, we believe these tips are helpful for all individuals, especially those underrepresented in medicine, looking to advance their leadership skills and enhance allyship in medicine.

Tip 1 – Practice public speaking

Every time I am about to present my patient, no matter how effectively I have pre-charted, my heart rate rises and my hands get clammy. After speaking to some of my residents, I realized the fear of public speaking is nearly universal. And while TEDx speakers seem calm and collected, I have learned that hours of practice and coaching produce those talks we enjoy watching.

Public speaking is a skill that takes time to develop. Take advantage of everyday opportunities, like teaching medical students or presenting at noon conferences or journal clubs, to become more comfortable in front of an audience. Raising the volume of your voice and straightening your posture can also project an air of confidence. Ultimately, what helps calm me down the most is imagining myself having a conversation with a friend and telling a story – about a patient, physiological processes, research – and it becomes more manageable. 

Tip 2 – Identify mentors, build relationships, and network with others 

Becoming a leader does not only involve yourself; the process humbly involves a team of people who invest in and support your endeavors. Finding your team may seem daunting with various clinical environments, hierarchies in medicine, or perhaps feeling shy or burdensome when approaching potential mentors. However, one such skill to build your network is through learning how to engage in conversations with people from all walks of life. To start, ask about others’ interests and backgrounds to explore commonalities unveiled through conversation. We also find it easy to stimulate discussions with questions such as, “What is an exciting project you are working on?” or “What are your thoughts on [blank] event?”. We also recommend preparing a short 30-second elevator pitch of yourself (your educational background, interests, and goals) to use in the appropriate settings. These conversations may not seem natural at first. However, by practicing with each social opportunity you may have, you will feel more comfortable to humbly approach others and form new relationships.

One fortuitous experience I had was going to a medical conference across the country initially not knowing anyone. I remember grabbing a bagel from the breakfast station and saw another woman sitting nearby and eating alone. I decided to strike up a conversation in hopes of building a connection and friendship. We became friends and, to this day (although living many miles apart), have continued to support one another while working on projects and holding leadership roles in the same Asian American organization.

Tip 3 – Resolve conflicts when necessary 

When it comes to conflict resolution, many individuals may struggle with the internal monologue, “Do I speak up? Or, do I keep my head down and stay quiet?” On one hand, many – especially Asian American women – have grown up with the virtue of humility, to “not rock the boat” and take a back seat. However, learning the art of conflict resolution is important and necessary to not only pave the wave for smooth relationships but also can influence team dynamics in the future. Here are some steps that I take to ease my stress before I manage conflict: 

1. Address the issue early
2. Find the right place and right time to converse honestly with the other party 
3. Use AEIOU (Acknowledge, Express, Identify, Outcome, Understanding)
   1. I find it helpful to use “I feel/think…” statements to clarify how I feel I have been impacted. Use non-defensive phrases like “I would like…” instead of “I want…”. 
4. Overall, I try to keep a calm mind and separate the person from the problem. 

Tip 4 – Ask for what you deserve and be aware that negotiation is a process

While negotiating a salary may seem more relevant after residency, try to consistently check in with yourself on your short-term and long-term career goals to see if the trajectory you are on will meet them. Also, understand that business is not always a meritocracy. You may be a diligent and hard worker, but you may be selling yourself short by not asking for the compensation or promotions you deserve.

Some actionable items that you can consider doing are recognizing the skills you bring to a team and the deliverables you have produced. Do research on the current job market to know the ballpark range you should be negotiating within. And be patient, as negotiation is a dance between two parties and takes time. Bottom line: Ask or you don’t get, and do not sign the first contract you see!

Tip 5 – Find your work style and that of your colleagues  

Understanding you and your colleagues’ work styles can help improve synergy between one another. While there are multiple personality assessment tools, I like to use the “Five-Factor model of personality”, which helps ascertain how you score on each of the Big Five (OCEAN: Openness, Conscientiousness, Extroversion, Agreeableness, Neuroticism) personality traits. Finding your work style is important for self-reflection. It can be invaluable in knowing your boundaries, especially when it comes to learning when to say “yes” and how to say “no.” And, personality tests can be used as a team-building exercise. As a peer, knowing your colleagues’ work styles can be essential to learn how to collaborate effectively with one another. As a leader, learning your colleagues’ work styles can help assign team roles, set expectations, leverage strengths, and cater to individual work styles.

Conclusion

To the AAWM and individuals reading these tips, we hope that these tips and references provide great resources to help you succeed in your medical career and develop your personal leadership style. Ultimately, we hope that the medical community can come together to break through systemic barriers and cultivate diverse, equitable leadership that enhances patient care and drives positive healthcare outcomes.

Written by APAMSA National Board Members: Sonia K. Scallon, MD; Ellis Jang, BS; Victoria V. Nguyen, BS; Sunny S. Park, MD, MPH; Cynthia X. Pan, MD