Small Changes Big Impact

Taking career risks with Dr. Giovanna Sirianni

November 20, 2019 Season 1 Episode 4
Small Changes Big Impact
Taking career risks with Dr. Giovanna Sirianni
Chapters
Small Changes Big Impact
Taking career risks with Dr. Giovanna Sirianni
Nov 20, 2019 Season 1 Episode 4
University of Toronto - Department of Family & Community Medicine

Today's episode discusses the importance of taking risk in one's career. In studio today we have Giovanna Sirianni, a family doctor with a focused practice in palliative care at Sunnybrook Health Sciences Centre. She's also the enhanced program director in the Department of Family and Community Medicine at the University of Toronto. She is the faculty development lead for palliative care and the workplace based assessment lead for the MD program. She is also the cohost and co-creator of the About Empathy podcast. 

Show Notes Transcript

Today's episode discusses the importance of taking risk in one's career. In studio today we have Giovanna Sirianni, a family doctor with a focused practice in palliative care at Sunnybrook Health Sciences Centre. She's also the enhanced program director in the Department of Family and Community Medicine at the University of Toronto. She is the faculty development lead for palliative care and the workplace based assessment lead for the MD program. She is also the cohost and co-creator of the About Empathy podcast. 

Dr. Rezmovitz:
0:01
Small Changes, Big Impact: a DFCM podcast. I'm your host, Dr. Jeremy Rezmovitz. Today's episode discusses the importance of taking risk in one's career. In studio today we have Giovanna Sirianni, a family doctor with a focused practice in palliative care at Sunnybrook Health Sciences Centre. She's also the enhanced program director in the Department of Family and Community Medicine at the University of Toronto. She is the faculty development lead for palliative care and the workplace based assessment lead for the MD program. She is also the cohost and co-creator of the About Empathy podcast. Welcome Giovanna. Thank you for coming today.
Dr. Rezmovitz:
0:42
Tell me, tell me a time that you made a change and the impact it had.
Dr. Sirianni:
0:47
So what comes to mind for me is a few years ago, I'm starting to think a little bit differently about my career and how I wanted things to go. Um, I started looking at different career opportunities. I noticed myself looking at job descriptions and saying, I can't do that. I can't do that. I don't meet sort of the criteria for that job description or that job description. And then I heard something really interesting about how women in general look at job descriptions or job postings. And there was some research that was done that said that women in general want to meet 100% of the criteria on a, on a job description before putting their name forward or before trying out for something. And men in general, if they fit about 60% of the criteria of a job posting tend to put themselves forward or tend to put themselves in the mix. And I found that really striking because it spoke to me in terms of my approach to looking at opportunities and I thought, why am I waiting to meet 100% of the criteria for opportunities? I feel like I need to be jumping in a little bit sooner than I was. So that was something I think that sparked a change in my approach to my own career.
Dr. Rezmovitz:
2:09
So then two questions. One, why were you looking for job opportunities? What, what was causing that look for the change? And then what was the impact? Did you actually apply for a job that only like did you go less than 60? Did you go to like 30%?
Dr. Sirianni:
2:24
I'm not sure I have that kind of confidence to go with 30%. So I was looking, looking for - so I have a clinical role in palliative care, so that's part of the work I do. And I have an interest in medical education and primarily my work was in the clinical realm, but I had been in practice for over 10 years and I thought well wouldn't it be interesting to try and expand my other interests, my academic interests, my interest in medical education. So that's why I was looking for, for other opportunities. I was trying to see if I could spread my, my academic plan a little bit more so than I, I was at the time. And so what was the impact of that? I, I did put myself out for a few opportunities, some of which turned out well for me and some of which didn't actually. So even though I put myself out there, sometimes it worked out, sometimes it didn't.
Dr. Sirianni:
3:24
And I think for me that was a big change because I think before I was much more hesitant to put myself in a situation where I might potentially fail because that fear of failure, um, it's still there with me, but I think it's always going to be there. But I think I was really frightened of failure. Um, and I think now I kind of take it a little bit more so with kind of a grain of salt and kinda to learn from, from even that the things that don't work out.
Dr. Rezmovitz:
3:53
How did that happen? What happened that you're like "you know what? I'm okay with failing?"
Dr. Sirianni:
3:59
Well, I think the first time I put myself forward for a job opportunity where I didn't get that opportunity, I kind of looked back and said, well, that wasn't all that bad. I mean, what was the worst that happened? They said, no, you know, we don't think you're right for this role. But I learned a lot from the process. I learned a lot from interviewing and seeing how I could be better and improve myself. And you know what, it wasn't as bad as I thought it would be. I think I created something in my head about how, you know, if I failed at this, that that would kind of ruin me and looking back. Well, no it didn't. I, I did okay.
Dr. Rezmovitz:
4:36
Where do you think that came from?
Dr. Sirianni:
4:40
It's a good question. You know, I, I'm not sure. I think it's, Hmm, it's a good question. I don't know. I don't know where that came from.
Dr. Rezmovitz:
4:48
So I've explored, um, these questions cause um, I've been, I was very fortunate to grow up with a father who pushed me to knock on doors and cold call and you know, as a entrepreneur, you know, he's like, what's the worst they're going to say no. Right? So from the age of like six, what's the worst they're going to say no. And so I don't know, Maybe there is a cultural difference. Maybe there is a gender difference being pushed into something where, you know, I, I apply for jobs where I only meet 60% criteria. Again, a statistic, I assume that I only apply for jobs where I meet 100% of the criteria. I'm just curious like, so what was the change like what were the, what was the environment that you're in that you said, you know what, I actually am going to go for this. Like what other than saying, you know what, that wasn't so bad, but usually one occurrence isn't enough for people to take that step. So what else was going on in your life at the time?
Dr. Sirianni:
5:42
Well, I think I was, because I was looking to shift from more of a clinical role to more of an education role or like, um, a clinician educator role. I was deciding, you know what, if I want to do this, I need to learn more. So I chose to do my masters, um, in health practitioner teacher education. So I thought, well, if I'm going to do this and be legitimate about it, well I need to develop myself as a, as a, as an educator. So I, I took that on. Um, I think that might've been part of it kind of feeling maybe a little bit more of a sense of confidence around, uh, you know what, I do have some knowledge and I have something to give back and that might've been part of it.
Dr. Rezmovitz:
6:25
Yeah. I've worked with you before. I know you have something to give back. You do, you're doing great work in the, in the department right now. What actually, what's your title right now?
Dr. Sirianni:
6:35
So in the Department of Family Medicine, I'm the enhance skills program director. So I'm the program director for all of the PGY3 programs.
Dr. Rezmovitz:
6:44
Okay. That's a great educational role for you. Do you feel, um, like how many, um, applications did you make before you decided, you know, this is the, this is the one that I wanted to go for?
Dr. Sirianni:
6:57
Let me think. You know, I think I applied for probably two different opportunities in medical education before that. One within the department, one outside the department, both of which didn't work out. And actually I think for the better because I think actually this role is best suited for me because I have a focused practice in palliative care. I have an interest in enhanced skills programs and it aligned with my interest in medical education. So I think both my clinical interests and my medical education interests aligned. So I think that ultimately it was, it was for the better that this was the role that I ended up with.
Dr. Rezmovitz:
7:35
I try to impart on all the students, learners, even patients that when we can get alignment, it actually leads to ease. Right? You, you, you dissipate some of that conflict that you have in your life. And, and once you have that alignment and that ease in your life, that's the time to start applying the effort because it makes it so easy and that's where you see passion coming out. Um, so tell me about the impact of applying then for the job. Cause you made a small change, you went for it. And so what happened?
Dr. Sirianni:
8:08
Well, you know, worked out for me. I've been in the role for over a year now. Um, you know, I think even before I applied, actually, interestingly, I saw the posting and I thought, well this would be interesting. Something to, to consider. And then I got a call from Risa Freeman and I think - Risa Freeman, who's our vice chair education - and I think Risa is very suited to that role of encouraging people to take on opportunities, um, that they might be well suited for. So I saw her do that to me. She reached out to me. I see her do it with others in the, in the department. So I think that, um, that, that mentorship and that, that, that leadership from others around, you know, Hey, you know, you should consider this and think that was really important.
Dr. Rezmovitz:
8:57
So earlier, earlier I made a comment about what do you think were the environmental factors surrounding your change? And so that's exactly what I'm alluding to is that we make these small changes, but they don't happen in silo. Right?
Dr. Sirianni:
9:09
That's true.
Dr. Rezmovitz:
9:09
If we're in a system - and the fact is you had support.
Dr. Sirianni:
9:13
That's true.
Dr. Rezmovitz:
9:14
And that support enabled you to have that confidence that, you know what, I'm going to go for this. Where else have you seen something like that before? Where like where else do you practice this type of? Um, I don't know what the word is. It's practice of what? Confidence? Uh, practice of risk-taking? Practice - Cause you took a risk and, and it, it, it, it panned out for you. So do you do this in other systems, like your clinical system, your home system?
Dr. Sirianni:
9:44
I mean, I can think that uh, myself and my collaborator started a podcast so much like you're starting your podcast and getting things going and putting something out there that's new. I think that was new for us. Um, so my collaborators, Irene Yang and Dori Seccareccia - we started a podcast called About Empathy and that was a big risk for us because we knew nothing about podcasts. We knew nothing about getting you going. And, uh, we decided, number one, we love podcasts. We see their value in medical education and we think we can contribute to our knowledge of palliative care, communication skills, compassion and empathy. That we can make a difference by starting this podcast. And so that was, um, us going out on a limb and doing something new that we hadn't done before.
Dr. Rezmovitz:
10:31
So I've listened to your podcast. They're called About Empathy by the way, available on Google Play and the iTunes, um, library as well.
Dr. Sirianni:
10:38
Thanks for that promotion.
Dr. Rezmovitz:
10:39
No problem. Um, one of them actually spoke to me really well. Um, and it, it dawned on me that I don't know if we do this enough in medicine. Um, I know that three of you are focused on palliative care and it dawned on me, why aren't we doing this in, um, I dunno, regular care? Um, what do they call that? Medicine. It was a dignity therapy. And, um, I've, you know, I think the greatest commodity that we can give to our patients is time and listening. And it was something that, um, I think Jennifer Moore mentioned about, uh, you know, not dragging the patient through the system, but allowing them to explore their own journey. Um, maybe that's what's happening with you. You got gentle nudges and you are allowed to explore. And so the small change that you're talking about is, um, you know, part of the dignity that you, um, were developing to, to make it through medical education.
Dr. Sirianni:
11:40
I think that's a great analogy. I never really thought about it like that.
Dr. Rezmovitz:
11:43
Ah, my brain works differently. What do you think? So what's the impact? What's, so you make this small change, you have more confidence, you're getting supported. Now what?
Dr. Sirianni:
11:57
So, you know, I think I see myself being someone who contributes, who contributes to, to the department, um, through leadership. Um, so hopefully that will help in terms of supporting the program directors who lead the PGY3 programs. But ultimately it's really about the residents and making sure that they are having the best possible educational experience that they're meeting their competencies and their goals and their PGY3 program and that they are providing excellent patient care. So I'm hoping that through my, my support and leadership around the PGY3 programs that ultimately through the residents that leads to better patient care. That's my, that's my hope. Obviously it's multiple steps kind of removed, but ultimately that's why we're medical educators is because we want to provide excellent care.
Dr. Rezmovitz:
12:41
No, I agree with you. I mean the purpose of this podcast actually is to identify small changes that have led to to better patient care. And I think it's great that, uh, the small change that you've, um, that you've made in your life, um, hopefully will be seen as a metric in better patient care. Um, you know, you do it on your podcast, we do it on our podcast, you know, the, the final thoughts, the um, you know, you call it if, if only if only they knew. Right. So, so let's, let's play.
Dr. Sirianni:
13:14
Yeah, sounds good.
Dr. Rezmovitz:
13:14
Yeah. So if only they knew, um, you know, but I'd like to take it to your, um, to yourself 15 years ago, right? Like if only you knew you know, if only you knew 15 years ago what you know now, what kind of advice would you give to the learners coming through our department right now and to yourself 15 years ago?
Dr. Sirianni:
13:36
Well, I would tell myself to be less afraid because I think I was afraid of what people would think about me if I, if I put myself forward for something that maybe I wasn't quite, quite ready for yet. I was afraid of, you know, how would I be perceived and if I failed, well, what would that, what would that do to my career? And I think I was afraid and I think I would tell myself to be a little bit less afraid because like you said, so they say no, you know, what's the worst that can happen? Well, you try again. I think so - I would tell myself to be a little bit less, um, afraid. I think I would, I would say -sorry, Jeremy -
Dr. Rezmovitz:
14:12
No, no. Listen - they can't see what we're doing here. So that's why I was keeping sign. Yeah. What are you afraid of? Afraid of. You said failure, but afraid of failing, and then what? This, what I'm trying to understand is, is what is the actual fear? What is the, what are we really afraid of?
Dr. Sirianni:
14:31
It's a good question. I mean, fear of failure itself, I think.
Dr. Rezmovitz:
14:36
And then what? I mean, we fail at stuff all the time. I failed to be on time this morning. I just, we fail. And then what? You apologize and then you move on.
Dr. Sirianni:
14:47
Yeah, I mean, I guess, is it, is it more of, um, a reflection then on me? Is it a reflection on me, on my quality, on my character, on my abilities? I think that's the concern for me is, is failure. Uh, is it outing me as an impostor?
Dr. Rezmovitz:
15:05
Right.
Dr. Sirianni:
15:05
Is it outing me as an impostor?
Dr. Rezmovitz:
15:06
But, so I agree with you. So I think one of our greatest fears is the fear of separation. And by being an impostor, you feel you might be separated from the group. Um, in fact, the final separation is a, and you work in this area, this is what people fear the final separation, right? You must see this every day.
:
15:25
Of course. Death.
Dr. Sirianni:
15:26
Um, people are afraid to leave. Yeah, of course.
Dr. Sirianni:
15:28
Yeah, absolutely.
Dr. Rezmovitz:
15:30
And so how do we improve the feeling of community, the feeling of support to, to decrease, to diminish that feeling of failure?
Dr. Sirianni:
15:43
It's a good question. I think it's really tough in medicine. I feel like there is, I would hope it's improved, but, but my, my sense is, is in medicine we're expected to do things right all the time. And I guess my worry is that if I'm not doing something right then I'm, I'm failing is a part of the culture of medicine around, you know, perfection and not admitting, admitting your failures, not admitting your mistakes. I feel like that's improving and there's more of that. Um, is that part of it? I think that's, it's a culture change and that that culture change takes time.
Dr. Rezmovitz:
16:27
It does take time. And time, we know is the greatest commodity. So maybe the lesson that we can learn from here today is we need to offer time to our colleagues as much as we offer them to our patients.
Dr. Sirianni:
16:38
And that's a really good point.
Dr. Rezmovitz:
16:40
Yeah. Um, anything else you'd like to impart today?
Dr. Sirianni:
16:47
Thank you for having me.
Dr. Rezmovitz:
16:49
I want to thank you for, you know, being here today and, and having this genuine conversation. It's not everyday you get opportunities like this. So thank you so much. And, um, I'm sure I'll see you soon.
Dr. Sirianni:
17:00
I'll see you soon.
Dr. Rezmovitz:
17:01
Take care.
Dr. Rezmovitz:
17:05
This podcast was made possible through the support of the Department of Family and Community Medicine at the University of Toronto. Special thanks to Allison Mullin, Brian Da Silva, and the whole podcast committee. Thanks for tuning in. See you next time.
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