To Advance as a Fellow, Be Open to the Unexpected

“I ended up going back to medicine because I think the interactions you have with families and with patients – can support a patient in what is usually a very difficult time in their life and help them heal – I think that’s a real privilege, ”she said.

Today, Lee-Kim is director of the pediatric hematology-oncology fellowship program at Texas Children’s Cancer and Hematology Centers and an associate professor of pediatrics at Baylor College of Medicine in Houston. Even that comes as a surprise; she thought she was going to be a researcher instead of a doctor and clerk. Pediatric hematology oncology lends itself to a research career because it is a highly research-driven field, she said.

Instead, shortly after completing her own fellowship in pediatric hematology and oncology at Baylor, she became the Associate Program Director in 2008. She has been program director since 2018.

“Since I wasn’t that far out of fellowship, I thought, ‘Well, I could contribute to this because I was a recent guy.’ Medical education in itself is a very robust and rewarding career path, ”she said. “I went on to get my Master of Education degree and became more involved in medical education. And honestly, that’s been one of the best things in my career to be involved in – training fellows and working with fellows, residents, and medical students. “

In an interview with Oncology Fellows, Lee-Kim discussed the differences between working with pediatric patients rather than adults, handling money during fellowship, and how Texas Children’s faculty strives to show its appreciation for fellows.

OncLive®: How is a fellowship training to treat pediatric patients different from a fellowship training to treat adult patients?

Lee-Kim: The communication skills you need in pediatrics may be different from what you need in adult medicine. We see patients up to age 21 so there is a bit of overlap, but when dealing with a younger child there are different kinds of skills you need to be able to talk to them and understand what it is that they to hear.

And then of course the way you deal with parents. They make decisions for another person. As a parent, I find that it is much more difficult to make decisions for my children than it is for myself. There is another level of concern, or even guilt, that you are making the wrong decision on behalf of someone else.

Most of our fellows are already aware of these differences because they have already completed a pediatric residency. But I think the way the training can be different is just a little more focused on the whole family unit and the social issues that come with it. The other thing, however, is how people deal with death or bad outcomes. It’s very difficult to see a child failing or a child succeeding, so we have resources for our fellow humans. We have debriefings and opportunities for them to share about the difficulties of facing situations like that.

What do you tell your fellow humans about managing their money?

This is an area of ​​focus among our fellows, and we have a faculty member who has a personal interest in financial health and who has conducted a workshop on this for our fellows.

At the institutional level, we also have workshops for the fellows. The course of your income in medicine is quite atypical compared to other job markets and industries.

To be fair, if you go down the path of pediatrics, most of us don’t do it for the money to start with. I don’t think people go into pediatrics because they will get rich.

How do you encourage your fellow humans to take their own health and well-being seriously?

We have made planned efforts for this. And then, as a fellowship director, I look at them too, especially with the pandemic that has created its own welfare problems. We also evolved in this at the beginning of the pandemic; our welfare problems were very different from what we see now.

We have wellness programs that are offered at the institutional level and at the level of what we call fellows college, which is for all fellows in our institution. Finally, our fellowship has its own wellness activities, some led by us as a faculty and others led by the fellows themselves, and we encourage them because I think wellness means different things to different people.

I am always well aware of the impact of the work fellows do on their well-being and health when deciding on their rotations or their schedules for the year, or even what they do during each rotation. One of the things that I focus on a lot is how this will affect them, not just at the educational level, but only at the health and wellness level. Is this too much for 1 person to deal with? Is this going to burn them out? These are all things that we as program directors and as leadership in our section think about as we create the program for the fellows.

This year we decided to organize a Fellows Appreciation Week. All our faculties sign up every day of the week to do special things for our fellows. The application form filled to the point where some faculty felt sad because they didn’t get the chance to apply to do anything.

Every day this week we have had people doing special things for our fellow human beings. The giver gets a lot out of it and the recipient of course also feels appreciated. That’s just one example of the kind of activities and culture we have in our training program.

Is there one thing a guy should take from a community?

If you ask a certification body, you’ll be given a 50-page document at the end detailing what fellows need to know. I think what you need to get out of a fellowship is, of course, that you have to be able to recognize the disease. You need to know how to perform basic treatment for that disease and when to ask for help.

We have made so much progress in medicine and that makes our patient population much more complex. But because things are so complex, you also need to know when you are beyond your expertise and when to reach out and ask for help.

All other things – be it academics, academic medicine, or if you are going to take a leadership role in clinical care or research – look for opportunities to do things that you may not have considered before, but you may not know that you it likes it. If there is an opportunity to teach, or to be involved in a collaborative research project, you won’t know whether you like it or not until you’ve tried it.

Be open to other ideas. Find out what you love, and maybe find out the things you don’t like very much. But stay open because you don’t know where your career will evolve.

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