Dr. Lindsey A. Criswell, is the director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Prior to joining NIAMS, Dr. Criswell was vice chancellor of research at the University of California, San Francisco. 

She has a bachelor’s degree in genetics and a master’s degree in public health from the University of California, Berkeley, and an M.D. from UCSF. 

As the NIAMS director, Dr. Criswell oversees the Institute’s annual budget of nearly $625 million, which supports research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases. 

Between 1994 and the time she became NIAMS director, Criswell was a principal investigator on multiple NIH grants and published more than 250 peer-reviewed journal papers. 

In this episode, we discuss her journey as a leader in medicine and science. Welcome to Leading the Rounds. 

Questions We Asked: 

• When did you start to see yourself as a leader? 
• What experiences helped you build your leadership style? 
• When you stepped into your current role, did you feel ready? 
• What are the greatest challenges you face in your current leadership? 
• When do you know when a good opportunity comes along to pursue? 
• Were there things in your training that weren’t addressed?
• How do you avoid being “scooped” in medical research? 
• How does one decide what leadership route to choose? 
• How has failure impacted you as a physician, scientist and leader? 

Quotes and Ideas: 

• My leadership style reflects my own personality 
• “It really does take a team effort to be successful in science and medicine” 
• “There’s no one way to be an effective leader” 
• You can learn a lot by observing people you respect in positions of leadership 
• “I’m in a stage in my career where I really want to make an impact” 
• “As an investigator, if you can’t communicate effectively at the appropriate level… you’re not going to be successful.” 
• Most, if not all, of the impactful research done is a team effort 
• “Just say no” 

Dan Dworkis, MD PhD FACEP is the Chief Medical Officer at the Mission Critical Team Institute, a board-certified emergency physician, and an assistant professor of emergency medicine at the Keck School of Medicine of USC where he works at LAC+USC. He performed his emergency medicine residency with Harvard Medical School at the Harvard Affiliated Emergency Medicine Residency at Massachusetts General Hospital / Brigham Health, and holds an MD and PhD in molecular medicine from the Boston University School of Medicine. Dr. Dworkis is the founder of The  Emergency Mind Podcast , and the author of The Emergency Mind: Wiring Your Brain for Performance Under Pressure. 

Questions We Asked: 

• Why did you feel the need to create The Emergency Mind? 
• Is poise under pressure a learned skill or innate? 
• What are valuable skills you have learned creating The Emergency Mind? 
• How does someone successfully improve through a performance loop? 
• What are ways to decrease stress while performing procedures? 
• How does the Emergency Mind address team dynamics? 
• How do you build a well functioning solid team?
• How do you run a successful debrief?  
• Advice for medical leaders under pressure? 
• Book Suggestions? 

Quotes & Ideas: 

• Applying knowledge under pressure is a separate learned skill 
• What happens when you are trying to intubate a patient and miss the first time? How do you recover and make the second attempt? 
• Prepare-> Perform-> Recover-> Evolve 
• “Create an environment that sets you up for success” 
• Experiment and be a scientist of yourself: Build->measure->learn 
• Exposing yourself to stressful scenarios outside of the hospital can help you build skills to help clinically 
• Use self-talk to help yourself manage acute stress 
• When debriefing, learn to separate outcome from performance. You can sometimes have a poor outcome with perfect performance and also a good outcome with poor performance. 
• Debriefs can use outcome vs. performance on a 2x2 matrix. 
• Never Waste Suffering. Both ours as providers and the patients. 
• Harness the wisdom in the room around you 
• Practice when you are outside of pressure and then slowly introduce it to stressful situations 

Book Suggestions: 

• Thinking Fast and Slow by Daniel 
• Sources of Power by Gary Klein 
  • “A Failure to Disagree” paper by both 
• Ghosts of the Fireground by Peter Leschak 

Intro: 

Dr. Thomas Varghese Jr. is the Associate Chief Medical Quality Officer and Chief Value Officer at the Huntsman Cancer Institute, and Chief of General Thoracic Surgery at the University of Utah. 

Dr. Varghese is a national leader in minimally invasive applications for general thoracic surgery, recognized by Castle Connolly as one of America’s “Top Docs”, and is ranked in the top 10% of the nation by Press Ganey for patient satisfaction scores. 

His research interests bridge the world of Educational Research and Health Services Research, specifically in the arena of optimizing performance at the patient, surgeon and system levels. He created the Strong for Surgery program, which is now a formal Quality Improvement program of the American College of Surgeons, and active at 331 clinical sites across the nation and 3 state surgical collaboratives.

Dr. Varghese holds national leadership positions in the Society of Thoracic Surgeons, Thoracic Surgery Directors Association, American College of Surgeons, and the Society of University Surgeons. Dr. Varghese is active on social media and is the Deputy Editor of Digital Media and Digital Scholarship for the Annals of Thoracic Surgery.

Questions We Asked: 

• Where did your passion for leadership come from? 
• Who were your mentors and what made that relationship special? 
• Have you found your mentors formally or informally? 
• How can you create a good formalized mentorship program? 
• How do mentors effectively help their mentees find their career path? 
• How do you create a good mentor/mentee relationship? 
• How can those in the majority be allies to minority groups in medicine and science? 
• How do you be comfortable saying “I don’t know”? 

Quotes & Ideas: 

• “Never stop looking for best practices” 
• You can and should have different mentors for the various areas of your life (academic, career, social, spiritual, etc.) 
• “Mentorship is someone with a particular knowledge or skills that shares them with someone else who does not have it on their own.” 
• “A mentor does not always have to be older than you.” 
• Identify OKR (objectives and key results) and set a time deadline for it 
• “An ally is someone who builds a culture of inclusion” and “A leader is someone who betters the culture of those they lead”. Leaders need to be allies. 
• “Are we better today than we were yesterday, and are we going to be better tomorrow than we were today and how do we achieve that.” 
• “Diversity doesn’t end because you hire the next diverse faculty. You have to make sure they thrive in their position.” 
• “You don’t know, doesn’t necessarily mean you don’t act.” 
• “MD means make decisions.” 
• “We are living in the greatest time in history.” 
• “Seek your tribe members” 

Books Suggestions: 

• The 4 Disciplines of Execution by Sean Covey 
• Peter Drucker 
• Start With Why by Simon Sinek 
• Adam Grant