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Building Relationships as a Millennial Pathologist

Relationships Make or Break Careers

It's not easy being new. In my first months, it felt like everyone was sizing me up. I did the same thing to everyone I met too. Regardless of your career, relationships are at the core of your working life. Even if you're a brilliant diagnostician who's been published in major journals or someone who breezed through residency with ease, relationships with your fellow pathologists, clinicians, trainees, staff, administration, patients, and other professional colleagues can make or break your career. The concept is nothing new, but it’s easier said than done.

Dealing with Imposter Syndrome

If you're transitioning from trainee to faculty, it can take time to establish your credibility as a full-fledged pathologist. If you're starting a position at a new institution, there’s bound to be some pain points as you insert yourself into a complex web of existing relationships.

I struggled with self-confidence in my first year. Some of my residents and fellows were older and more experienced, and everyone had more seniority at my new institution. Luckily, I had a mentor who told me that it was natural to feel uncomfortable. She reminded me that I was there for a reason and that I had more experience in my particular subspecialty than the trainees I was supervising. I think this is an important thing for all new pathologists to remember: you're the one who got the job, and you're there for a reason. I was also reminded that this experience is not "new" for millennials. Everyone struggles with self-confidence in their first year and also into the future. Imposter syndrome is not immune to experience, expertise, age, or generation.

Establishing Yourself

I consider myself an easygoing person, but I still managed to rub a couple colleagues the wrong way. Given the variety of personalities, preferences, and styles among people in the workforce, no one is going to get along with every single person all the time.

When I started my new job, I thought I was successfully navigating the politics of the organization and developing good relationships. I was both surprised and disappointed when my boss told me in confidence that she had received a few complaints about my interactions with others. I couldn’t believe it. Apparently, people didn’t appreciate when I pointed out every flaw in their documents nor did they enjoy my steady stream of emails requesting help or information. While it was difficult to hear these criticisms, I was grateful that someone had made them known to me before they became much larger problems. Further, I understood the point of the criticism: with all the important work being done, I was distracting my colleagues with tedious corrections and email. I turned my conversation with my boss into an opportunity for improvement; I learned to relax, exercise patience, and give thoughtful consideration to my correspondences.

Millennials vs Other Generations

Criticism of the millennial generation is widespread. On the negative side, we are often described as lazy, spoiled, arrogant, and insubordinate. More positively, we are regarded as energetic, innovative, practical, and technologically adept. There seems to be a repeating phenomenon where older generations disapprove of younger generations, while the younger generations complain that the older generations are too resistant to change. Instead of focusing on sweeping generalizations rooted in generational theory, I've learned it's best to build relationships by getting to know people on an individual level and work toward identifying shared values and interests.

I work with colleagues from all generations, but we've succeeded in finding common ground in conversations on myriad topics: new restaurants in the area, biking, travel, home improvement, and TV shows.

Employers Aren't Your Parents

You may have a great relationship built on bidirectional communication with your parents, but you shouldn't assume a one-to-one transfer of this dynamic to your dealings with your employer. Your boss may not appreciate your input at every turn. As a new-in-practice pathologist, devote your time to listening, observing, and understanding pre-existing conflicts, standards, or workplace politics.

When starting my first position, I assumed my enthusiasm and suggestions for improvement would be as welcome as they were at home and during residency, but I later realized my suggestions ignored the group's history and therefore kept me from choosing my battles more carefully. Constantly questioning the status quo and negatively comparing your new institution to your previous employer are surefire ways to annoy your new coworkers. While getting feedback and input about your performance is great for continual improvement, remember that your employers may subscribe to a "no news is good news" philosophy or prefer less frequent check-ins. As you get more comfortable practicing independently, strike a balance between offering your own ideas and experience with learning to navigate your new environment with some cultural sensitivity in mind. No person or place is perfect, so practice patience and understanding.

Avoid Asking for Special Treatment

When negotiating your new job and starting in a new position, don't be the one to stand out as a demanding complainer. Sure, you want to negotiate a fair salary and benefits, but if you’re asking for, or somehow already receiving, special treatment beyond that of other recent hires or more seasoned pathologists, the disparity is likely to breed discontent and resentment. Even if taking Clinical Pathology call or an extra holiday call isn’t your idea of fun, you need to build up goodwill with your colleagues for when you do need extra time off for an emergency. Plus, you might even learn something useful.

Remember that as the new-in-practice pathologist, you have to prove yourself to clinical colleagues, coworkers, and staff. Millennials have a reputation for asking for too much too soon. Once you earn people's trust and establish relationships based on mutual respect, you'll find them more receptive to conversations about what you want. Be a team player: you're all in it together.

When Expectations Fall Short

To avoid disappointment, make sure that your expectations are realistic. Just because your new place of employment seemed amazing during the interview process doesn’t mean you won’t hit any speed bumps. You might have more tedious administrative duties than initially advertised, your mentors and senior pathologists will probably not be staying with you past 5 PM to review challenging cases, and you’re probably going to be working longer hours than your family would prefer. It's unrealistic to think that you won't make mistakes or need help. But learn from everyone you can, and be clear about what the expectations are for the job and your productivity. I found it helpful to chat with another new pathologist who did her residency at the institution where we were both hired. She had the inside scoop about what to expect and gave me advice about what to negotiate.

Slow Down

Millennials are gifted multitaskers, and with your phone, pager, email, laptop, and open office door, it's easier than ever to do so. However, with multitasking comes more opportunity to be distracted or feel overwhelmed. Executing a task that requires a high degree of concentration (e.g., looking at slides) while talking on your phone and checking your email is doing everyone a disservice. Learn to distinguish between when you can go fast and when you need to slow down and concentrate. Further, don't underestimate the power of face-to-face conversations. While it’s convenient to send a text message or email, complex questions or discussions usually benefits from a more personal touch. My initial urge is always to respond to every email right away, but sometimes waiting a couple hours—or even a couple days—is appropriate. If it's an emergency, pick up the phone or use a pager. A conversation helps prevent misinterpretation of emails. And never, ever send an email or text when you're upset—you will regret it.

Personal and Professional Boundaries

While we as millennial pathologists might be more comfortable blending our personal and professional lives, others may prefer strict separation of these spheres. For this reason, you should communicate about communication. Make sure you’re clear about when, how, and how often your colleagues want to communicate about work. While you may think it'd be great to have some fun at work and to get to know your coworkers outside of the office, not everyone will be enthusiastic about office parties and happy hours. You should also not make assumptions about their personal lives or take it personally. Everyone has their own style, problems, etc. Instead of thinking that they don't want to have fun with you, consider that their life may be so stressful that they cannot take the time away from other obligations. In the end, remember that good relationships are built on a foundation of trust and mutual respect. Even if you get off on the wrong foot with a colleague, clear communication—and maybe even cookies—can help smooth things over. Respect people’s boundaries and their privacy, and this includes steering clear of malicious gossip. While I may not get along with all of my coworkers, I make sure to treat everyone with the same level of respect that I want them to show me.

Roseann I. Wu, MD, MPH, FCAP, is a staff pathologist and assistant professor of clinical pathology & laboratory medicine at the Perelman School of Medicine/University of Pennsylvania Health System in Philadelphia. She has clinical and educational responsibilities in cytopathology, breast and pulmonary surgical pathology, and medical pathology. Her interests include fine-needle aspiration, organized pathology, and innovative ways to deliver pathology education.

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