Feature | My Leadership Story: On the Road to Developing Nonclinical Competencies

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With the rapidly changing paradigm shifts and growing demands of the current health care scenario, institutions within academic medicine and private practice now expect physicians, at all levels, to operate with emotional intelligence, change readiness, and an eagerness to serve as competent and capable leaders.

Often leadership development is not formally addressed during residency and fellowship as a core curriculum. Leadership development in medicine remains an important organizational priority across hospitals.1

The Leadership Academy came to life in 2014 as a part of ACC's five-year Strategic Plan and to meet its commitment to enhance the leadership skills of its members and specifically prepare and develop the next generation of cardiovascular leaders.

It has been a wonderful longitudinal career development curriculum aimed at developing leadership skills, emotional intelligence and collaborative teamwork within the next generation of cardiologists.

This program has evolved as a highly regarded and coveted professional development course and is very highly appreciated by Fellows in Training (FIT) and Early Career (EC) cardiovascular professionals. The overall aim is to foster personal and professional growth.

Personally, for me, it has been a transformative experience in my life. I am currently a member of Cohort III and this experience will culminate in a capstone project to be shared with my peers in 2020.

Leadership Academy Curriculum

A few years ago, the ACC conducted a targeted needs assessment of FITs and EC professionals and found a greater need and a growing appetite for increased leadership development programming and support. From this assessment, the Leadership Academy curriculum was designed to address distinct leadership needs and development areas based on the qualitative and quantitative data obtained surrounding the specific challenges of this demographic.

ACC.19 Intensive on Clinician Well-Being

Join Dipti Itchhaporia, MD, FACC, and James L. Januzzi, MD, FACC, on March 16, for a deep dive session focused on strategies and techniques to promote well-being for all clinicians.

This Intensive session will be kicked off with the Louis F. Bishop Keynote Lecture by Tait Shanafelt, MD, chief physician wellness officer at Stanford Medicine and nationally recognized expert in physician wellness. Visit accscientificsession.acc.org for the itinerary planner.

During ACC.14, selected EC professionals convened in Washington, DC, to review the baseline leadership needs findings, share collective challenges and hear from William A. Zoghbi, MD, MACC, past president of ACC, about leadership development, balancing family and work and being an authentic leader. ACC staffer Rosanne Nelson, who helped design and launch the program, has been a wonderful mentor and friend to graduates since 2014.

The comprehensive and robust curriculum encompasses a variety of different types of learning modalities, including:

  • Individual coaching sessions to analyze and learn from leadership case studies.
  • A 360-degree assessment of emotional intelligence on key competencies like self-awareness, self-management, relationship management and social awareness.
  • Peer mentoring that pairs two cohort members, based on their career goals and complimentary personality styles, to create a strong bond that's cultivated through offline meetings and aimed at providing an avenue for support and reflection in their respective leadership journeys.

The final activity of the Leadership Academy is focused on two primary areas: mentoring and a capstone project. Each participant is paired with a current or former leader of the College who serves as their mentor. With the mentor's guidance, each participant is charged with determining a capstone project that is meaningful to them, while also aligned with a strategic objective of the College.

My Project: Nonclinical Competency Curriculum

My capstone project is to develop a curriculum on nonclinical competency for my fellowship training program at Johns Hopkins School of Medicine. It is based on the same principles as the ACC Leadership Academy while also incorporating the Quadruple Aim – specifically addressing the fourth and newest aim of workforce and member well-being.2,3 The Quadruple Aim is incorporated into ACC's next Strategic Plan (2019-2023).

ACC president C. Michael Valentine MD, FACC, addressed this topic in April in a Leadership Page in the Journal of the American College of Cardiology.4

Our aim is to design a robust, longitudinal curriculum to develop and foster interpersonal communication skills, including empathy, conflict mode assessment and social awareness; increase financial acumen; target work-life integration; and harness the power of professional organizations to advance one's career.

It takes a village to create such a program and I'm fortunate at Johns Hopkins to work with several leaders who are integral to this work and its success: Steven P. Schulman, MD, fellowship training director, Virginia Hahn, MD, chief fellow, and Lauren Rodgers, MBA, program coordinator.

Together we first conducted a pretest assessment of current fellows to understand their specific needs and what they most wanted to gain from the curriculum. Not surprisingly, these objectives were most highly rated:

  • Mentoring
  • More access to research
  • Develop grant writing skills
  • Develop leadership skills
  • Achieve work-life balance

Charged with this responsibility, we have: 1) incorporated some essential elements of the ACC Leadership Academy; 2) used our institutional resources from the Office of Faculty Development at Johns Hopkins; and 3) recruited local medical education leaders within the institution to fulfill this curriculum.

The primary pillars of our curriculum are wellness, leadership skills and social awareness, and building emotional intelligence and empathy. A series of workshops and small group sessions are built into our clinical curriculum.

There are four sessions in each quarter. So far, we've implemented a Myers-Briggs personality assessment, grant writing 101 skills, work-life integration strategies, and lectures on how to best engage with professional organizations.

In the next phase, we will take on contract negotiation, managing personal wealth in fellowship, understanding performance metrics, billing and coding, and MACRA and MIPS; and how to use the electronic health record (EHR) to our advantage. And there'll be women in cardiology networking sessions.

We're also tackling burnout with more social engagement with faculty and peers. Faculty and fellows enjoy evenings and night outs and this further strengthens the professional and personal bonds between trainees and mentors.

Expected Outcomes

The ACC has formed the Leadership Academy to provide aspiring leaders with valuable experience and develop essential skills. Its participants examine team-building dynamics, such as negotiating difficult conversations, managing conflict resolution and finding appropriate balance between competing priorities. This training augments the professionalism, communication and reflection skills necessary for members' success in future leadership endeavors.

My team and I hope to bring the same to Johns Hopkins and increase the impact of this wonderful national initiative at a local level. The ultimate goal: to enhance fellowship training and infuse the existing curriculum with life skills that are required to be well-adjusted, adaptable and successful cardiovascular professionals.

Further, we hope to provide this essential leadership training to the existing clinical competencies set by COCATS 4 and the Accreditation Council for Graduate Medical Education so graduating fellows are able to: 1) serve the community, patients, institutions and their families; 2) continue to achieve professional success; and 3) be visionaries in their respective fields despite the pressures of our changing times.

At this end of this year, we're conducting a post-test assessment to evaluate how our curriculum has fared overall and to measure tangible outcomes. Our objective is to increase engagement with our fellows and to develop the nonclinical competencies of professionalism, interpersonal communication and leaderships skills, financial acumen, and the oft-neglected but important components of cardiology training.

My capstone project will be presented to the Leadership Academy at ACC.20. By then, we hope to have some important post-test analysis on the success of our curriculum.

My Personal Growth

The process of developing the nonclinical competency curriculum at Johns Hopkins has been a transformative experience for me at a very personal level. First, it has provided me the opportunity to serve my institution with purpose and passion. Medical education is a career pathway that I feel very passionate about and I've been able to serve it with authenticity.

Second, it has helped me connect with like-minded individuals within my institution and nationally. This has led to some novel and innovative collaborations in fellowship education. It has positively impacted my self-confidence and amplified my unique voice within my institution and nationally.

I greatly value the divisional mentorship that I've received from my collaborating team and I dedicate this article to them. We look forward to seeing the impact of this novel leadership development and wellness initiative at Johns Hopkins in the next year.

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This article was authored by Garima Sharma, MD, FACC, an assistant professor of medicine at Johns Hopkins School of Medicine, in Baltimore, MD. She dedicates it to her collaborators for this project: Steven P. Schulman, MD; Virginia Hahn, MD; and Lauren Rodgers, MBA.


  1. Freeman AM, Nelson R, Sinha S. The essential role of leadership development. J Am Coll Cardiol 2018;72:2272-5.
  2. Seals AA. Fellowship training in cardiology. Finding synergies between academic program clinical competencies and ACC-developed nonclinical competencies. J Am Coll Cardiol 2016;68:2376-8.
  3. Sinha S, Cullen M. Mentorship, leadership, and teamwork harnessing the power of professional societies to develop nonclinical competencies. J Am Coll Cardiol 2015;66:1079-82.
  4. Valentine CM. Tackling the quadruple aim: helping cardiovascular professionals find work-life balance. J Am Coll Cardiol 2018;71:1707-9.

Keywords: ACC Publications, Cardiology Magazine, Accreditation, Burnout, Professional, Clinical Competence, Cohort Studies, Communication, Curriculum, Demography, Education, Medical, Education, Medical, Graduate, Electronic Health Records, Emotional Intelligence, Empathy, Fellowships and Scholarships, Friends, Goals, Internship and Residency, Leadership, Faculty, Mentors, Needs Assessment, Personality, Private Practice, Program Development, Work-Life Balance, Writing

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