Spring 2023

Members & Publications

A Resident's Leadership Journey



Christopher Bonilla, MD, MS
PGY4, PHiT Ambassador
VA Caribbean Healthcare System PM&R Program

As an early-career or resident physiatrist, seeking a leadership role can be daunting, especially since time is a rare commodity within a perpetual flux between career and personal endeavors. However, the solution may be more simple than perceived. Here is my journey in leadership. 

First, I started by identifying the most common qualities a leader possesses. The inspiration came from various military personnel, including contemporary leaders such as Jocko Willink, General Mattis and my brother. Their success is due to their many qualities that inspire and guide others to achieve a common goal. While many attributes exist, the paramount ones are compassion/empathy, open communication, a firm desire to improve those around them, the ability to take ownership, adapt and stay focused. Mastering these qualities allows you to cultivate an environment primed for success. Compassion and empathy encourage understanding of the needs of others and enables you to find a middle ground. Communication breakdown can sabotage any endeavor and a great leader can combat this by maintaining an open dialogue among group members. A leader can only succeed when those around him are growing. To accomplish this, they must place the needs of others above their own. Adaptability increases the probability of success by allowing one to learn from mistakes, carefully removing errors while keeping the triumphs and ultimately progressing toward the goal. As the saying by ancient philosopher Seneca goes, "No wind blows in favor of a ship without direction." The leader must stay focused on the shared goals of the group. The next area to focus on is discovering the goals you want to achieve.

Secondly, a leader needs to be able to identify areas of improvement, whether it be for an individual or an entire group. Residency exposes us to the depths of physical medicine and rehabilitation and its sub-specialties. Since no two residencies are the same, one can use objective observation to identify the strengths and weaknesses that can serve as starting points. Presenting the strength attributes of our specialty to other hospital staff, for instance, a presentation on pre-surgical amputation evaluation, is beneficial for the surgical team or demystifying deconditioning to internal medicine. Both these examples place you as a leader in improving the quality of care for our patients. Weakness also provides an opportunity for improvement and leadership. Using root cause analysis, we can find the starting point for action. It can be as simple as providing education on a topic with little exposure in residency, starting a journal club of particular interest or teaching patients, colleagues or civilians a specific interest you may know more about.

Lastly and most importantly, you must execute. There is a saying by ancient philosopher, Marcus Tullius Cicero, "More is lost with indecision than wrong decision."

My residency program in San Juan, Puerto Rico, is a cozy three residents per year program led by an approachable group of eclectic attendings, each with different interests and subspecialties. One of the areas of improvement was our representation on a national level and participation in AAPM&R. This academic year, we have a PHiT Ambassador and started a group on PhyzForum for current residents, alums and future residents called Puerto Rican Physiatrists (give us a follow). We also have a recurrent resident's corner didactic. We collectively discuss areas of improvement, educate on the variety of opportunities in national associations like AAPM&R and AAP, discuss what we learned at conferences and provide education aimed at success at each PGY level. We strive to maintain an open dialogue to avoid pitfalls as well as provide guidance and support. We are starting our resident-run mentorship program, where one resident of each post-graduate year meets to discuss topics in career, residency, research and medical student education. We have even focused on improving our wellness with the first annual "Resi-lympics;" a competition pitting attendings against residents in various games over a few weeks. When speaking of our accomplishments, I use the word "we" because it was a collaborative effort that I would not have been able to do alone, and although cliche, there is no "I" in team.

The effect these decisions have had on me has been great and I can appreciate the influence it has had on my co-residents and colleagues. We have become more unified and created a great trust and communication channel. We share motivation and energy when working hard and accomplishing our goals. It has pushed me out of my comfort zone and given me the confidence to tackle previously daunting tasks, like writing this, for example. It also has allowed me to become introspective and find ways to improve.

In closing, becoming a leader is a laborious task that is very fulfilling and worth it. Multiple paths exist to reach the same destination, each unique to the individual. Additionally, information is available in books, podcasts and seminars. Best of luck to you in your journey!