Medical School Life

What I wish I knew in medical school about student leadership

Brendan Murphy , Senior News Writer

AMA News Wire

What I wish I knew in medical school about student leadership

Jul 3, 2024

Upon becoming chair of the AMA Medical Student Section (AMA-MSS) in 2018-19, Karen Dionesotes, MD, MPH, brought big ideas to the office. Some worked out. Others did not. But both the successes and the failures, she said, helped shape her leadership in organized medicine and in the clinical arena.

“Being involved as a leader during medical school helped make me a well-rounded physician,” said Dr.  Dionesotes, who graduated from Creighton University School of Medicine in Omaha, Nebraska. “As a physician, you are the leader of the health care team. Having the skills to be able to negotiate, navigate difficult conversations, give feedback. Those are all skills I learned in my time as a  leader, and a lot of them were with the AMA."

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A recently graduated geriatric psychiatry fellow at Johns Hopkins Medicine, Dr. Dionesotes spoke on the lessons she gained from her medical student leadership experiences and what she wished she knew about medical student leadership.

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“I was definitely more involved in activities and organizations than I probably should have been,” said Dr. Dionesotes. “There were times where I bit off more than I could chew. A lot of the work I did with the AMA didn’t take up too much time, outside of my year as chair of MSS. But I was also really involved in extracurricular activities at my school. When you are a medical student, you do have to put academics first, make them the most important thing.

“When I was in med school at Creighton, a few students and I started a global health conference. We wanted it to be a major event and it quickly grew—it got huge. It’s still happening, but it’s not being run by three medical students. Big ideas are amazing, but you also have to be realistic about what you are capable of doing while you are also a full-time student.”

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“The amazing thing about being a medical student is you are undifferentiated,” she said. “You don’t have a specialty you have allegiance  to. When you go into a specialty, it’s easy to become pigeonholed and you might not pay attention to what’s happening outside your day-to-day purview. What I loved about leading in the MSS was you are able to look at everything.”

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“There were times where maybe I pushed too much for things at my medical school,” Dr. Dionesotes said. “Being a medical student is hard and every comment and opinion about you matter. If someone even implies that you're ‘unprofessional’, ‘pushy’, or ‘difficult to work with,’ it can be viewed as a black mark, especially if it gets mentioned on your residency application. It never got that far for me. But you are toeing this line of trying to create change without upsetting people or getting into trouble.

“There was a group of us that was doing a lot of social justice work” inspired by the Black Lives Matter movement. “Our medical school didn’t love when we staged a die-in on the floor of the main health-sciences building. They weren’t happy about it potentially interfering in people being able to get to classes. It can be a difficult balance. Being involved in those things and taking a stand has always been important to me.”

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“My leadership style is more hands-on than I would like it to be, but I have evolved,” Dr. Dionesotes said. “When I was chair of the Medical Student Section, I was too much of a micromanager. Everybody had tasks they had to do, and I’d have everybody report on what they were doing on a document. If I wasn’t involved in something, I’d ask to be CC’d on emails. I have shifted for that. You realize—especially as you transition into residency—that you simply don’t have the capacity to keep up with 500 emails a day.” 

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“At times I didn’t take the long view,” Dr. Dionesotes said. “In my time on the [AMA-MSS] governing council we wanted to bring back region meetings. It took years of planning and ended up happening but went away quickly. And when I look back at that, I think it had to do with what we as individual leaders cared about as opposed to what was potentially best for the section. Everybody gets excited for their own ideas, the things that they want to do. A real strategic plan in that instance—where we looked at what was done previously and helped build off of that—would have been more beneficial. We didn’t need to start everything from scratch. 

“Leading isn’t about your idea,” she added. “Everybody’s voice matters equally, including mine, even if I’m in a leadership role. It’s about gathering thoughts and building consensus. That’s more important than following your individual opinion. As I’ve grown as a leader, I think I’ve become more of a neutral voice, coalescing everyone’s thoughts into to one cohesive idea over time. At the beginning of my leadership, I think I may have pushed my agenda more than I would now.”

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“One of the things I loved doing when I was chair of MSS was meeting with smaller groups to hear their thoughts and concerns,” Dr. Dionesotes said. “For instance, there hasn’t always been a great relationship between students at osteopathic and allopathic medical schools. In the section, I created a group of DO students and I would sit with them at every meeting and ask what are the things you are struggling with as a DO student and how can we as a section support you. More voices are better. That has shifted how I think about things. Diversifying those voices really helped us as a section.”

“It’s important to be able to talk about what you’ve done for residency interviews,” Dr. Dionesotes said. “I had a program director essentially ask me if I was going to come and learn psychiatry or if I was going to chair committees. My answer was: I’m going to do both, thank you. You want to make sure your application is well-balanced in a way that shows you are taking your clinical growth seriously, but I’ve been able to find time to balance leadership and learning.”

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